Diabetic macular edema with pachychoroid features.

Area of Science:

• Ophthalmology
• Retinal Imaging
• Diabetic Retinopathy

Background:

• Diabetic macular edema (DME) is a significant cause of vision loss in diabetic patients.
• Pachychoroid phenotypes, characterized by a thickened choroid, are increasingly recognized in various retinal conditions.
• The interplay between DME and pachychoroid phenotypes requires further elucidation.

Purpose of the Study:

• To investigate the clinical and multimodal imaging features of diabetic macular edema (DME) in eyes presenting with pachychoroid phenotypes.
• To compare eyes with DME and pachychoroid phenotypes with those without, and with a control group of diabetic patients without DME.

Main Methods:

• Retrospective analysis of 210 eyes from DME patients, categorized into those with (Group 1) and without (Group 2) submacular detachment (SMD).
• Inclusion of 285 eyes from diabetic patients without DME as a control group.
• Evaluation of visual acuity, central macular thickness (CMT), subfoveal choroidal thickness (SFCT), neural retina layer thickness (NRT), and presence of pachychoroid phenotypes.

Main Results:

• Pachychoroid phenotypes were significantly more prevalent in DME eyes with SMD (66.25%) compared to those without SMD (40.77%).
• Eyes with SMD exhibited greater CMT and NRT.
• Focal edema in DME eyes with pachychoroid phenotypes, especially those lacking definite microaneurysms, suggests a potential link to choroidal vascular changes.

Conclusions:

• Submacular detachment (SMD) and focal edema without clear microaneurysms may serve as indicators of DME with underlying pachychoroid phenotypes.
• These findings suggest a possible association with choroidal circulation disturbances in the context of DME.