Retinal Layer and Choroidal Changes in Deep and Scuba Divers: Evidence of Pachychoroid Spectrum-Like Findings

Purpose: Diving is an intense physical activity under hyperbaric and hyperoxic conditions. The aim of this study is to evaluate the long-term effects of diving on the thicknesses of retinal layers and retinal anatomy in professional deep and scuba divers. Methods: The study included 52 eyes of deep divers who dive to depths of more than 130 feet (ft), 49 eyes of scuba divers who dive up to 130 ft, and 66 eyes of the control group, consisting of nondiving but regularly exercising males. Measurements of macular retinal layer thicknesses, peripapillary nerve fiber layer thickness, subfoveal choroidal thickness, and peripheral retinal examinations with scleral indentation were performed and statistically compared between the groups. Results: The mean diving duration was 455.00 ± 318.88 h in deep divers and 451.67 ± 281.10 h in scuba divers. The retinal pigment epithelium (RPE) was statistically significantly thicker in deep divers than in scuba divers and the control group on the 3 mm ring of the Early Treatment Diabetic Retinopathy Study grid. Subfoveal choroidal thickness was significantly thicker in deep divers than in scuba divers (p < 0.05). RPE abnormalities showed a significant increase in both the deep and scuba diver groups (p=0.01). Conclusion: An increased thickening of the subfoveal choroid and RPE, resembling pachychoroid pigment epitheliopathy, was detected in deep divers over a long-term duration.