玻璃体切割手术治疗增生型糖尿病视网膜病变的疗效观察

目的 评估玻璃体切割手术治疗1型糖尿病(diabetes mellitus,DM)所致增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的临床疗效及并发症特点.方法 回顾性分析2010年1月至2016年1月于我院确诊为PDR并行玻璃体切割手术治疗的18例(28眼)小于30岁的1型DM患者的临床资料,观察术后视力改善程度及术中、术后并发症.结果 术后随访6 ～ 72(平均43.0)个月,23眼(82.1％)术后视力维持或改善,5眼(17.9％)视力下降,其中无光感2眼(7.1％);1次手术复位视网膜脱离12眼(92.3％);术中并发症为医源性视网膜裂孔3眼;术后并发症:前房炎症反应9眼,前房积血5眼,复发性玻璃体积血2眼,复发性视网膜脱离3眼,虹膜红变5眼,新生血管性青光眼4眼.结论 玻璃体切割手术可以很好地恢复年轻1型DM所致PDR患者的视网膜解剖结构及功能,术后新生血管相关性并发症重,需行充足全视网膜光凝及术前抗VEGF注药治疗.     

Prevalence of diabetic retinopathy in Iran: a systematic review and Meta-analysis

AIM: To estimate the overall prevalence of diabetic retinopathy (DR) in Iran by a systematic review and Meta-analysis. METHODS: We conducted a search of all published literature on diabetic patients for the prevalence of DR using Web of Sciences, PubMed, Scopus, Google Scholar, and national electronic databases SID, Magiran, and Iranmedex from their inception until September 2016 with standard keywords. Pooled estimates of the DR prevalence and the corresponding 95% confidence intervals (CI) were calculated using random effects models. RESULTS: Thirty-one studies involving 23 729 patients with type I and II diabetes were included. The publication bias assumption for prevalence of DR was rejected by Begg and Egger tests (P=0.825, P=0.057, respectively). The results of Cochran test and I2 statistics showed considerable heterogeneity for prevalence of DR (Q=1278.21, d.f.=30, P<0.001 and I2=97.7%). The prevalence of DR, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) in Iranian diabetic patients were 41.9% (95% CI: 35.6-48.2), 32.2% (95% CI: 28.7-35.8), and 13.2% (95% CI: 8.3-18.1), respectively. CONCLUSION: The prevalence of DR in Iran appears a little high. NPDR was more common. This study highlights the necessity for DR screening and management in diabetic patients in Iran.     

非增殖期糖尿病视网膜病变微血管直径的变化

目的：探讨不同分期下的非增殖期糖尿病视网膜病变微血管直径的变化。

方法：前瞻性病例对照研究。选取2020-09/2021-03于本院内分泌科室住院的2型糖尿病并糖尿病视网膜病变患者,据我国中华医学会于1985年制定的“糖尿病视网膜病变分期标准”将其分为糖尿病无视网膜病变组(50例50眼)、糖尿病视网膜病变Ⅰ期组(50例50眼)、糖尿病视网膜病变Ⅱ期组(50例50眼)、糖尿病视网膜病变Ⅲ期组(50例50眼),另取体检正常的对照组50例50眼,共计250例250眼。摄取眼底彩照图,录入ARIA1.0自动分析软件,记录不同范围内动静脉与毛细血管直径,每个范围取值4段,每组为200段,进行统计学分析。

结果：不同分期的非增殖期糖尿病视网膜病变的视网膜动脉直径均无差异(P>0.05),不同分期的非增殖期糖尿病视网膜病变的视网膜静脉直径、黄斑周围毛细血管直径均有差异(P<0.05),视网膜静脉直径与黄斑周围毛细血管直径的不同组别事后多重比较均有差异(P<0.01),0～<0.5PD和0.5～1.0PD范围的视网膜静脉直径组别平均值得分对比结果为“视网膜病变Ⅲ期组>视网膜病变Ⅱ期组>视网膜病变I期组>糖尿病无视网膜病变组>正常对照组”,黄斑周围毛细血管直径组别平均值得分对比结果为“视网膜病变Ⅲ期组>视网膜病变Ⅰ期组>正常对照组; 视网膜病变Ⅲ期组>糖尿病无视网膜病变组; 视网膜病变Ⅱ期组>视网膜病变Ⅰ期组>正常对照组; 视网膜病变Ⅱ期组>糖尿病无视网膜病变组; 糖尿病无视网膜病变组>正常对照组”,而视网膜病变Ⅲ期组与视网膜病变Ⅱ期组,视网膜病变Ⅰ期组与糖尿病无视网膜病变组均无显著差异(P>0.05)。

