Korean J Ophthalmol.  2024 Oct;38(5):331-341. 10.3341/kjo.2024.0039.

Choroidal Thickening Induced by Pioglitazone in Diabetic Patients

• Lee JS
• Kim CZ
• Lee SU
• Lee SJ

• KMID: 2559616
• DOI: http://doi.org/10.3341/kjo.2024.0039

Abstract

Purpose
This study aimed to determine the changes in choroidal thickness induced by pioglitazone in diabetic patients.
Methods
A total of 261 patients diagnosed with type 2 diabetes who had taken oral pioglitazone for more than 6 months were included in the study. After excluding patients who did not undergo regular eye examinations or who had ophthalmic surgery/interventions during the treatment period, a total of 40 eyes were included. The study examined the duration and dosage of pioglitazone, patient age, ocular axial length, refraction, glycated hemoglobin, systolic blood pressure, corrected visual acuity, macular thickness, choroidal thickness, and choroidal vascular index. Patients were categorized into a high-dose group if their pioglitazone dose was 30 mg or more per day, and a low-dose group if it was 15 mg or less. Choroidal thickness was measured below the subfovea and a 500 µm radius nasal and temporal to that location.
Results
Choroidal thickness significantly increased after 6 and 12 months of pioglitazone (6.70 and 13.65 µm, respectively) in all subjects. When stratified by pioglitazone dosage, choroidal thickness increased at 6 and 12 months in both high-dose group (4.48 and 0.84 µm, respectively) and low-dose groups (6.85 and 21.45 µm, respectively), with a greater change observed in the low-dose group (p < 0.05). Based on the location of choroidal thickness measurements, a significant increase in choroidal thickness was observed at 6 and 12 months of pioglitazone treatment in the subfoveal (7.00 and 13.15 µm, respectively) and nasal regions (6.43 and 19.24 µm, respectively), while a significant increase was only observed after 6 months of treatment in the temporal region (8.53 µm, p < 0.05). The largest increase in choroidal thickness was observed in the nasal side.
Conclusions
This study found that choroidal thickness increased in diabetic patients after taking pioglitazone. Regular eye examinations are recommended for diabetic patients who are on pioglitazone.

Keyword

Choroidal thickness; Choroidal vascular index; Diabetic macular edema; Diabetic retinopathy; Pioglitazone