Evaluation of the effect of sodium-glucose cotransporter-2 inhibitor treatment on choroidal vascular parameters in patients with type 2 diabetes mellitus

Background: To evaluate the effect of sodium-glucose cotransporter-2 inhibitor treatment on choroidal vascular parameters in patients with type 2 diabetes mellitus (T2DM).Methods: Twenty eyes of 20 patients with T2DM without diabetic retinopathy and 20 eyes of 20 age-and sex-matched patients as the control group were included in the study. The patients were evaluated using enhanced depth imaging optic coherence tomography before treatment and at the third month of treatment. The choroidal images were binarized into luminal areas (LAs) and stromal areas (SAs). The choroidal vascularity index (CVI) was defined as the ratio of the LA to the total circumscribed choroid area (TCA).Results: The mean age of the patients was 56.65 +/- 8.41 years. The patients' mean disease duration was 6.65 +/- 5.72 years, the mean HbA1c level was 8.89 +/-;1.62%, and the mean body mass index was 33.13 +/- 4.84 kg/m2. The subfoveal TCA, subfoveal LA, subfoveal SA, total TCA, total LA, and total SA values of the patient group were found to be significantly lower than those of the control group (p = 0.006, p = 0.003, p = 0.028, p = 0.001, p = 0.001, and p = 0.006, respectively). There was a significant increase in the subfoveal TCA, subfoveal LA, sub-foveal SA, subfoveal CVI, total TCA, total LA, and total SA values after empagliflozin treatment compared to before empagliflozin treatment (p = 0.005, p = 0.003, p = 0.021, p = 0.032, p < 0.001, p < 0.001, andp = 0.001 respectively).Conclusions: Empagliflozin provides an improvement in diabetic choroidal changes through its effect on choroidal vascularity parameters.