J Korean Ophthalmol Soc.  2023 Dec;64(12):1208-1217. 10.3341/jkos.2023.64.12.1208.

Long-term Longitudinal Analysis of Subfoveal Choroidal Thickness Following Sulodexide Treatment in Diabetic Retinopathy Patients

• Cha CM
• Lim JW
• Kim CZ
• Lee SU
• Lee SJ

• KMID: 2549026
• DOI: http://doi.org/10.3341/jkos.2023.64.12.1208

Abstract

Purpose
To evaluate the two-year longitudinal changes in subfoveal choroidal thickness (CT) following sulodexide treatment in patients with diabetic retinopathy.
Methods
Thirty-eight eyes from patients with diabetic retinopathy, followed for a minimum of two years after sulodexide administration, were included. Subfoveal CT, measured using optical coherence tomography, was analyzed prospectively. Variables including age, sex, duration of diabetes mellitus, HbA1c, blood pressure, sulodexide treatment duration, refractive error, axial length, central macular thickness (CMT), visual acuity, laser photocoagulation, and intravitreal anti-vascular endothelial growth factor injections were evaluated for potential effects on CT. CMT, subfoveal CT, and choroidal vascularity index were compared at baseline and at 6, 12, and 24 months after sulodexide.
Results
Of the 38 eyes, 10 belonged to males and 28 to females. The mean data were as follows: age, 67.18 ± 8.87 years; duration of diabetes, 18.11 ± 7.57 years; HbA1c, 8.76 ± 1.60 mmol/L; systolic blood pressure, 134.69 ± 14.68 mmHg; diastolic blood pressure, 73.72 ± 11.90 mmHg; duration of sulodexide, 25.79 ± 3.17 months; refractive error, 0.22 ± 2.19 diopters (D); and axial length, 23.32 ± 0.89 mm. During the observation period, 15 eyes underwent laser photocoagulation and 17 eyes received intravitreal anti-vascular endothelial growth factor injections. The mean subfoveal CT was 216.00 ± 64.23 μm before sulodexide administration and increased to 223.87 ± 62.18 μm, 225.53 ± 62.02 μm, and 225.76 ± 63.62 μm at 6, 12, and 24 months, respectively (p = 0.0377, p = 0.0159, p = 0.0135). The CMT was 318.14 ± 102.28 μm initially and changed to 313.08 ± 77.47 μm, 314.97 ± 88.32 μm, and 320.03 ± 97.36 μm at the aforementioned intervals, with no significant variation (p = 0.904, p = 0.736, p = 0.892).
Conclusions
Sulodexide administration led to a significant rise in subfoveal CT over a 2-year follow-up. This change in CT was not mirrored in the CMT.

Keyword

Diabetic retinopathy, Macula lutea, Optical coherence tomography, Subfoveal choroidal thickness, Sulodexide