Choroidal Thickness Research Articles

Crossover to 689 nm laser therapy after poor responsiveness to subthreshold micropulse laser for chronic central serous chorioretinopathy

PurposeTo compare the visual and anatomical outcomes of 689 nm laser therapy (689-LT) and continued subthreshold micropulse laser (SML) therapy, for chronic central serous chorioretinopathy (cCSC) eyes after poor responsiveness to initial SML treatment. MethodsThe retrospective study included 32 cCSC patients, of which 15 patients received continued SML, and 17 patients received 689-LT. Best corrected visual acuity (BCVA), central retinal thickness (CRT), the maximum height of subretinal fluid (mSRF), subfoveal choroidal thickness (SFCT), three-dimensional choroidal vascularity index (CVI), and the vascular density of choriocapillaris (CCVD) of two groups were evaluated and compared at baseline, one-month and three-month follow-up after treatment. ResultsThirty-two cCSC eyes of 32 patients (7 female, 25 male) were included in our study, with a mean age of 46.69 ± 6.56 years. Three months after treatment, complete resolution of SRF was achieved in four eyes in the 689-LT group, whereas no eyes displayed complete resolution in the SML group. There were no significant improvements in BCVA and CCVD at the three-month follow-up in both groups. In the 689-LT group, at one-month and three-month follow-ups, there was a significant reduction in CRT, mSRF, SFCT and CVI, compared to the baseline (p < 0.001 in all analyses). There were no statistically significant changes in CRT, mSRF, SFCT and CVI in the SML group (p > 0.05 in all analyses). The ANOVA test for repeated measures showed the changes in the measurements over time were significantly different between the two groups (P value using Greenhouse–Geisser test < 0.05). Conclusion689 nm laser therapy provides the opportunity for cCSC eyes with poor responsiveness to SML treatment, especially when verteporfin is unavailable. There was also a notable recovery in the abnormal dilatation of choroidal vessels in the 689-LT group. Further studies are warranted to investigate the long-term efficacy and safety of 689 nm laser therapy in the management of cCSC.

An investigation on choroidal and retinal thickness alterations in Posner-Schlossman syndrome patients

BackgroundWe aimed to compare choroidal thickness (ChT) and retinal nerve fiber layer (RNFL) thickness in the affected and contralateral eyes of patients with Posner-Schlossman Syndrome (PSS) during acute, remission, and intermittent phases.MethodsThis prospective observational study included 18 patients(36 eyes) diagnosed with PSS. These patients underwent a comprehensive ophthalmologic evaluation including slit lamp examination, visual acuity testing, intraocular pressure (IOP) measurement, and funduscopic examination, and assessment of RNFL thickness, macular thickness, and macular ChT. Patient data collected included gender, age, number of keratic precipitates (KPs), and number of episodes. Optical coherence tomography (OCT) was used to measure RNFL thickness, macular thickness, and macular ChT in both eyes during the acute, remission, and intermittent phases. The affected eye was compared with the unaffected eye at each phase.ResultsIn affected eyes, macular ChT was lower in the acute phase compared to the remission phase at N1500, N1000, N500, and subfoveal locations (allp < 0.05).The central macular recess ChT was also significantly thinner in the acute phase compared to the intermittent and remission phases. Age significantly correlated with ChT in the central recess (p = .024). Macular thickness was thinner during the acute phase in the affected eye (p = .048). The RNFL in the affected eye was thinner in the intermittent phase than in the acute phase at the inferior-temporal (p = .011) and global sectors (p = .044). During the acute phase, RNFL in the affected eye was thinner at the superior-nasal (p = .049), inferior-temporal (p = .003), and global (p = .041) sectors compared to the unaffected eye. In the intermittent phase, the affected eye’s RNFL was thinner at the superior-nasal, inferior-temporal, inferior-nasal, and global sectors compared to the unaffected eye (allp < 0.05), while no difference was observed in both eyes at the nasal, superior-temporal, and temporal sectors. The number of episodes and age were significantly associated with RNFL thickness (p < .05).ConclusionThis study demonstrated that in eyes affected by PSS, RNFL, macular ChT, and macular thickness thinned during the acute phase. The number of episodes and age are significant factors in the development of PSS.

Relationship between Choroidal Thickness and Anterior Scleral Thickness in Patients with Keratoconus.

