Choroidal Thickness Research Articles

Choroidal Response to Intravitreal Bevacizumab Injections in Treatment-Naïve Macular Neovascularization Secondary to Chronic Central Serous Chorioretinopathy

Background/Objectives: To evaluate the impact of intravitreal bevacizumab (IVB) therapy on anatomical and visual outcomes in patients with macular neovascularization (MNV) secondary to chronic central serous chorioretinopathy (cCSC). Methods: This retrospective observational study reviewed the medical records of treatment-naïve patients diagnosed with cCSC complicated by MNV and treated with IVB injections over a 5-year period. The presence of MNV was confirmed using optical coherence tomography angiography (OCTA). Best-corrected visual acuity (BCVA), subfoveal choroidal thickness (SFCT), and subretinal fluid (SRF) were recorded pre- and post-IVB treatment. Results: Twenty-two eyes of 22 patients (mean age, 68 ± 11 years) were included. After a mean follow-up of 21.0 ± 14.6 months, SRF significantly decreased from baseline (176.86 ± 115.62 µm) to the final follow-up (80.95 ± 87.32 µm, p = 0.003). A greater SRF reduction was associated with more injections (>7) (p = 0.047). However, no significant changes were observed in BCVA (p > 0.05) or SFCT (p > 0.05), irrespective of follow-up duration or injection frequency. Complete resolution of SRF was achieved in nine patients (40.9%), and a significantly greater reduction in SFCT was observed in complete responders compared to non-responders (p = 0.03). Conclusions: IVB therapy significantly reduced SRF in cCSC patients with secondary MNV, though it did not lead to visual improvement or significant changes in SFCT. However, greater choroidal thinning in patients with complete fluid resorption may suggest distinct underlying mechanisms or alternative sources of subretinal fluid beyond the MNV itself.

Automatic measurement of choroidal thickness with swept-source optical coherence tomography in chronic Vogt-Koyanagi-Harada disease: 3 years’ follow-up

PurposeThe course of Vogt-Koyanagi-Harada (VKH) disease is typically assessed qualitatively using indocyanine green angiography (ICGA) and enhanced-depth imaging optical coherence tomography (EDI-OCT). However, a quantitative approach could improve accuracy and objectivity. The aim of this study was to assess the clinical value of the automated measurement capabilities of swept-source optical coherence tomography (SS-OCT) to measure choroidal thickness (quantitative approach) in chronic VKH.MethodsProspective, longitudinal case–control study at a tertiary university hospital involving 23 chronic VKH patients (9 convalescent and 14 quiescent) and 17 age-matched controls. Choroidal thickness was automatically measured with SS-OCT.ResultsChoroidal thinning and improved vision were associated with treatment while increasing thickness and worsening vision were associated with posterior relapse. Overall, 41.6% of asymptomatic (no change in visual acuity) recurrences in the convalescent group and 25% of recurrences in the quiescent group were detected by SS-OCT. All recurrences diagnosed by SS-OCT showed signs of inflammation on ICGA.ConclusionsAutomatic measurement of choroidal thickness with SS-OCT is a rapid, non-invasive method of detecting posterior segment recurrences and treatment response in VKH patients, and could reduce the need for angiography to monitor this disease.

Changes in Choroidal Thickness in Pre-Myopic Children After Repeated Low-Level Red-Light Therapy and Their Role in Predicting Myopia Prevention and Controlling Myopic Shift