结论：视网膜动脉直径在非增殖期糖尿病视网膜病变不同分期中无明显变化; 糖尿病患者视网膜静脉及黄斑周围毛细血管扩张,在非增殖期糖尿病视网膜病变不同分期中,静脉与黄斑周围毛细血管的直径呈逐渐增宽的趋势。     

糖尿病玻璃体性状特点及其与增殖性糖尿病视网膜病变的关系

糖尿病患者体内持续的高血糖及相应的病理状态不仅会导致糖尿病视网膜病变(DR)，也会影响玻璃体代谢，导致糖尿病玻璃体病变。由于玻璃体与视网膜在解剖位置上毗邻，因此糖尿病玻璃体病变与DR在发生发展方面相互促进，特别是玻璃体后脱离(PVD)和玻璃体劈裂等玻璃体视网膜界面的改变，为纤维血管增殖膜的生长提供了支架，并与玻璃体切割术(PPV)术中操作密切相关。本文整理了糖尿病患者玻璃体结构及胶原交联产物改变、玻璃体视网膜界面改变及其与增殖性糖尿病视网膜病变(PDR)关系的相关研究，旨在深入了解糖尿病玻璃体病变，为DR的研究和治疗、PPV手术方案的制定等提供参考。     

伴有增殖型糖尿病视网膜病变的1型糖尿病孕妇的不良结局

目的:报道伴有增殖型糖尿病视网膜病变的糖尿病孕妇,在给予适当的治疗与随访后,产妇和胎儿的不良结局。方法:对患有 1 型糖尿病及增殖型糖尿病视网膜病变的四位年轻的糖尿病孕妇( 年龄 20 ～25 岁) ,进行随访观察。结果:孕妇的不良后果: 流产 1 例,先兆子痫及早产 1 例,肾功能衰竭需要透析 1 例; 胎儿的不良后果: 新生儿死亡1 例,早产婴儿 1 例。结论:对于糖尿病孕妇出现增殖型视网膜病变时,妇产科医生应该给予紧密的随访。对于患有糖尿病的妇女,在其妊娠期间的产前检查与随访中,增殖型糖尿病视网膜病变应当作为疾病的评估之一。     

Adverse outcomes in Type I diabetic pregnant women with proliferative diabetic retinopathy

AIM: To report maternal and fetal adverse outcomes, in spite of appropriate treatment and regular follow up, in diabetic pregnant women with proliferative diabetic retinopathy. METHODS: Case series of four young pregnant diabetics aged between 20 and 25 years with type I diabetes mellitus and proliferative diabetic retrinopathy. RESULTS: The maternal adverse outcomes were abortion in one patient, pre-eclampsia and preterm delivery in one patient, and renal failure requiring dialysis in one patient. The fetal adverse outcomes were neonatal death in one case and premature baby in another case. CONCLUSION: These cases highlight the fact that diabetic pregnant women should be closely followed up by the obstetricians and physicians when they have proliferative retinopathy. The proliferative diabetic retinopathy should be considered as a part of the assessment when counseling a diabetic woman in antenatal check up and also in the follow up visits during pregnancy.     

Adverse outcomes in type 1 diabetic pregnant women with proliferative diabetic retinopathy

AIM: To report maternal and fetal adverse outcomes, in spite of appropriate treatment and regular follow up, in diabetic pregnant women with proliferative diabetic retinopathy. METHODS: Case series of four young pregnant diabetics aged between 20 and 25 years with type 1 diabetes mellitus and proliferative diabetic retrinopathy. RESULTS: The maternal adverse outcomes were abortion in one patient, pre-eclampsia and preterm delivery in one patient, and renal failure requiring dialysis in one patient. The fetal adverse outcomes were neonatal death in one case and premature baby in another case. CONCLUSION: These cases highlight the fact that diabetic pregnant women should be closely followed up by the obstetricians and physicians when they have proliferative retinopathy. The proliferative diabetic retinopathy should be considered as a part of the assessment when counseling a diabetic woman in antenatal check up and also in the follow up visits during pregnancy.     

