Materials and Methods: This prospective, observational, cross-sectional study included 51 healthy postmenopausal women and 51 healthy women of reproductive age. Choroidal images were obtained using extended depth imaging (EDI) mode on spectral-domain optical coherence tomography (SD-OCT). Using a binarization method, luminal choroidal area (LCA), stromal choroidal area (SCA), total choroidal area (TCA), and choroidal vascularity index (CVI) were calculated in both subfoveal and peripapillary regions. Ageadjusted analyses were performed using analysis of covariance (ANCOVA) and quantile regression, as appropriate.

Results: The mean age was 55.4 ± 5.5 years in the postmenopausal group and 43.9 ± 2.5 years in the control group (p < 0.001). In unadjusted analyses, there were no significant differences between the groups in subfoveal LCA, SCA, TCA, subfoveal CVI, or subfoveal choroidal thickness (SFCT) (p > 0.05). Peripapillary LCA, SCA, TCA, and CVI were significantly lower in postmenopausal women compared with controls (p = 0.022, 0.012, 0.016, and 0.037, respectively). However, after adjustment for age, these peripapillary differences were no longer statistically significant.

Conclusion: Postmenopausal women exhibited lower peripapillary CVI compared with premenopausal women; however, this difference was no longer present after age adjustment, indicating that the observed reduction was driven by age rather than menopausal status. Keywords : Menopause, choroidal thickness, choroidal vascularity index, optical coherence tomography