PurposeTo investigate longitudinal changes in choroidal thickness (ChT) after 1-year treatment of repeated low-level red-light (RLRL) and their predictive value in efficacy on myopia prevention and myopic shift among pre-myopic children. Methods278 pre-myopic (-0.50 D < spherical equivalent refraction, SER ≤ 0.50 D) participants were assigned to the RLRL group and control group randomly and evenly. The OCT, visual acuity, AL, SER and other parameters were measured before enrollment and every 3 months after intervention. The data from both eyes of the included participants were analyzed. ResultsA total of 463 eyes were analyzed. Due to the COVID-19 pandemic, 176 participants in the RLRL group had treatment interrupted. The continued RLRL group, interrupted RLRL group and control group were well balanced in baseline characteristics. In the continued and interrupted RLRL group, the average ChT increased significantly at 3-month visit (all P < 0.001) and the subfoveal ChT thickened evidently. The area under the curve (AUC) for the models including gender and 3-month change in ChT to predict satisfactory myopia prevention at 12 months was 0.983. The efficacy of the models that also used the combined indicators of baseline age, gender and the 3-month change in ChT to predict AL progression control over 12 months reached 0.944. ConclusionsContinued RLRL intervention induced notable thickening of ChT in premyopic population, especially at the subfoveal sector. For participants received RLRL treatment, the 3-month change in ChT combined with other baseline factors have acceptable predictive discrimination of myopia prevention efficacy.

Microcirculatory parameters as risk factors for predicting progression of posterior staphyloma in highly myopic eyes: a case–control study

BackgroundTo assess the rate of macular blood flow decreasing in adults with and without posterior staphyloma (PS) using optical coherence tomography angiography (OCTA) and to identify risk factors associated with PS progression.MethodsThis longitudinal case-control study enrolled 122 eyes of 122 patients—64 patients with PS (PS group) and 58 patients without PS (NPS group). Participants underwent OCTA and clinical examinations at least twice, and those followed for at least one year were included in the analysis. Logistic regression analysis and machine learning were applied to explore the risk factors for PS and its progression.ResultsPatients in the PS group exhibited faster growth rates of spherical equivalent refraction (SER), axial length (AL), curvature index (CI), and posterior scleral height (PSH) as well as higher loss rates of choriocapillaris perfusion area (CCPA), choroid perfusion area (CPA) and choroidal vascularity index (CVI) compared to the NPS group (all P < 0.05). The baseline SER (B = − 1.291, OR = 0.275, P = 0.008), baseline subfoveal scleral thickness (B = − 1.621, OR = 0.198, P = 0.046), baseline PSH (B = 2.959, OR = 19.282, P = 0.001) and foveal CVI changes per year (B = − 2.776, OR = 0.062, P < 0.001) were the risk factors for PS. Baseline AL (B = 0.561, OR = 1.752, P = 0.033), parafoveal choroidal thickness changes per year (B = − 0.094, OR = 0.910, P = 0.032), foveal retinal vascular density changes per year (B = 0.104, OR = 1.110, P = 0.013) and foveal CCPA changes per year (B = − 0.214, OR = 0.807, P = 0.038) were the risk factors for the PS progression.ConclusionsDuring the progression of myopia in adults, changes in the morphology of the eye's posterior pole are not limited to axial lengthening alone; there also will be a phase of compensatory lateral expansion. Baseline AL and changes in the microcirculation can be utilized to predict the progression of PS.

Semiautomated measures of foveal immaturity from handheld swept-source optical coherence tomography are associated with retinopathy of prematurity severity

Background/aimsHandheld swept-source optical coherence tomography (SS-OCT) was previously used to measure foveal maturity through semiautomated methods in awake premature infants. This study assesses the relationship between foveal maturity and retinopathy...

Analysis of Optic Disc Morphology and the Peripapillary Retinal and Choroidal Thickness by the Swept Source Optical Coherence Tomography in Patients with Moyamoya Disease