To evaluate the relationship between choroidal thickness (CT) and anterior scleral thickness (AST) in patients with subclinical keratoconus (SKC) and established keratoconus (KC). This single-center prospective case-control study included 97 eyes of 97 patients: 44 KC eyes, 14 SKC eyes, and 39 age- and axial length (AL)-matched healthy eyes. Using swept-source optical coherence tomography, the AST was manually measured in four directions and the CT was obtained automatically from the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Principal component analysis (PCA) was used to linearly reduce the dimensionality of nine CT inputs to one significant component, CT1. A multivariate model was created to evaluate the association between CT1, AST, and several ocular parameters in SKC and KC patients. Partial correlation was then performed to adjust the confounding factors and to examine the effect of AST on CT1. The PCA showed that CT1 accounts for 86.54% of the total variance in the nine original CTs of the ETDRS grid. The CT1 model was associated with age, AL, and AST in the superior meridian in SKC eyes, whereas in KC eyes, it was correlated with gender, age, AL, and AST in the inferior meridian (p < 0.001). The partial correlation between CT1 and AST in the superior zone was found to be significant, positive, and strong in SKC eyes (r = 0.79, p = 0.019), whereas a significant, positive, and moderate correlation between CT1 and AST at the inferior zone (r = 0.41, p = 0.017) was observed in KC eyes. Choroidal tissue was significantly correlated with the anterior sclera across the vertical meridian. This relationship was observed over the superior sclera in SKC eyes, whereas in established KC, it was over the inferior sclera. These results reveal new insights regarding the interactions between the anterior and posterior structures of the KC eyes and confirm the enigma of the pathophysiology of KC.

Importance of OCT-derived biomarkers for the recurrence of central serous chorioretinopathy using statistics and predictive modelling

Central serous chorioretinopathy (CSCR) is a retinal disease characterised by the accumulation of subretinal fluid, which often resolves spontaneously in acute cases. However, approximately one-third of patients experience recurrences that may cause severe and irreversible vision. This study aimed to identify parameters derived from optical coherence tomography (OCT) that are associated with CSCR recurrence. Our dataset included 5211 OCT scans from 344 eyes of 255 patients diagnosed with CSCR. 178 eyes were identified as recurrent, 109 as non-recurrent, and 57 were excluded. We extracted parameters using artificial intelligence algorithms based on U-Nets, convolutional kernels, and morphological operators. We applied inferential statistics to evaluate differences between the recurrent and non-recurrent groups, and we used a logistic regression predictive model, reporting the coefficients as a measure of biomarker importance. We identified nine predictive biomarkers for CSCR recurrence: age, intraretinal fluid, subretinal fluid, pigment epithelial detachments, choroidal vascularity index, integrity of photoreceptors and retinal pigment epithelium layer, choriocapillaris and choroidal stroma thickness, and thinning of the outer nuclear layer, and of the inner nuclear layer combined with the outer plexiform layer. These results could enable future developments in the automatic detection of CSCR recurrence, paving the way for translational medical applications.

Choroidal structural changes in inactive thyroid eye disease: a cross-sectional analysis of the choroidal vascularity index

Objective In this study, we aimed to compare choroidal vascular changes using the Choroidal Vascularity Index (CVI) between patients with inactive Thyroid Eye Disease (iTED) and healthy individuals, and to assess the relationship between CVI and choroidal thickness (CT), smoking history, and clinical parameters. Methods In this cross-sectional observational study, the eyes of 30 patients aged 18 to 45 with iTED were compared with the randomly selected eyes of 35 age and gender-matched healthy control individuals. Optical coherence tomography (OCT) scans were taken from all participants. The images were binarized using the ImageJ software, and the total choroidal area (TCA) and luminal area (LA) were measured. The ratio of the LA to the TCA was used to calculate the CVI. The relationships between these measurement parameters and clinical activity score (CAS), exophthalmometry, smoking status, and other clinical parameters were examined. Results In the iTED group, CT and CVI values were significantly higher compared to the control group (p < 0.001, p = 0.029). No significant effect of smoking on choroidal parameters was detected in the iTED group. Additionally, there was no statistical correlation between choroidal parameters and either exophthalmometry or CAS (p > 0.05). In the multivariate regression analysis, it was determined that CT showed a significant relationship with thyroid stimulating immunoglobulin (TSI) (p = 0.003). Conclusions This study found that CT and CVI were increased in the eyes of patients with iTED compared to healthy controls. The history of smoking did not appear to have any effect on CT and CVI in iTED patients.

