Risk factors for diabetic choroidopathy in patients with diabetic retinopathy

Purpose: To identify risk factors for diabetic choroidopathy in patients with type 2 diabetes. Methods: Forty-five consecutive patients with diabetic retinopathy underwent simultaneous indocyanine green angiography (ICG) and fluorescein angiography using a double detector and confocal scanning laser ophthalmoscopy in both eyes. Choroidal vascular abnormalities were evaluated by comparing the angiographic findings derived from the two methods. We analyzed the association between the presence of abnormal choroidal lesions evident on ICG angiography and several risk factors. Results: Choroidal abnormalities evident on ICG angiography but not on fluorescein angiography included hypofluorescent spots in 72 eyes (80%) of 40 patients (89%), small hyperfluorescent spots in 61 eyes (68%) of 35 patients (78%), and large hyperfluorescent spots in 32 eyes (36%) of 21 patients (47%). The severity of diabetic retinopathy was significantly associated with the presence of hypofluorescent spots (P=0.002, Cochran-Armitage test) in both eyes and with the small hyperfluorescent spots in the right eyes (P=0.047, Cochran-Armitage test). Glycosylated hemoglobin levels were significantly associated with the large hyperfluorescent spots in the right eyes (P=0.003, Fisher's exact probability test), and the treatment regimen was significantly associated with the small hyperfluorescent spots in the left eyes (P=0.048, chi-square test). Conclusion: These data suggest that risk factors influencing the prevalence of diabetic choroidopathy in patients with type 2 diabetes mellitus may include severity of diabetic retinopathy, degree of diabetic control and treatment regimen.