Introduction: Moyamoya Disease (MMD) is a chronic cerebrovascular occlusive disorder. Ocular involvement in patients with MMD has increasingly been recognized and reported in recent years. This study aimed to investigate the changes of optic disc morphology and the peripapillary retinal and choroidal thickness in patients with MMD. Methods: This cross-sectional study included 56 patients diagnosed with idiopathic MMD and 56 healthy controls matched by age and gender. All participants underwent swept-source optical coherence tomography to capture the optic disc morphology as well as the peripapillary retinal and choroidal thickness. Optic disc parameters, including cup area, rim area, cup volume, rim volume, C/D area ratio (CDR), linear CDR, and vertical CDR were measured and compared between the two groups. Additionally, the thickness of the peripapillary whole retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and choroid were evaluated and analyzed across 12 clock-hour segments around the peripapillary region. Results: The rim area in MMD patients was significant less than controls while the CDR in MMD patients was significantly larger than that in the control group. There was no statistically significant difference between the two groups regarding disc area, cup area, cup volume, rim volume, vertical and horizontal diameter of disc. The retinal thickness at the 7 o'clock position was significantly thinner in the MMD group compared to the control group and the temporal RNFL thickness, particularly at the 7 o'clock and 9 o'clock positions, was significantly reduced in the MMD group (p&lt;0.05). The GCL layer at the 7 o'clock position was thinner in the MMD group than in the control group (p&lt;0.05). The MMD group showed a notably reduced average choroidal thickness, particularly in the inferior-temporal region (p&lt;0.05). There was a correlation between peripapillary choroidal and GCL layer thickness in the MMD group, but no significant correlations were found with rim area, CDR, or RNFL. Conclusions: In patients with MMD, there is an increase in the CDR accompanied by a decrease in the rim area. Additionally, there is thinning of the temporal RNFL, GCL, and choroidal thickness, notably in the inferotemporal quadrant of the optic disc.

Optical coherence tomography as an adjunct tool to assess response to treatment in cerebral venous thrombosis: A prospective longitudinal study

IntroductionPapilledema, due to raised intracranial pressure (ICP) is commonly seen in cerebral venous thrombosis (CVT) and can have serious complications. This study reports the quantitative assessment of papilledema through the measurement of the Peripapillary choroidal thickness (ChT) and Peripapillary retinal nerve fiber layer thickness (RNFLT) using optical coherence tomography (OCT). MethodsWe conducted a prospective longitudinal study of 30 subjects with CVT. Age and gender-matched healthy individuals were included as controls. In addition to history, RNFLT and ChT measurements were obtained at presentation, discharge, and follow-up two months after discharge. ResultsThe mean age of the patients was 32.8 ± 9.9 years. Papilledema was seen in 14 (46.66 %) patients. The peripapillary RNFLT and ChT were significantly greater in patients with CVT [RNFLT 121.5 μm (105,169) in the right eye (RE), 120 μm (103,148) in the left eye (LE); ChT 159 μm (143,171) in the RE, 155.5 μm (140,166) in the LE] as compared to controls [RNFLT 106.5 μm (102,111) in RE, 103.5 μm (98,107) in LE; ChT 130 μm (119,134) in RE, 124 μm (119,136) in LE]. There was a significant decrease in the peripapillary RNFLT and ChT in patients with papilledema at follow-up after two months in all segments in both eyes. ConclusionIn patients with CVT, RNFLT, and ChT reduced significantly with treatment. OCT is potentially useful to objectively assess response to treatment in patients with CVT.

Adrenal Cortical Carcinoma Presenting as CSCR.

We describe a case of bilateral chronic central serous chorioretinopathy (CSCR) secondary to adrenal cortical carcinoma. Case report of a 70-year-old Hispanic man presenting with bilateral multifocal CSCR. Clinical findings of bilateral chronic CSCR along with 160 µm of subretinal fluid (SRF) and choroidal thickness greater than 400 µm without enhanced depth optical coherence tomography was noted in a patient presenting with distortion in vision in both eyes and weight gain of 15 pounds, weakness, and fatigue starting 8 months prior. Further endocrine testing showed an elevated 24-hour urinary free cortisol level of 137 µg with no change in serum cortisol levels following low-dose dexamethasone suppression test and undetectable serum adrenocorticotropic hormone (ACTH) levels consistent with ACTH-independent Cushing's syndrome. Imaging of the abdomen revealed heterogeneously enhancing masses, and biopsy of the adrenal tumor led to the diagnosis of adrenal cortical carcinoma. He died 3 weeks after starting hospice care, and only completed one round of chemotherapy. Adrenal tumors including adrenal cortical carcinoma may present as bilateral chronic central serous chorioretinopathy.

