Maad Rayan Publishing Company Biomedicine Advances 3080-0382 3 3 2026 07 30 Unveiling Retinal Effects of SGLT2 Inhibition: A Retrospective Analysis of Empagliflozin on Macular Thickness in Type 2 Diabetes with Macular Edema 111 116 10.34172/bma.72 EN Neda Lotfi Yagin https://orcid.org/0000-0001-8778-9582 Naimeh Mesri Alamdari Siamak Khavandi Soghra Aliasgharzadeh Alireza Ostadrahimi Majid Mobasseri https://orcid.org/0000-0002-8108-5979 Journal Article 10.34172/bma.72 2026 04 11 2026 06 28 Introduction: Diabetic macular edema (DME) continues to be a primary cause of visual impairment in non-proliferative diabetic retinopathy. Sodium–glucose cotransporter-2 inhibitors (SGLT2i) are suggested to provide vasculoprotective benefits and may have pleiotropic effects that could improve macular edema in patients with DME. This study aimed to determine whether empagliflozin use in routine clinical care is associated with differences in central macular thickness at a ~8-week follow-up, through retrospective analysis of medical records. Methods: This retrospective observational before-and-after study included patients aged 45–75 years with type 2 diabetes mellitus and OCT-confirmed DME in whom empagliflozin therapy was initiated as part of routine clinical care. Central macular thickness (CMT) and visual acuity were extracted from medical records at baseline and approximately 8 weeks after treatment initiation. Results: Forty-seven eyes from 30 patients (mean age: 66.9±8.4 years) were analyzed. Mean central subfield thickness (CST) decreased from 400.4±84.8 µm at baseline to 344.3±76.7 µm at follow-up, representing a mean reduction of 14.0% (56.06 µm; P=0.003). Mean visual acuity improved from 0.323±0.209 to 0.266±0.276 logMAR (20/41 to 20/36 Snellen) (mean change in LogMAR (−0.057±0.098)), although this change was not statistically significant (P=0.57). Conclusion: Empagliflozin initiation was associated with a significant short-term reduction in CST in patients with type 2 diabetes and DME. These preliminary findings suggest a potential therapeutic benefit in DME that warrants investigation in prospective, controlled trials.