Choroidal and Choriocapillaris Changes after Photodynamic Therapy and Subthreshold Micropulse Laser Treatment for Central Serous Chorioretinopathy.

Background and Objectives: The aim of the present study is to analyze choroidal and choriocapillaris structural and functional changes in eyes affected by Central serous chorioretinopathy after Photodynamic Therapy (PDT) and Subthreshold Micropulse laser (SML) treatment. Materials and Methods: Forty-two eyes of forty-two patients were analyzed in this observational study. Twenty-four patients underwent SML treatment, whereas eighteen patients were treated with PDT. Examinations were performed at baseline and after 3 months of treatment. Main outcome measures were: Best corrected visual acuity (BCVA), central macular thickness (CMT), central choroidal thickness (CCT), pigment epithelial detachment (PED) presence and maximum height (PEDMH), and choroidal vascularity index (CVI) measured by means of Spectralis HRA + OCT (Heidelberg Engineering, Heidelberg, Germany) Optical coherence tomography (OCT) and choriocapillaris flow voids (CCFV) measured on Optical Coherence Tomography Angiography (OCT-A) platform PLEX Elite 9000 device (Carl Zeiss Meditec Inc., Dublin, CA, USA). Results: Changes in BCVA were registered in both groups over time (p < 0.001). Structural changes in terms of reduced CMT and PED presence were noted in the two groups at follow-up (p < 0.001 and p = 0.001, respectively). Structural and functional choroidal changes were found in the two groups with reduced CCT and CVI over time (p = 0.004 and p = 0.007, respectively), with significant differences between the two groups for CVI parameter (p = 0.001). CCFV increased over time in the PDT group and decreased in the SML group. Conclusions: PDT and SML are effective approaches in CSC eyes and are able to improve structural and functional parameters over time. Choroidal and choriocapillaris parameters are promising biomarkers able to monitor disease course, showing greater impact of PDT on choroid-choriocapillaris complex over time.

Quantitative analysis of three-dimensional choroidal changes in coronary artery disease patients with swept-source optical coherence tomography angiography

PurposeTo quantitatively analyze three-dimensional (3D) choroidal changes in coronary artery disease (CAD) patients with swept-source optical coherence tomography angiography (SS-OCTA) based on a scan area of 12×12mm. Methods236 CAD patients and 78 controls were included after coronary angiography (CAG) evaluation in this prospective cross-sectional study. Choroidal and foveal avascular zone (FAZ) parameters were compared between the two groups. Choroidal morphological characteristics were also evaluated based on ETDRS quadrants. Receiver operating characteristics (ROC) curves were generated to determine the discriminative power of choroidal and FAZ parameters. Linear regression analysis was used to determine the relationships between Gensini score and choroidal parameters. ResultsChoroidal thickness (CT), choroidal vascular volume/ area (CVV/a), and choroidal stromal volume/ area (CSV/a) were significantly reduced in CAD patients, while 2D vascular density decreased only in 1–6 mm, and no statistical difference in choroidal vascularity index (CVI) values was detected. The AUC values of choroidal parameters were greater in the inner-6 mm area than the outer-6 mm area, and good performance was found with a combination with FAZ parameters (AUC=0.77, P < 0.001). For morphological analysis, both groups showed the greatest values in superior quadrant and the lowest in nasal quadrant. After controlling for confounding factors, Gensini score was negatively associated with CT (β = -0.35, P = 0.003), CVV/a (β = -0.17, P = 0.004), and CSV/a (β = -0.18, P = 0.005). ConclusionThe SS-OCTA provided excellent visualization and quantification of the choroid and showed decreased choroidal thickness and volume in CAD patients, but the morphological features were unchanged. The severity of coronary artery stenosis was independently associated with choroidal changes.