Impact of repeated low-level red-light exposure on choroidal thickness and blood flow in pediatric patients: A SS-OCTA study

PurposeTo evaluate the impact of repeated low-level red-light (RLRL) therapy on choroidal thickness and blood flow in pediatric myopia. MethodsA three-month trial (April 1, 2023 – September 30, 2023) was conducted involving 44 children (ages 6–16) with myopia. Participants underwent RLRL therapy at home twice daily for five days per week, with each session lasting three minutes. Assessments at baseline, one month, and three months included cycloplegic refraction, best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular biometrics, swept-source optical coherence tomography angiography (SS-OCTA), slit-lamp, and fundus examinations. ResultsThe study included 44 children (average age: 9.79 years; 56.82 % male). RLRL therapy significantly increased subfoveal choroidal thickness (Baseline: 272.82 ± 64.01 μm; 1-month: 297.77 ± 72.94 μm; 3-month: 298.77 ± 77.17 μm, p = 0.001), reduced axial length (Baseline: 24.97 ± 1.47 mm; 3-month: 24.88 ± 1.38 mm, p = 0.002), and showed a marginal regression in spherical equivalent (p = 0.055). Significant elevations in choroidal vessel volume and thickness were noted, with positive correlations intensifying with distance from the fovea. ConclusionRLRL therapy shows promise in managing pediatric myopia by increasing choroidal vessel volume and thickness, potentially mitigating myopia progression.

Bilateral Involvement in Childhood Presumed Trematode Induced Granulomatous Anterior Uveitis

ABSTRACT Purpose This study aims to elucidate the clinical spectrum of trematode-induced uveitis (TIU), with a particular focus on its bilateral presentation and providing significant insights into its pathophysiology. Methods A prospective cross-sectional observational study was conducted at the uveitis outpatient clinic of Mansoura University Ophthalmic Center. The study involved children diagnosed with presumed TIU. Comprehensive clinical evaluations were performed, including detailed history taking and thorough ophthalmological examinations of both the anterior and posterior segments, emphasizing the unaffected fellow eye. Results The cohort consisted of 80 children, with a male predominance of 98.75%. The proportion of bilateral involvement was observed in 12 out of 80 (15%). The involvement of the fellow eye was observed as follows: conjunctival hyperemia (3/80), conjunctival phlycten-like lesions (3/80), ciliary injection (10/80), corneal immune infiltration (4/80), retro-corneal membrane (5/80), anterior chamber granuloma (5/80), peripheral anterior synechiae (3/80), complicated cataract (2/80), diffuse cyclitis and choroid thickening (12/80), and intermediate uveitis (11/80). Conclusion This study demonstrates that TIU is not confined to the initially affected eye; the fellow eye may also be affected in a significant number of cases. Therefore, it is crucial to conduct thorough examinations of both eyes in patients diagnosed with TIU to ensure comprehensive clinical management.

Early Changes in Ocular Biomarkers in Patients with Vogt-Koyanagi-Harada Disease After Pulse Steroid Therapy.

This study aimed to identify when ocular biomarker changes occur within 1 month and which ocular biomarkers correlate with best-corrected visual acuity (BCVA) at months 1 and 6. We evaluated 33 patients with Vogt-Koyanagi-Harada (VKH) disease who received pulse steroid therapy. The central anterior-chamber depth (ACD) and peripheral ACD were evaluated. We also analyzed axial length (AL), BCVA, spherical equivalent (SE), choroidal foveal thickness (CFT), and retinal foveal thickness (RFT). Patients were divided into two groups based on BCVA at months 1 and 6, and correlations with ocular biomarkers were investigated. RFT and CFT were significantly reduced as early as day 1 (P < 0.001). AL gradually increased, with a significant increase observed at month 1 (P < 0.05). BCVA improved significantly along with SE reduction, with significant changes observed at week 1 (P < 0.05 and P < 0.01, respectively). Anterior chamber biomarkers gradually increased, with significant increases at week 2 for central ACD (P < 0.05) and at month 1 for peripheral ACD (P < 0.05). The better BCVA group at month 1 significantly correlated with thicker RFT (P < 0.01), better BCVA (P < 0.05), shallower central ACD (P < 0.05), and shallower peripheral ACD (P < 0.05) at the initial visit. No correlation was observed between the better BCVA group at month 6 and ocular biomarkers at the initial visit. Although RFT and CFT changes are the earliest indicators, changes in the anterior-chamber structure appeared to be slow and delayed. Thicker RFT, better BCVA, shallower central ACD, and shallower peripheral ACD at the initial visit correlated with better BCVA at 1 month.

