Purpose: This study aimed to investigate the association between autonomic dysfunction and choroidal microvasculature in patients with type 2 diabetes.Methods: We conducted a retrospective single-center study of patients with type 2 diabetes who attended Seoul St. Mary's Hospital between January 2018 and December 2022.Clinical features, laboratory findings, heart rate variability, and the findings of ophthalmic examinations were analyzed.Results: Seventy-four patients were divided into no diabetic retinopathy (no DR; 28 patients), non-proliferative DR (28 patients), and proliferative DR (PDR; 18 patients) groups.The standard deviation of the NN-interval (SDNN) index, best-corrected visual acuity (BCVA), and choroidal vascularity index (CVI) differed significantly in the PDR group (p < 0.01).Univariate regression analysis revealed that the urine albumin-to-creatinine ratio and SDNN were significantly associated with CVI (p < 0.05).However, only the SDNN was significantly associated with CVI (p = 0.026) in the multivariate regression analysis.This association did not remain significant after Bonferroni correction for two comparisons ( = 0.025).CVI showed a significant correlation with SDNN (r = 0.254, p = 0.029) and BCVA (r = -0.424,p < 0.001).Conclusions: Given the significant association between autonomic dysfunction and choroidal microvascular changes, it is recommended that patients presenting with either condition undergo comprehensive evaluation for the other in type 2 diabetes.
Hong et al. (Wed,) studied this question.