Rheumatic fever and long-term use of benzathine penicillin as possible risk factors for extensive macular atrophy with pseudodrusen in a Brazilian cohort

BackgroundAlthough there has been a large increase in the number of extensive macular atrophy with pseudodrusen (EMAP) cases, the basic aspects of this disease remain unknown. Brazilian patients have a common past history of rheumatic fever (RF) and/or benzathine penicillin (BP) treatment possibly related to the disease. We analyzed how RF and BP might be correlated with EMAP in Brazilian patients.DesignObservational, retrospective, case-control study.MethodsThe databases of three private eye clinics in Brazil were searched for patients with an EMAP-like appearance. Each patient was asked about a previous history of RF and/or long-term use of BP. Patients underwent best-corrected visual acuity (BCVA) measurement, color fundus imaging, fundus autofluorescence (FAF) imaging, optical coherence tomography (OCT) imaging, and electroretinography (ERG). The following characteristics were analyzed: subretinal drusenoid deposits (SDD), pigment mottling, retinal pigment epithelial/basement membrane (RPE/BM) separation, outer retinal or RPE atrophy, and identification of a paving stone-like appearance. The choroidal thickness was measured using enhanced depth imaging OCT. The central atrophic area was measured manually on ultra-wide-field FAF.ResultsA total of 154 eyes of 77 patients (women, 66.2%; mean age, 58.6 years) with EMAP were included; 90.9% of patients were diagnosed with RF; 94.8% had been treated with BP and treatment was started at an average age of 7.3 years (mean duration, 11.8 years). The treatment duration was significant for the area of atrophy (P = 0.027) in which each 1-year increase in treatment duration led to an average reduction of 6.91 mm2 in area. The age at diagnosis of RF was significant (P = 0.026) for SDD. The increase of 1 year in the diagnosis of RF (late disease) led to a reduction of 24% in the chance of central SDD being present. On OCT, 65.5% eyes had SDD and more than 70% had a split RPE/BM and outer retinal or RPE atrophy. The choroidal thickness in patients with EMAP was significantly (P < 0.001) thinner than the control group. The ERG was abnormal in all eyes.ConclusionThese findings may suggest a relation between RF and EMAP in Brazilian patients. Patients with EMAP should be questioned about a history of RF.

Dynamic BMP gene expression regulation in chick RPE during recovery from short term optical defocus and form-deprivation.

This study investigated the differential gene expression of BMPs in chick retinal pigment epithelium (RPE) during recovery from short term exposure to optical defocus and form-deprivation (FD) treatments. 14-day old White-Leghorn chicks wore either monocular +10 or -10 D lenses, or diffusers for 2 or 48 h, after which eyes were allowed unobstructed vision for up to 96 h. Over this recovery period, refractive errors and choroidal thickness (ChT) were tracked using retinoscopy and high-frequency A-scan ultrasonography. Real-time PCR was used to examine the expression of BMP2, 4, and 7 genes in RPE samples collected 0, 15 min, 2, 24, 48, and 96 h after the termination of treatments. Expression levels in treated eyes and their contralateral control eyes were compared. After the termination of the lens and diffuser treatments, eyes gradually recovered from induced shifts in refractive error. With all three treatments, ChT changes reached statistical significance after 48 h of treatment, be it thinning with the -10 D lens and diffuser treatments (-0.06 ± 0.03mm, p < 0.05; -0.11 ± 0.04 mm, p < 0.05, resp.), or thickening with the +10 D lens (0.31 ± 0.04 mm, p < 0.001). BMP2 gene expression was rapidly upregulated in eyes wearing the +10 D lens, being statistical significance after 2 h, as well as 48 h of treatment. With the 2 h treatment, the latter gene expression pattern persisted for 15 min into the recovery period, before decreasing to the same level as that of contralateral control eyes, with a short-lived rebound, i.e., upregulation, 24 h into the recovery period. With the longer, 48 h treatment, BMP2 gene expression decreased more gradually, from 739 ± 121% at the end of the treatment period, to 72 ± 14% after 48 h of recovery. Two and 48 h of both -10 D and FD treatments resulted in BMP2 gene expression downregulation, with the time taken for gene expression levels to fully recover varying with the duration of initial treatments. In both cases, BMP2 gene expression downregulation persisted for 15 min into the recovery period, but reversed to upregulation by 2 h. Similar gene expression patterns were also observed for BMP4, although the changes were smaller. The observed changes in BMP gene expression in chick RPE imply dynamic, albeit complex regulation, with the duration of exposure and recovery being critical variables for all three types of visual manipulations. This study provides further evidence for a role of the RPE as an important signal relay linking the retina to the choroid and sclera in eye growth regulation.

Persistent Serous Choroidal and Retinal Detachment After Ab Interno Trabeculotomy for Glaucoma.