OCT analysis and MPOD assessment in patients affected by retinitis pigmentosa

This study aimed to analyze Optical Coherence Tomography (OCT) parameters and Macular Pigment Optical Density (MPOD) changes in patients affected by Retinitis pigmentosa (RP). Eighteen eyes of 18 patients suffering from early-stage RP were enrolled in our observational study. 18 eyes of 18 patients age and gender matched were enrolled as controls. Patients were analyzed at baseline by undergoing complete baseline ophthalmologic examination, Spectral-domain Optical Coherence Tomography (OCT), Electroretinogram (ERG) and Heterochromatic Flicker Photometry (HFP). Main outcome measures were Macular Pigment Optical Density (MPOD), Central macular thickness (CMT), Central Choroidal Thickness (CCT) and Choroidal Vascularity Index (CVI). Lower CCT (p = 0.006), CVI (p < 0.001) and MPOD levels (p = 0.038) were found in affected patients, whereas higher CMT was detected in cases compared to healthy controls. Correlation analysis revealed the presence of a negative correlation between BCVA and Age and CMT and BCVA and a positive correlation between CCT and MPOD and CVI and CCT. Retinal and choroidal variations occur in patients affected by early-stage RP regarding functional and anatomical changes.

Investigation of choroidal vascular alterations in eyes with myopia using ultrawidefield optical coherence tomography angiography

Background/aimsThe study aims to evaluate choroidal vascular changes in younger patients with myopia using ultrawidefield swept-source optical coherence tomography angiography (SS-OCTA).MethodsOverall, 724 eyes of 362 participants (177 males, 185 females,...

Factors Predictive of Persistent Subretinal Fluid in Acute Central Serous Chorioretinopathy

Purpose: To identify the clinical parameters predictive of persistent subretinal fluid in acute central serous chorioretinopathy (CSC). Methods: Clinical data of consecutive eyes diagnosed with first-time, acute, treatment-naïve CSC followed up for at least 6 months from symptom onset were evaluated retrospectively. Acute CSC was defined as CSC in which symptoms were noticed within 3 months of presentation. Subretinal fluid, central retinal thickness (CRT), subfoveal choroidal thickness, and fundus autofluorescence (FAF) were examined. Results: Of the 48 eyes in 48 patients, 38% exhibited subretinal fluid persisting for at least 6 months after the symptom onset. FAF alterations at baseline were observed in 52 and 36% of affected and fellow eyes, respectively. Multivariable analysis showed that persistent fluid was significantly associated with the presence of FAF alterations in fellow eyes (odds ratio = 23.5, P = 0.024), in addition to greater age (odds ratio = 1.16, P = 0.015) and thicker CRT (odds ratio = 1.01, P = 0.022). Conclusion: Fellow eye FAF alterations, in addition to older age and thicker CRT, were significant predictors of persistent subretinal fluid in patients with acute CSC. These findings underscore CSC's bilateral aspects and noninvasive markers' role in predicting persistent subretinal fluid.

Three-Dimensional Choroidal Vessels Assessment in Age-Related Macular Degeneration.

