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

•Sodium-glucose cotransporter 2 inhibitors are low-affinity, high-capacity cotransporters as a new treatment option for diabetes mellitus.•Choroidal blood flow accounts for 90% of ocular blood flow; therefore, compared to the retina, the choroid is more susceptible to ocular microcirculation in the presence of DM.•An increase was found in the subfoveal LA, total LA, and subfoveal CVI values of the patients with type 2 diabetes mellitus after three months of sodium-glucose cotransporter 2 inhibitors inhibitor treatment.•Empagliflozin provides an improvement in diabetic choroidal changes through its effect on choroidal vascularity parameters. To evaluate the effect of sodium-glucose cotransporter-2 inhibitor treatment on choroidal vascular parameters in patients with type 2 diabetes mellitus (T2DM). 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). 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, subfoveal 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