马来亚大学医学中心门诊糖尿病患者视网膜病变的发病率(英文)

目的:评估马来亚大学医学中心眼科门诊的糖尿病性视网膜病变的发病率和它在糖尿病患者中的危险因素。方法:该横向研究包括100例近期被诊断为糖尿病患者的200眼。采集有关的眼部和全身病史并对所有的眼进行彻底散瞳眼底检查。视网膜病变的状况根据早期糖尿病性视网膜病变治疗研究(ETDRS)的结果进行分类。造成视网膜病变的危险因素是通过卡方检验进行分析的,P<0.05被认为有意义。结果:在我们的研究中,近期被诊断为糖尿病人群中糖尿病性视网膜病变的发病率为28%,Ⅱ型糖尿病患者中非增殖性视网膜病变的发病率(36%)比Ⅰ型糖尿病患者高(24%)。在两种类型的糖尿病患者中,视网膜病变的发病率与性别、年龄、种族、社会经济状况、糖尿病类型和体重指数无关。糖尿病病史较长并控制不良的患者,高血压者,伴有神经病变者,高脂血症以及有吸烟史者,视网膜病变的发病率明显高。结论:对糖尿病患者进行视网膜病变的基线筛查是可取的,因为早期发现,规律随访,合理的推荐给眼科医生并进行有效的治疗将减少以及避免患者严重的视力丧失。     

Inhibition of TGF-β2-induced migration and epithelial-mesenchymal transition in ARPE-19 by sulforaphane

AIM: To investigate the effects of sulforaphane (SFN) on transforming growth factor (TGF)-β2 stimulated migration and epithelial-mesenchymal transition (EMT) in ARPE-19 cells. METHODS: ARPE-19 cells were cultured in the presence or absence of SFN or TGF-β2. SFN toxicity was assessed by performing a lactate dehydrogenase assay (LDH) and 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assays, and cell migration was evaluated by Transwell migration assay. Actin stress fiber formation in ARPE-19 cells was determined using immunofluorescence analysis. Immunoblotting analysis was used to determine fibronectin and α-smooth muscle actin expressions along with the degree of Smad and Akt phosphorylation. RESULTS: SFN inhibited ARPE-19 migration. Additionally, SFN attenuated TGF-β2-induced appearance of actin stress fibers as well as fibronectin and α-smooth muscle actin expressions in these cells. SFN also hindered the TGF-β2-stimulated phosphorylation of Smad2, Smad3, and Akt. SFN showed no cytotoxicity towards ARPE-19 cells. CONCLUSION: SFN inhibits TGF-β2-stimulated migration and EMT in ARPE-19 cells, probably by preventing the establishment of actin stress fibers and Akt and Smad2/3 signaling.     

2型糖尿病患者糖尿病视网膜病变相关危险因素分析

目的：探讨2型糖尿病( type 2 diabetic mellitus,T2DM)患者糖尿病视网膜病变(diabetic retinopathy,DR)相关危险因素。

方法：回顾性分析2013-01/2017-04收治入院的1 013例T2DM患者病例资料,将DR患者纳入观察组,非DR患者纳入对照组。分析T2DM患者DR相关危险因素。

结果：经调查统计DR发生率为27.74%(281/1 013)。经单因素分析,两组患者性别、年龄、T2DM病程、血压、糖化血红蛋白、高密度脂蛋白胆固醇、肌酐以及24h尿蛋白比较,差异有统计学意义(P<0.05)。经多因素Logistic回归分析,男性、年龄>60岁、T2DM病程>10a以及血压、糖化血红蛋白、高密度脂蛋白胆固醇以及肌酐和24h尿蛋白表达异常均是T2DM患者并发DR的危险因素(P<0.05)。

结论：T2DM患者并发DR风险较高,男性、年龄>60岁、T2DM病程>10a以及血压、糖化血红蛋白、高密度脂蛋白胆固醇以及肌酐和24h尿蛋白的高水平表达均可能是诱发DR的危险因素。     

2型糖尿病住院患者糖尿病视网膜病变患病率及危险因素分析

目的调查40岁以上2型糖尿病(diabetic mellitus,DM)住院患者中糖尿病视网膜病变(diabetic retinopathy,DR)的患病率及危险因素,为DR的临床防治提供依据。方法选取2009年3月至7月广东省人民医院内分泌科住院的40岁以上的2型DM患者240例进行调查,内容包括患者的基本情况、相关病史资料、实验室检查以及眼部检查等,调查DR、增生性糖尿病视网膜病变、糖尿病黄斑水肿的患病率,分析并探讨影响DR发生、发展的危险因素。结果 DR、增生性糖尿病视网膜病变、糖尿病黄斑水肿患病率分别为35.00%、9.17%、7.92%。DM病程、收缩压、胆固醇、肌酐、尿素氮、24h尿白蛋白量、24h尿白蛋白浓度、尿微量蛋白浓度、胰岛素使用、合并周围神经病变、合并肾脏病变与DR的发生、发展有关。Logistic回归分析发现病程、24h尿白蛋白量、合并周围神经病变是DR发生、发展的独立危险因素。结论病程、24h尿白蛋白量、合并周围神经病变是DR发生、发展的独立危险因素。     