To compare the choroidal vasculature in eyes with early- and intermediate-stage age-related macular degeneration (dAMD) and healthy using a novel three-dimensional algorithm. Patients with dAMD and healthy controls underwent clinical examinations and swept-source optical coherence tomography scans (PlexElite-9000 device) centered on the fovea. Scans with quality scores >6 were included. Eyes with any signs of neovascular AMD or geographic atrophy were excluded. The choroidal layer was segmented using ResUNet model and volumetric smoothing. Phansalkar thresholding was used to binarize the choroidal vasculature. The three-dimensional maps were divided into five sectors. The three largest vessels in each sector were measured to determine the mean choroidal vessel diameter (MChVD) and inter-vessel distance (IVD). Volumetric choroidal thickness (ChT) and vascularity index (CVI) were also calculated. This retrospective cross-sectional study analyzed 60 eyes from 45 dAMD patients (27 early-stage, 33 intermediate-stage) and 26 eyes from 16 healthy controls. The average MChVD was increased in dAMD eyes compared to healthy eyes (239.559 ± 47.058 µm vs. 197.873 ± 49.047 µm, P < 0.001). The average MChVD in each sector increased significantly in eyes with dAMD (P < 0.05). The average IVD was increased significantly in dAMD eyes compared to healthy eyes (234.128 ± 69.537 µm vs. 179.914 ± 49.995 µm, P < 0.001). The average IVD in each sector was significantly increased in eyes with dAMD (P < 0.05). Average ChT and CVI in dAMD were reduced compared to healthy eyes (P < 0.05). Eyes with dAMD demonstrated increased MChVD and IVD and decreased ChT and CVI, possibly related to smaller-vessel atrophy and larger-vessel dilation.

Three-dimensional choroidal characteristics in different subtypes of central serous chorioretinopathy using swept-source optical coherence tomography angiography.

To assess choroid vascular characteristics in four subtypes of central serous chorioretinopathy (CSC) eyes under the new classification system. There were 83 subjects in total for analysis including 16 individuals with acute CSC, 13 with non-resolving CSC, 12 with recurrent CSC, 16 with chronic CSC, and 26 healthy control eyes. We utilized the integrated software of SS-OCTA to acquire measurements of the central choroidal thickness (CT), the choriocapillaris perfusion area (CCPA), three-dimensional choroidal vascularity index (CVI) and three-dimensional choroidal vessel volume (CVV). The SNK-q test was conducted for pairwise comparisons among four subgroups of CSC and healthy control eyes. A multiple linear regression model was employed to investigate the relationship between CVI, CCPA and other factors. CT, CVI, and CCPA of the chronic CSC subgroup were significantly lower than the other three CSC subgroups. Lower CVI was significantly correlated with the subgroup of chronic CSC (β = -0.140, P = 0.016), lower CT (β = 0.0014, P < 0.01), and higher CCPA (β = -0.141, P < 0.01). Lower CCPA was significantly correlated with the subgroup of chronic CSC (β = -0.937, P < 0.01), diabetes (β = -0.118, P = 0.015), higher CVV (β = -0.414, P = 0.014), and higher CVI (β = -0.764, P < 0.01). This is the first study to evaluate the choroidal characteristics of four subtypes of CSC under the new classification system in detail. It seems that chronic CSC displays distinct pathophysiological alterations in choroidal characteristics. NCT05687422.

Analysis of the Natural Course of Quiescent Macular Neovascularization with Optical Coherence Tomography Angiography

Purpose This study investigates the natural progression of quiescent macular neovascularization (qMNV) using optical coherence tomography angiography (OCTA). Methods The study monitored 30 eyes of 28 qMNV patients over a period of at least six months. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and OCTA were used to perform qualitative and quantitative analyses, noting any cases of activation during follow-up. Results Among the 30 eyes (14 female, mean age 69.70 ± 7.63 years), 21 had age-related macular degeneration (AMD) and 9 had pachychoroid neovasculopathy (PNV). The mean follow-up duration was 18.9 months. There were no significant changes in qualitative morphological features, BCVA, or choroidal thickness ( p &gt; 0.05). However, there was a statistically significant increase in the areas of MNV and flow ( p = 0.043 and p = 0.018, respectively). BCVA and MNV area showed no significant correlation ( p = 0.103). Four cases (13.33%) showed activation after an average follow-up period of 27.75 months (6 to 48). Additionally, extrafoveal location was identified as a significant risk factor for exudation ( p = 0.033). Conclusion OCTA is a valuable tool for monitoring qMNV and identifying potential predictors of disease activation. The qMNV area may increase over time, even in the absence of activation. Extrafoveal location appears to be a potential risk factor for qMNV activation.