We describe a case of serous retinal detachment (SRD) with ciliochoroidal detachment (CCD) that persisted for 2 years and 7 months after minimally invasive glaucoma surgery (MIGS). A 71-year-old woman with primary open-angle glaucoma and cataracts had a central corneal thickness of 489 μm/492 μm and an ocular axis length of 24.05 mm/24.30 mm. She underwent phacoemulsification and intraocular lens implantation in the right eye (OD), along with goniosynechialysis and microhook ab interno trabeculotomy. Postoperative intraocular pressure was 4-6 mmHg in the OD. Five months later, SRD was observed temporally and inferiorly to the macula, with increased choroidal thickness. Best-corrected visual acuity at 5 months was (1.2)/(1.2) (right eye [OD]/left eye [OS]), and intraocular pressure was 6 mmHg/13 mmHg. CCD in the OD was accompanied by choroidal vessel dilation and choroidal vascular hyperpermeability. Two years and 7 months post-surgery, intraocular pressure spiked to 50-54 mmHg but settled at 12 mmHg 1 week later. CCD resolved, and choroidal folds and SRD disappeared, with decreased choroid thickness. Two years and 10 months postoperatively, there was no SRD recurrence at 10 mmHg on two antiglaucoma eye drops, and best-corrected visual acuity remained stable at (1.0)/(1.0). This case suggests that SRD may result from increased choroidal vessel permeability and retinal pigment epithelium dysfunction secondary to prolonged CCD/low IOP after MIGS. The prolonged disease course may be attributed to the balance between aqueous humor excretion and absorption, influenced by the limited size of the cyclodialysis cleft caused by MIGS.

A comprehensive evaluation of efficacy of hyperbaric oxygen therapy in non-arteritic central retinal artery occlusion using enhanced depth imaging optical coherence tomography

This study aimed to assess the efficacy of hyperbaric oxygen therapy (HBOT) in patients with central retinal artery occlusion (CRAO) by analyzing changes in visual acuity (VA) and enhanced depth imaging optical coherence tomography (EDI-OCT) parameters. A comparative retrospective study was conducted by reviewing the medical records of all HBO-treated RAO patients in our department and comparing them with matched RAO patients who did not receive HBO treatment. All patients treated with HBO received treatment within 7 days of the onset of visual symptoms. Baseline characteristics were compared, and VA and OCT parameters were evaluated at baseline and follow-up visits. A total of 50 eyes from 50 patients were included, with 29 eyes in the HBOT group and 21 eyes in the control group. The mean BCVA of the HBOT group at the initial visit was 2.03 logMAR, which improved to 1.55 logMAR at 6 months, with the change being statistically significant (P < 0.01), while the control group's BCVA remained almost unchanged, from 2.1 to 2.11 logMAR (P = 0.762). The central choroidal thickness increased significantly in the HBOT group over the subsequent period. The central fovea, and outer retinal layer thickness in the HBOT group were significantly greater than those in the control group at the 6-month follow-up after treatment. HBOT appears to be effective in improving VA and inducing favorable changes in OCT parameters in patients with CRAO. It helps to preserve retinal layer thickness, especially in the outer retinal layer.

Genome-wide association study of subfoveal choroidal thickness in a longitudinal cohort of older adults

To identify genetic influences on subfoveal choroidal thickness of older adults using a genome-wide association study (GWAS). We recruited 300 participants from the population-based Korean Longitudinal Study on Health and Aging (KLoSHA) and Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) cohort studies and 500 participants from the Bundang age-related macular degeneration (AMD) cohort study dataset. We conducted a GWAS on older adult populations in the KLoSHA and KLOSCAD cohorts. Single nucleotide polymorphisms (SNPs) associated with choroidal thickness were identified with P values < 1.0 × 10−4 in both the right and left eyes, followed by validation using the Bundang AMD cohort dataset. This association was further confirmed by a functional in vitro study using human umbilical vein endothelial cells (HUVECs). The ages of the cohort participants in the discovery and validation datasets were 73.5 ± 3.3 and 71.3 ± 7.9 years, respectively. In the discovery dataset, three SNPs (rs1916762, rs7587019, and rs13320098) were significantly associated with choroidal thickness in both eyes. This association was confirmed for rs1916762 (genotypes GG, GA, and AA) and rs7587019 (genotypes GG, GA, and AA), but not for rs13320098. The mean choroidal thickness decreased by 56.7 μm (AA, 73.8%) and 31.1 μm (GA, 85.6%) compared with that of the GG genotype of rs1916762, and by 55.4 μm (AA, 74.2%) and 28.2 μm (GA, 86.7%) compared with that of the GG genotype of rs7587019. The SNPs rs1916762 and rs7587019 were located close to the FAM124B gene near its cis-regulatory region. Moreover, FAM124B was highly expressed in vascular endothelial cells. In vitro HUVEC experiments showed that the inhibition of FAM124B was associated with decreased vascular endothelial proliferation, suggesting a potential mechanism of choroidal thinning. FAM124B was identified as a susceptibility gene affecting subfoveal choroidal thickness in older adults. This gene may be involved in mechanisms underlying retinal diseases associated with altered choroidal thickness, such as age-related macular degeneration.