活性维生素D治疗非增殖型糖尿病视网膜病变的疗效

目的:探讨活性维生素D(骨化三醇)治疗非增殖型糖尿病视网膜病变的临床疗效。方法:选取本院眼科门诊及内分泌科病房诊断明确的2型糖尿病视网膜病变患者96例,患者按随机数字表法随机均分为对照组(C组)和观察组(T组)各48例,C组给予二甲双胍降糖治疗,T组患者在对照组的基础上给予骨化三醇0.25μg/d治疗。另选取本院体检中心健康体检者20例作为正常组(N组),观察各组患者治疗前后血清钙、磷、25-(OH)D3、1,25-(OH)2D3及甲状旁腺激素(PTH)水平,并观察两组患者治疗后眼底病变减轻的有效率。结果:与N组相比,C组、T组患者治疗前均存在血清25-(OH)D3和1,25-(OH)2D3水平低下,甲状旁腺素上升;给予骨化三醇治疗后,T组患者维生素D及甲状旁腺素水平有改善,同时视力及眼底出血渗出均改善,有效率明显高于C组,两组比较差异均有统计学意义(P<0.05)。以上三组患者治疗前后血清钙、磷水平差异无统计学意义。结论:DR患者存在血清维生素D代谢紊乱,给予维生素D治疗可以改善其代谢紊乱,同时可以明显改善患者视力及眼底病变。     

瘦素在增殖性糖尿病性视网膜病变和增殖性玻璃体视网膜病变中的表达

目的 通过检测瘦素在增殖性糖尿病性视网膜病变（proliferative diabetic retinopathy,PDR）和增殖性玻璃体视网膜病变（proliferative vitreous retinopathy,PVR）中的表达,探讨瘦素在PDR、PVR发生、发展过程中可能的调节机制。方法 分别用免疫组织化学染色的方法和酶联免疫吸附实验检测30例PDR患者、20例PVR病变患者眼内视网膜前膜中瘦素的表达,以及患者的血清、眼前房水、玻璃体液中瘦素的浓度。用Chi－Square Tests统计学方法分析和比较PDR、PVR与对照组之间瘦素表达的差异。结果 免疫组织化学染色结果：30例PDR患者中,有18例患者眼内视网膜前膜的瘦素受体呈阳性表达,阳性率为60%,与对照组比较,差异有统计学意义;20例PVR患者中,有3例患者眼内视网膜前膜的瘦素受体呈阳性表达,其中2例为血管纤维性视网膜前膜,1例为细胞纤维性视网膜前膜,阳性率为15%,与对照组比较,差异无统计学意义。ELISA结果：检测30例PDR患者的血清、眼前房水、玻璃体液中瘦素的浓度,与对照组之间差异有统计学意义（P＜0.05）;检测20例PVR患者的血清、眼前房水、玻璃体液中瘦素的浓度,与对照组之间差异无统计学意义（P＞0.05）。结论 瘦素可能主要是通过促进新生血管的生成参与到增殖性糖尿病性视网膜病变的发生、发展中,与增殖性玻璃体视网膜病变的发生、发展无明显相关性。     

玻璃体腔注射贝伐单抗治疗增生性糖尿病视网膜病变

糖尿病视网膜病变（diabetic retinopathy,DR）是糖尿病的严重并发症,尤其是增生性糖尿病视网膜病变（proliferative diabetic retinopathy,PDR）是工作年龄人群中首位致盲性眼病.近年来采用血管内皮生长因子抑制剂贝伐单抗（Bevacizumab,商品名Avastin）治疗PDR取得一定成效,其可促进玻璃体积血吸收,视网膜新生血管消退,减轻黄斑水肿,降低视网膜脱离的发生率,甚至使PDR患者避免玻璃体手术.     