Comment on: Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography.

Comment on: Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography.

Short-term effectiveness of intelligent navigated laser photocoagulation versus subthreshold micropulse laser in patients with chronic central serous chorioretinopathy.

To compare the short-term effectiveness of intelligent navigated laser photocoagulation and 577-nm subthreshold micropulse laser (SML) treatment in patients with chronic central serous chorioretinopathy (cCSC). This observational retrospective cohort study included 60 consecutive patients who underwent intelligent navigated laser photocoagulation (n=30) or 577-nm SML treatment (n=30) for cCSC between Jan. 2021 and Oct. 2022. During 3mo follow-up, all patients underwent assessments of best correct visual acuity (BCVA) and optical coherence tomography (OCT). The operation of laser treatment was successful in all cases. At 1mo, BCVA improved significantly more in the intelligent navigated laser photocoagulation group compared to the SML group (P<0.05). The change was not significantly different at 3mo (P>0.05). Central macular thickness (CMT) in the intelligent navigated laser photocoagulation group was lower than in the SML group at 1mo (P<0.05). The subfoveal choroidal thickness (SFCT) in two groups were all significantly improved at 3mo (all P<0.05). The change between two groups was not significantly different at 1mo or at 3mo (P>0.05). Intelligent navigated laser photocoagulation is superior to SML for treating cCSC, leading to better improvements in vision and CMT for short term.

Changes in choroidal thickness quantified by Optical Coherence Tomography across cognitive impairment: data from the NORFACE cohort

BackgroundOptical coherence tomography (OCT) enables high-resolution imaging of ocular structures in health and disease. Choroid thickness (CT) is a key vascular retinal parameter that can be assessed by OCT and might be relevant in the evaluation of the vascular component of cognitive decline. We aimed to investigate CT changes in a large cohort of individuals cognitive unimpaired (CU), with mild cognitive impairment due to Alzheimer's (MCI-AD), mild cognitive impairment due to cerebrovascular disease (MCI-Va), Alzheimer’s disease dementia (ADD), and vascular dementia (VaD).MethodsClinical, demographical, ophthalmological and OCT data from the Neuro-ophthalmological Research at Fundació ACE (NORFACE) project were analyzed. CT was assessed in the macula across nine Early Treatment Diabetic Retinopathy Study (ETDRS) quadrants, average thickness, total volume, and subfoveal choroidal thickness. Differences of CT among the five diagnostic groups were assessed in a multivariate regression model, adjusting for demographic and cardiovascular risk factors and OCT image quality. A comparison between manual and automatic CT measurements in a subset of participants was also performed.ResultsThe study cohort comprised 1,280 participants: 301 CU, 196 MCI-AD, 112 MCI-Va, 578 ADD, and 93 VaD. CT was significantly increased in individuals with cognitive impairment compared to those CU, particularly in the VaD and MCI-Va groups and in the peripheral ETDRS regions. No significant differences were found in inner superior, center and subfoveal choroidal thickness. The interaction of sex and diagnosis had no effect in differentiating CT. Mini-Mental State Examination (MMSE) scores were not correlated to CT. Manual and automated CT measurements showed good reliability.DiscussionOur findings indicated that peripheral choroidal thickening, especially in patients with cerebrovascular disease, may serve as a potential choroidal biomarker for cognitive decline and suggest different pathogenic pathways in AD and VaD. Further research is required to explore CT as a reliable ocular biomarker for cognitive impairment.