[Choroidal folds in diabetic retinopathy]

Abstract

Purpose: Choroidal folds are wrinkles of the inner part of the choroid, Bruch's membrane, retinal pigment epithelium and the outer retinal layers that produce alternate yellow and dark streaks. We have made a bibliographic checking of all of the causes and we have not found a clear relationship with diabetic retinopathy. Our purpose is to study a group of cases that we found with choroidal folds and diabetic retinopathy.

Methods: We have checked 1,019 angiographies of diabetic patients and we have found 16 cases with choroidal folds. Medical and ocular history have been analysed, as well as the state of the retinopathy and the morphology and pattern of the folds.

Results: All the cases had a similar pattern, bend shaped and horizontal, concentric, outside the macula and variable length. Changes of the appearance in the time have been demonstrated. 88% were women; 54% had a mild hyperopia (less than 2.5 diopters); 100% were diabetic type II and 85% insulin-dependent. The clinical appearance of the retinopathy was in 44% of moderate background, in 12% of severe background and in 44% of proliferative retinopathy. Arterial hypertension was the systemic disease more frequently associated (50%).

Conclusions: We have found choroidal folds in patients with diabetic retinopathy of similar appearance. Changes observed in the time in angiographies reveal that, with high probability, they are acquired. The thick choroid that is developed in diabetics, together with the hypertensive retinopathy could be the cause of these folds.