Ocular effects of synthetic cannabinoids: a case-control study.

To evaluate the ocular effects of "Bonzai", a synthetic cannabinoid (SC), in seropositive and seronegative users. Sixty eyes of 60 consecutive male patients with a history of "Bonzai" use and 30 eyes of 30 age-matched male healthy controls were enrolled in this case-control study. Patients with past "Bonzai" use were grouped as seropositive (n:30) and seronegative (n:30) according to urine toxicology tests. All groups were compared for blood pressures, intraocular pressure, foveal and parafoveal retinal thicknesses, subfoveal and parafoveal choroidal thicknesses, measurements of the peripapillary retinal nerve fibre layer (RNFL), and macular ganglion cell complex (GCC), subfoveal total choroidal, luminal and stromal areas, and choroidal vascularity index (CVI). No differences were noted in blood pressures between the groups (p > 0.05). The mean intraocular pressure was significantly lower in the seropositive group than in the other groups (p < 0.001). Foveal and retinal thicknesses, RNFL, and GCC measurements did not differ between the groups (p > 0.05). Subfoveal and parafoveal choroidal thicknesses and areas were lower in the seropositive group than in the other groups (p < 0.001, for all). CVI increased in both groups with "Bonzai" use compared to the control group (p < 0.001, for all). This study indicates that intraocular pressure may decrease, and choroidal changes may be observed in SC users. Further clinical studies with a larger sample size, especially using purified SC for therapeutic purposes, are needed to confirm the present findings, and further histopathologic studies are required to clarify the changes in the choroid despite SC seronegativity. NCT06235346.

Evaluation of the early effects of the first-dose administration of the Sinovac vaccine on the retina, choroid, and optic disc using optical coherence tomography (OCT) and OCT-angiography

Aim To determine the effects of the first-dose administration of the Sinovac vaccine on the retina, choroid, and optic disc in healthy participants. Methods This prospective design study was conducted with 27 healthy healthcare workers who received the first dose of Sinovac vaccine and 25 healthy controls who were not vaccinated. In the vaccinated group, ophthalmological examinations and measurements were performed before vaccination and one week and one month after vaccination. Subfoveal, nasal, and temporal choroidal thicknesses (CTs), retinal nerve fiber layer (RNFL) thickness, and macular thickness (MT) were determined using spectral domain-optical coherence tomography at all visits. Superficial, deep, and peripapillary radial capillary plexus (superficial capillary plexus, deep capillary plexus (DCP), and radial peripapillary capillary, respectively), choriocapillaris vascular density, and foveal avascular zone parameters were measured on optical coherence tomography-angiography (OCT-A). Results No significant difference was detected between the two groups in terms of the parameters measured by OCT and OCT-A (p > 0.05 for all). The CT values measured in all quadrants were significantly higher at the first week after vaccination (p < 0.05 for all), and they returned to their pre-vaccination values at the first month post-vaccination measurement (p > 0.05 for all). Concerning the RNFL and MT values, there was no significant difference between the pre-vaccination and post-vaccination first-week measurements (p > 0.05 for all), but a statistically significant increase was detected in the post-vaccination first-month MT and RNFL measurements (p < 0.05 for all). Only the decreases in the foveal DCP and choriocapillaris vascular density values were significant at the first week after vaccination (p < 0.05 for all). Conclusion The early changes detected after vaccination in this study suggest the possibility that autoimmune, vascular, and inflammatory diseases may simultaneously emerge in the early post-vaccination period or may be triggered after vaccination, or that the vaccine may unmask these diseases.