不同程度糖尿病视网膜病变患者血浆炎性因子检测

目的研究不同程度糖尿病视网膜病变(DR)患者血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、可溶性白介素-2受体(IL-2R)及C反应蛋白(CRP)水平,为探究炎性反应在DR发病机制中的作用提供依据。设计前瞻性比较性病例系列。研究对象2型糖尿病但无DR患者21例(DM无DR组),非增生性DR患者17例(NPDR组),增生性DR患者23例(PDR组),无糖尿病患者23例作为对照组(无DM组)。方法记录患者年龄、性别、病史资料。行视力、眼压、裂隙灯及眼底检查。采集静脉血检测糖化血红蛋白(HbA1c)、空腹血糖(Glu)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL)、高密度脂蛋白胆固醇(HDL)、甘油三酯(TG)、同型半胱氨酸(Hcy)、肌酐(CR),以及炎症相关指标TNF-α、IL-2R、IL-8 IL-6及CRP的水平。主要指标血浆炎性因子浓度。结果四组之间年龄、性别、既往高血压、冠心病及脑梗塞病史、TC、LDL、HDL、TG、Hcy和血浆CR均无显著统计学差异。HbA1c在PDR组(7.51±2.03)%、NPDR组(7.48±1.49)%、DM无DR组(7.09±1.54)%,均显著高于无DM对照组(5.35±0.54)%(P<0.001)。TNF-α水平在PDR组及NPDR组(42.54±31.80及32.07±28.84 pg/ml)显著高于无DM组(10.30±5.35 pg/ml)及DM无DR组(12.63±6.65 pg/ml)(P<0.001)。IL-8水平在PDR组及NPDR组(157.26±200.16及197.45±331.08 pg/ml)显著高于无DM组(30.23±29.41 pg/ml)及DM无DR组(29.70±22.04 pg/ml)(P=0.006)。四组之间IL-2R、IL-6及CRP浓度均无显著统计学差异。结论NPDR及PDR患者血浆炎性因子TNF-α及IL-8显著高于DM无DR及无DM对照者。血浆TNF-α升高为PDR的重要危险因素。血浆炎性因子与肌酐水平显著正相关,全身高炎症状态可能是糖尿病肾病及DR的共同危险因素。     

2型糖尿病住院患者糖尿病视网膜病变的相关危险因素分析

目的:探讨2型糖尿病视网膜病变(DR)的发病危险因素。方法:选择2014-01/06收治的2型糖尿病患者380例,分为DR组126例和对照组即糖尿病无视网膜病变(NDR)组254例,进行询问病史、体格检查、实验室检查和相关辅助检查,采用Logistic回归分析法对DR的相关危险因素进行单因素及多因素分析。结果:单因素Logistic回归分析结果表明,病程、收缩压、甘油三酯、总胆固醇、低密度脂蛋白、尿蛋白、眼压、颈动脉内中膜厚度、周围神经病变是DR发生的相关危险因素。对以上因素进行多因素Logistic回归分析,只发现病程是DR发生的相关危险因素。结论:DR的发生是多因素共同作用的结果,病程是DR发生的独立危险因素。     

Newly diagnosed diabetes mellitus patients presenting with proliferative diabetic retinopathy as an initial sign

AIM: To investigate the clinical features of newly diagnosed diabetes mellitus (NDM) patients showing proliferative diabetic retinopathy (PDR) as an initial sign.METHODS: As a retrospective case series, the medical records of a total of four hundred and thirty-two patients who underwent a vitrectomy due to PDR were reviewed to find the subjects. Of 432 patients, six cases of NDM patients showing PDR as an initial sign were included and analyzed with their systemic and ocular features. Main outcome measures:the systemic features and ocular features [preoperative and postoperative best corrected visual acuity (BCVA), intraoperative findings].RESULTS: The mean onset age of visual symptoms was 36.3 years old. The mean serum insulin and C-peptide titer was below the normal range. The mean fasting plasma glucose was 178mg/dL and the mean postprandial 2h plasma glucose was 306mg/dL. The mean HbA1c at diagnosis was 11.02%. In all cases, an acute progressive fibrovascular proliferation was observed. Intraoperative retinal tears were found in three cases of six. The mean preoperative BCVA was +0.67±0.58 logMAR and the mean BCVA at postoperative 6 months was +0.20±0.30 logMAR.CONCLUSION: All patients were considered to have latent autoimmune diabetes in adults (LADA). A rapid deterioration of kidney function as well as poor diabetic control status at diagnosis was observed in all six cases. The ocular features of the patients showed acute progressive fibrovascular proliferation and relatively favorable postoperative visual acuity.     

