Diabetic retinopathy (DR) is a major microvascular complication of diabetes and the leading cause of blindness in the working-age population. Diabetic choroidopathy (DC) often precedes clinically detectable retinal changes and participates in the onset and progression of DR. Given the scarcity of specific therapies for DC, it is necessary to actively explore the impact of existing DR treatments on choroidal lesions. Studies indicate that panretinal photocoagulation, anti-vascular endothelial growth factor drugs, corticosteroids, hypoglycemic agents, traditional Chinese medicine therapies, and integrated Chinese-Western medicine can all affect choroidal thickness, blood perfusion, and microcirculation through different mechanisms; however, the effects of interventions such as pars plana vitrectomy and cataract surgery on the choroid are more complex. Future research should focus on establishing a multi-parameter evaluation system for the choroid, conducting multi-center large-scale studies to improve the level of evidence-based medicine, and deeply investigating the mechanisms of traditional Chinese medicine to promote the establishment of integrated Chinese-Western medicine diagnosis and treatment models, thereby providing earlier and more precise intervention strategies for patients with DR and DC, and ultimately reducing the risk of blindness.
