Central Macular Choroidal Thickness Research Articles

Focal Choroidal Elevations: Localized Pigment Epithelial Contour Alterations due to Isolated Choroidal Vessels.

Purpose The objective of this case series was to describe the clinical and imaging features of focal choroidal elevations (FCE), which are chorioretinal contour changes induced by individual choroidal vessels within an overall thin-appearing choroid. Methods A total of 787 enhanced depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT) patient images were initially screened for the presence of FCE. Prospective imaging analysis of 38 patients with FCE was done. Mean central macular choroidal thickness (CMCT), FCE location, FCE vessel lumen diameter, patient demographics, cycloplegic autorefraction, ophthalmoscopic findings, and presence of choroidal neovascularization (CNV) in the fellow eye were recorded. Results FCE were observed in 25 patients with age-related macular degeneration (ARMD), in 5 patients with high myopia, and in 8 patients with age-related choroidal atrophy (ARCA). Mean patient age was 80 ± 9.4 years. Mean CMCT was 86 ± 40 μm. Mean lumen diameter of the vessels inducing FCE was 131 ± 33 μm. Conclusions FCE are relatively frequently encountered morphologic features of elderly patients with ARMD, high myopia, and ARCA, and have a distinct clinical and imaging morphology which differs from classically described chorioretinal folds. The lesions may commonly be mistaken for pigment epithelial detachments on ophthalmoscopy, may be associated with CNV in fellow eyes, and have a characteristic SD-OCT appearance.

A study on observing the central macular choroidal thickness of thyroid-associated ophthalmopathy patients with spectral-domain optical coherence tomography

Objective: To compare the differences in the central macular choroidal thickness (CMCT) between thyroid-associated ophthalmopathy (TAO) patients in active and inactive stages, and the healthy subjects used spectral-domain optical coherence tomography (SD-OCT) and assess the potential of using CMCT as an indicator for follow-up of TAO patients. Methods: Cross-sectional study. Eleven active stage TAO patients (22 eyes, active TAO group) and 21 inactive stage TAO patients (42 eyes, inactive TAO group) who received treatment at the Department of Ophthalmology, First People's Hospital of Nantong during January 2015 and December 2017 were enrolled. Twenty-three healthy subjects (46 eyes) with comparable ages to the two TAO groups were enrolled in the healthy control group. TAO activity was assessed using the TAO clinical activity score (CAS) system. All subjects underwent best corrected visual acuity, slit lamp examination, Goldmann tonometer for intraocular pressure measurement, direct ophthalmoscopy, A-superelocular measurement, ocular protrusion measurement, and SD-OCT detection of CMCT. The variance analysis was used to compare the differences of intraocular pressure, eyeball protrusion and CMCT between the three groups. The correlation between CMCT and various clinical indicators was analyzed by univariate linear regression analysis and multivariate linear regression analysis. Results: The intraocular pressure and eyeball protrusion indicators of the active TAO group, the inactive TAO group, and the control group were (20.16±3.49) mmHg (1 mmHg=0.133 kPa) and (18.68±1.64) mm, (15.42±2.49) mmHg and (15.64±1.01) mm, (15.72±2.38) mmHg and (12.02±0.83) mm, respectively. The intraocular pressure and ocular protrusion of the active TAO group were higher than those of the inactive TAO group and the healthy control group, the differences between the groups are of statistical significance (all P<0.001). The CMCT value of the active TAO group, the inactive TAO group and the healthy control group were (391.27±33.89) μm, (317.31±29.62) μm, and (304.26±42.26) μm, respectively. The CMCT of the active TAO group was significantly higher than the inactive group and the healthy control group, the differences between the groups are of statistical significance (all P<0.001). Based on univariate analysis, thicker CMCT was significantly associated with intraocular pressure (t=4.600, P<0.001); after correction of intraocular pressure, thicker CMCT was significantly associated with CAS (β=0.848, 95%CI 15.608-21.499, P<0.001). Multivariate analysis showed a correlation between thicker CMCT and CAS scores (P<0.001), thyroid function (P<0.001), and intraocular pressure(P=0.039). Conclusions: The CMCT in the eyes of active TAO patients is higher than that of the inactive TAO patients and healthy people. The CMCT examination is of referential value, and may be used as a tool for assessing the activity of lesions in patients with TAO and clinical follow-up. (Chin J Ophthalmol, 2018, 54: 688-693).