Role of Plasma Angiopoietin-1 and VEGF Levels as Potential Biomarkers in Chronic Central Serous Chorioretinopathy with Macular Neovascularization.

To evaluate the plasma levels of angiopoietin-1 and vascular endothelial growth factor (VEGF) and their association with macular neovascularization (MNV) in patients with chronic central serous chorioretinopathy (cCSC). Correlations between plasma cytokine levels, CSC duration, and mean choroidal thickness (CT) were also investigated. Of the 59 patients with cCSC, 10 patients with MNV secondary to cCSC and 10 patients with cCSC without MNV were enrolled in the study. The control group included 15 healthy volunteers matched for age, sex, smoking status, and comorbidities. Chronic CSC was diagnosed based on typical findings on swept-source optical coherence tomography (OCT), fundus fluorescein angiography, and indocyanine green angiography. Additionally, all patients underwent OCT angiography to help detect MNV. Plasma angiopoietin-1 and VEGF levels were assessed using multiplex immunoassay. The plasma angiopoietin-1 levels differed between the 3 groups (p = 0.005). The angiopoietin-1 levels were lower in patients with cCSC with MNV than in controls (p = 0.006). There were no differences in the plasma VEGF levels between all the 3 groups (p = 0.329). The VEGF levels were negatively correlated with mean CT in cCSC patients with MNV (rho = -0.683, p = 0.042) but correlated positively with disease duration in patients with cCSC without MNV (rho = 0.886, p = 0.003). Our study confirms that MNV is a common complication of cCSC and provides new insights into the role of angiopoietin-1 in cCSC and MNV. Reduced angiopoietin-1 levels in cCSC patients, regardless of MNV status, highlight the importance of the Ang-Tie2 pathway in disease pathogenesis and may point to new therapeutic targets and future novel treatments to improve the management of these patients.

Changes in choroidal thickness and blood flow in response to form deprivation-induced myopia and repeated low-level red-light therapy in Guinea pigs.

To evaluate ocular refractive development, choroidal thickness (ChT) and changes in choroidal blood flow in form-deprived myopia (FDM) Guinea pigs treated with repeated low-level red-light (RLRL) therapy. Twenty-eight 3-week-old male tricolour Guinea pigs were randomised into three groups: normal controls (NC, n = 10), form-deprived (FD, n = 10) and red light treated with form-deprivation (RLFD, n = 8). Interocular refraction and axial length (AL) changes were monitored. Optical coherence tomography angiography (OCTA) measured choroidal thickness, vessel area density, vessel skeleton density and blood flow signal intensity (flux) in the choriocapillaris and medium-large vessel layers. The experimental intervention lasted 3 weeks. At week 3, the FD group had higher myopia and longer axial length than the NC group (all p < 0.001). The RLFD group had higher hyperopia and shorter axial length than the FD group (all p < 0.001). At week 1, the NC group had a thicker choroidal thickness than the FD group (p < 0.05). At weeks 2 and 3, the RLFD group had a thicker choroidal thickness than the FD group (p = 0.002, p < 0.001, respectively). Additionally, the NC group had higher vessel area density, vessel skeleton density and flux in the choriocapillaris layer than the FD group at the three follow-up time points (all p < 0.05). At week 3, the vessel skeleton density and flux were higher in the RLFD group than in the FD group (all p < 0.05). Correlation analysis results showed that weekly changes in refraction and choroidal thickness were negatively correlated with changes in axial length (all p < 0.05). Choroidal thickness changes were positively correlated with alterations in the vessel area density, vessel skeleton density and flux in the choriocapillaris layer, as well as vessel skeleton density and flux changes in the medium-large vessel layers (all p < 0.05). Repeated low-level red-light (RLRL) therapy retards FDM progression in Guinea pigs, potentially through increased choroidal blood flow in the choriocapillaris layer.

