الفهرس 
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Abstract
Purpose: The aim of the study is to investigate the possibility of association between choriocapillaris and development of DME in comparison to superficial and deep vascular layers and to highlight the underlying mechanisms that choriocapillaris may be contributing to the development of DME using different metrics that could be exploited from optical coherence angiogram of these patients. Better understanding of pathophysiology of DME will allow us for more efficient evaluation of these patients, hence optimum treatment plans for them Patients and methods: This prospective cross sectional study was carried out at the department of Ophthalmology, Tanta University Hospitals, during the period of July 2020 to July 2021. 60 eyes were included in the study .30 eyes with DME and 30 eyes diabetic without macular edema. OCTA images were obtained with a commercially available OCTA system Triton (Topcon, Japan). It is ultra-high speed 1050nm swept source OCTA that can acquire 100000 A scan per second and each B scan position is repeated four times, which allow to visualize the choriocapillaris changes, and enable light penetration to choroid and reduce attenuation from ocular opacities. The images then analysed using the ImageJ software. Vessel density in superficial vascular plexus, deep vascular plexus and choriocapillaris were calculated as the percentage of detected vessels in area defined by 3x3 mm2 centered on the fovea. Results: There was no statistical significant difference in sex between DME group and control group. There was statistical significance in age and duration of DM in relation to development of DME. There was statistical significant difference in BCVA among studied group. It was significantly decrease in DME group than control group. The vessel density in superficial capillary plexus was no statistical significant difference among studied groups. The VD in deep capillary plexus was statically decreased in DME group than control group. The VD in choriocapillaris was with statistical significant difference between the two groups. The VD index in CC layer was decreased in DME group than VD index in DCP. The flow void area in choriocapillaris was statistically significant between studied groups. FVA was increased in DME group than control group. There was positive correlation between presence of DME and VD in DCP and CC layer.