Clinical observation on the efficacy of intravitreal injection of Ranibizumab for central serous chorioretinopathy

Objective To observe the efficacy of intravitreal injection of Ranibizumab for the treatment of chronic central serous chorioretinopathy(CSC). Methods Prospective cohort study. Forty-eight eyes of 45 cases with chronic CSC from Dec. 2015 to Jan. 2017 were recruited in this study. All cases received intravitreal injection of Ranibizumab. The visual acuities were recorded before and 2, 4, 8 weeks after injection. Subfoveal choroidal thickness (SFCT) and central macular choroidal thickness (CMCT) of 1 500 μm superior, inferior, nasal and temporal to the fovea were measured by OCT. Results The visual acuity (Log MAR) was 0.33±0.08, 0.24±0.19, 0.18±0.17 and 0.16±0.20 before and 2, 4, 8 weeks after injection. The visual acuities at different time point after injection were better than that before injection. The difference was significant between before and after injection(F=18.50, P=0.00). SFCT before injection was (443.63 ±98.32) μm, which decreased significantly to (393.55±97.66) μm, (379.53±93.55) μm, (388.30±96.52) μm at 2, 4, 8 weeks after treatment respectively(F=105.54, P<0.01). The changing trends of choroidal thickness measuring points were similar to the SFCT. Conclusion Intravitreal injection of Ranibizumab for the treatment of chronic CSC can reduce posterior choroidal thickness and improve vision. Key words: Chorioretinopathy, serous, central, chronic; Ranibizumab, intravitreal injection; Choroidal thickness

Peripapillary Choroidal Thickness and Retinal Nerve Fiber Layer in Untreated Patients with Obstructive Sleep Apnea-Hypopnea Syndrome: A Case–Control Study

ABSTRACTPurpose: To evaluate peripapillary choroidal thickness (PPCT), central macular choroidal thickness (CMCT), and retinal nerve fiber layer (RNFL) thickness in untreated patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods: This prospective, randomized, and comparative study was conducted in a university ophthalmology clinic. 106 eyes of 106 patients with OSAHS and 44 eyes of 44 healthy individuals were evaluated in this study. Only right eyes were evaluated. The patients with OSAHS were divided into three groups as mild (group 1), moderate (group 2), and severe (group 3) according to apnea-hypopnea index. The PPCT, CMCT, and RNFL measurements were performed by using spectral domain optical coherence tomography with enhanced depth imaging technique. The main parameters assessed were PPCT-Temporal, PPCT-Superior, PPCT-Nasal, PPCT-Inferior quadrants, CMCT, and RNFL thicknesses.Results: The PPCT of all quadrants was significantly thicker in the control group compared with the moderate and severe subgroups of OSAHS (p < 0.05). The PPCT-Superior and PPCT-Temporal were significantly thinner in the mild subgroup compared with the control group (p = 0.003 and p = 0.028, respectively). There was no difference between the control and mild groups regarding the RNFL thicknesses except nasal RNFL and inferotemporal RNFL which are thinner in the mild group. The RNFL thicknesses of all quadrants were significantly thicker in the control group compared with moderate and severe subgroups (p < 0.05). The CMCT was significantly thicker in the control group compared with all subgroups of OSAHS (p < 0.05).Conclusions: In OSAHS patients, PPCT, CMCT, and RNFL were significantly thinner compared with the control group. These results may explain why OSAHS patients are prone to normotensive glaucoma.