Comparison of visual acuity outcome and choroidal thickness variation of intravitreal ranibizumab injection for myopic choroidal neovascularization with or without dome-shaped macula

BackgroundTo investigate the visual acuity outcome and choroid thickness (CT) change after intravitreal ranibizumab in highly myopic eyes with or without dome-shaped macula (DSM) in Chinese patients. MethodsThis retrospective, observative study included 80 treatment-naive eyes (80 patients), which received ranibizumab according to the 1+PRN protocol. The best corrective visual acuity (BCVA) and CT change were compared between eyes with or without DSM. ResultsThere was no significant difference between eyes with or without DSM in BCVA and central macular thickness (CMT). The recurrent rate was not different between the two groups during the first year of treatment. The CT was significantly thinner in eyes with DSM than in eyes without DSM before treatment (median 40.00um versus 71.00um), at 1 month after treatment (median 31.00um versus 65.50um), and in the last follow up (median, 32.00um versus 65.00um) (p = 0.0101). Axial length (AL) was longer in eyes with DSM than those without DSM (median, 29.17 mm versus 28.10 mm) before treatment, and in the last follow up (median, 29.44 mm versus 28.20 mm) (p = 0.0055). The CT was significantly correlated with AL (p < 0.0001). ConclusionsNo difference was found in visual outcome between eyes with or without DSM. The visual acuity significantly improved at 1 month after ranibizumab injection and it was recovery sooner in extrafoveal choroidal neovascularization (CNV) group than in subfoveal CNV group. The CT was thinner in eyes with DSM, which was significantly correlated with AL.

Longitudinal structural changes in central serous chorioretinopathy: A multimodal imaging-based study.

To analyse the longitudinal changes in imaging parameters in eyes with acute or chronic central serous chorioretinopathy (CSCR). This was a multicentric, retrospective, longitudinal, observational study in patients with a diagnosis of CSCR and having at least 4 years of follow-up. Trend in choroidal thickness (CT), area of double layer sign (DLS), area of retinal pigment epithelium (RPE) alterations, and area of hyper-autofluorescence were analysed. A total of 175 eyes of 146 patients with a mean age of 52.9 ± 12.5 years were included. Fifty-two eyes had acute and 123 had chronic CSCR at baseline. There was an overall decreasing trend of CT values during follow up (from 354.4 ± 74.8 at baseline to 343.2 ± 109.4 at final visit). There was a steady rise in DLS width and RPE alteration in the overall cohort (from 811.7 ± 760.6 microns and 3.5 ± 3.3 disc areas respectively at baseline to 1209.1 ± 1113.18 microns, 4.1 ± 3.6 disc areas at final visit). An initial rise in hyper-autofluorescent area followed by steady fall was seen in chronic CSCR. A significant positive correlation (r = 0.54, p = 0.004) was seen between change in DLS width and change in area of hyper-autofluorescence. On linear regression analysis, lower CMT and absence of intraretinal fluid at baseline were associated with greater increase in RPE abnormalities. Acute and chronic CSCR had different pattern of change in imaging parameters with area of RPE alterations in acute CSCR not reaching values close to that of chronic CSCR eyes even after long follow up.

Contribution of the Association of CT scan and Ocular Trauma Score in Open Globe Ocular Injuries: Mohammed VI University Hospital Experience

Objective: The aim of this study was to assess the association between oculo-orbital CT scan results and Ocular Trauma Score (OTS) in open globe injuries. Methods: In 65 eyes with open globe injuries undergoing oculo-orbital CT, they were classified into 5 major types: intraocular foreign body/air, scleral irregularity with decreased globe volume, lens dislocation, abnormal vitreous density, choroid layer thickening, and choroidal detachment. The association between different types and the number of CT findings with OTS stages was evaluated. Results: The average age of patients was 37 ± 15.8 years. The most common CT findings were the presence of intraocular foreign bodies (63.1%), severe scleral irregularity (18.5%), and abnormal vitreous density (23.1%). The most frequent OTS stages were III (47.7%) and II (21.5%). Univariate analysis showed that severe scleral irregularity (OR = 0.015; p = 0.001), abnormal vitreous density (OR = 0.095; p &lt; 0.004), choroidal layer thickening (OR = 0.211; p = 0.006), and foreign body (OR = 9.50; p = 0.004) were associated with more advanced OTS stages (I and II). The discovery of more anomalies on CT was associated with severe ocular injuries, namely OTS I (p &lt; 0.001) with corresponding low final visual acuity. Conclusion: CT results can aid in predicting OTS stage and visual prognosis in open globe eye injuries.

Widefield swept source optical coherence tomography for the monitoring of choroidal infiltrates

Choroidal Infiltrates (Cis) detection is traditionally done using invasive imaging. We herein report the usage of topographic choroidal thickness maps (ChT maps) and en face swept-source Optical Coherence Tomography (OCT) as a rapid and non-invasive technique to monitor Cis in a patient with Chronic Lymphocytic Leukemia.