Macular Choroidal Thickness Measured by Swept Source Optical Coherence Tomography in Eyes with Inferior Posterior Staphyloma

Abstract

To study the choroidal thickness in eyes with inferior posterior staphyloma (IPS) and to elucidate its role in the development of macular complications. The macular area of 42 eyes of 32 patients with IPS was studied prospectively with swept source optical coherence tomography at 1050 nm. Using a raster scan protocol with 512 × 128 A-scans, we produced a macular choroidal thickness map (6 × 6-mm(2)). Eyes with IPS showed relatively well-preserved choroid outside of the staphyloma but the inferior-nasal choroid within the staphyloma was thinned substantially. In addition, eyes with IPS often had a belt-shaped area with the thinnest choroid along the superior border of the staphyloma. As patient age increased, choroidal thinning progressed in the entire macular area. The macular choroidal thickness showed a close correlation with age (R(2) = 0.506, P < 0.001). On the superior border of the staphyloma, 13 eyes (30.9%) showed serous retinal detachment and/or pigment epithelial detachment without neovascularization, and eight (19.0%) showed neovascularization. Patients with neovascularization were older and had worse visual acuity (P < 0.001). Macular choroidal thickness in eyes with neovascular complications (76.5 ± 19.9 μm) was significantly reduced compared with that of eyes with no complication (133.0 ± 61.9 μm, P = 0.035). Eyes with IPS showed marked choroidal thinning along the superior border of the staphyloma. Reduction of the choroidal thickness progressed with age and seemed to be involved in the development of neovascularization associated with the IPS.