新疆乌苏市糖尿病患者视网膜病变的患病率及危险因素

目的：：了解糖尿病患者糖尿病性视网膜病变( diabetic retinopathy,DR)的患病率及危险因素。方法：对已经确诊的3465例糖尿病患者进行系统的眼部检查,并对相关因素如患者的年龄、性别、居住地域、民族、糖尿病病程、空腹血糖、血脂及血压进行统计分析。结果：本组3465例糖尿病患者中,发生DR者1079例,患病率为31.14％。患者的居住地域、糖尿病病程、空腹血糖水平、血压与糖尿病人群DR患者病率的差异有统计学意义(P<0.05)。年龄、性别、民族及血脂与DR患病率差异无统计学意义(P>0.05)。结论：农村糖尿病人群DR患病率高于城市人群,DR的主要危险因素是糖尿病病程、血糖控制水平和高血压。     

C-reactive protein and diabetic retinopathy in Chinese patients with type 2 diabetes mellitus

AIM: To investigate the relationship between C-reactive protein (CRP) and diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM). METHODS: Community-based observational cohort study. There were 1131 participants recruited from November 2009 to September 2011 in Desheng community in urban Beijing. Patients diagnosed T2DM were recruited and underwent a standardized evaluation consisting of a questionnaire, ocular and anthropometric examinations and laboratory investigation. The presence and severity of DR were assessed by seven fields 30° color fundus photographs. Subjects were then classified into groups with no DR, any DR, or vision-threatening DR. CRP was analyzed from serum of study subjects. RESULTS: A total of 1007 patients with T2DM were included for analysis, including 408 (40.5%) men and 599 (59.5%) women. The median CRP level was 1.5 mg/L for women and 1.1 mg/L for men (P=0.004, OR 0.37, 95% CI 0.18-0.74). After adjusting for possible covariates, higher levels of CRP were associated with lower prevalence of any DR (P=0.02, OR 0.55, 95% CI 0.35-0.89), but not associated with vision-threatening DR (P=0.62, OR 0.78, 95% CI 0.28-2.14). After stratification by sex, the inverse association between CRP and DR was found to be statistically significant in men (P=0.006, OR 0.35, 95% CI 0.16-0.73), but not in women (P=0.58, OR 0.88, 95% CI 0.29-1.16). CONCLUSION: The data drawn from a Chinese population with T2DM suggest that increasing CRP levels may be inversely associated with development of DR.     

Choroidal thickness in diabetic patients of Indian ethnicity

Purpose:To evaluate choroidal thickness (CT) change in various grades of diabetic retinopathy (DR) in comparison to age-matched healthy subjects.Methods:This prospective observational study included 227 eyes of 125 subjects with diabetes (study group: 58 females) and 197 eyes of 110 age-matched healthy subjects (control group: 66 females). Collected data included age, gender, duration of diabetes, glycemic control, comprehensive ocular examination, fundus photography, and CT measurement on spectral domain ocular coherence tomography using enhanced depth imaging.Results:Mean age in the study group was 57.0 ± 9.37 years (43–73 years). The mean age was 41.48 ± 5.43 years in the control group. Subjects with diabetes with (252.8 ± 55.6 microns) and without (261.71 ± 51.8 microns) retinopathy had significantly thinner choroids when compared to the control group (281.7 ± 47.7 microns; P = 0.032). Seventy-four of 227 eyes did not have any evidence of DR, 89 eyes had features of nonproliferative diabetic retinopathy (NPDR), and 33 eyes had treatment naïve proliferative diabetic retinopathy (PDR). Thirty-one PDR eyes had received previous laser photocoagulation. Subjects with diabetes without retinopathy had a greater subfoveal choroidal thickness (SFCT) than subjects with diabetes with retinopathy (P < 0.001). Eyes with PDR (243.9 ± 56.2 microns) had thinner SFCT than those with NPDR (238.98 ± 111.23 microns). There was no difference in the SFCT between treated (laser photocoagulation done; 251.784 ± 103.72 microns) and treatment naïve PDR (258.405 ± 89.47 microns, P = 0.23).Conclusions:Control eyes had greater SFCT compared to subjects with diabetes, with and without retinopathy. The thinning progressed with increasing severity of DR. Choroidal thinning may contribute to DR pathogenesis.