Choroidal Changes Research Articles

Evaluation of retinal and choroidal microvascular alteration after ICL V4c implantation based on OCTA.

To evaluate the changes of retinal and choroidal microvascular including the superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP), choriocapillaris (CC), and central retinal thickness (CRT) in high myopic eyes after the implantable collamer lens with a central hole (ICL V4c) implantation using optical coherence tomography angiography (OCTA). This retrospective study included 30 eyes of 30 patients (14 males and 16 females) who underwent ICL V4c implantation in Tianjin Aier Eye Hospital from October 2022 to May 2023. Uncorrected distant visual acuity (UDVA), best corrected distance visual acuity (BDVA), intraocular pressure (IOP), spherical equivalent (SE), axial length (AL), and optical coherence tomography angiography (OCTA) were measured and assessed before surgery, and 1 week, 1 month, and 3 months after surgery. OCTA was used to image and measure several key indicators: the foveal avascular zone (FAZ), vascular density (VD) of the SCP and DCP, blood flow density (BD) of the CC, and CRT. All measurement data were obtained utilizing the instrument's proprietary software, ensuring accuracy and consistency. UDVA were significant improvements at the 1 week, 1 month, and 3 months after ICL V4c implantation surgery. BDVA, FAZ, and CRT maintained stable, however, IOP was higher at 1 week and 3 months post-operation compared to 1-month post-operation. The statistically significant difference was identified within the S3, S7, and S9 of SCP at each time point before and after the surgery (P1 = 0.004; P2 = 0.014; P3 = 0.037). However, paired analyses showed that there was a significant decrease in VD of S3 at 1 week after ICL V4c implantation surgery (P<0.05), which then returned to preoperative levels by 1 month (P>0.05), and the increase in VD of the S7 region at 1 month after ICL V4c implantation, which is significant compared to 1 week post-surgery, but not compared to preoperative levels. An overall comparison of the BD of the CC (2mm) at each time point showed a statistically significant difference (P = 0.029). ICL V4c implantation offers a safe and efficient therapy to the high myopic patients. However, the retinal and choroidal microvascular changes need to be paid attention to in post-ICL implantation patients.

Analysis of Choroidal Thickness Changes in Recurrent Rhegmatogenous Retinal Detachment.

To analyze changes in choroidal thickness in patients with recurrent rhegmatogenous retinal detachment (RRD) before and after surgical intervention and to identify factors that influence changes in choroidal thickness. A retrospective observational study was conducted on patients who underwent surgery for recurrent RRD from November 2019 to March 2023. Choroidal thickness was measured using optical coherence tomography (OCT) at baseline, and then at 2 and 6 months postoperatively. The study analyzed the impact of various factors on choroidal thickness changes. The study included 33 patients, demonstrating a significant decrease in choroidal thickness in the surgical eye compared to the fellow eye over a 6-month period. In the univariate analysis, changes in choroidal thickness were significantly correlated with changes in central retinal thickness (p=0.048) between 0-2 months, and with proliferative vitreoretinopathy (PVR) grade between 2-6 months (p=0.009) and 0-6 months(p=0.02). In the multivariate analysis, an association was found between changes in choroidal thickness from 2 to 6 months and PVR grade(p=0.030). The findings indicate that surgical reattachment in eyes with recurrent RRD leads to a significant reduction in choroidal thickness. The extent of this reduction is influenced by the severity of PVR, highlighting the importance of considering PVR severity when evaluating surgical outcomes in patients with recurrent RRD.

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 &lt; 0.001). Structural changes in terms of reduced CMT and PED presence were noted in the two groups at follow-up (p &lt; 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.

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.

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.

Choroidal Changes and Choroidal Neovascularization in Pathological Myopia

Among the complications of pathological myopia, myopic macular neovascularization (mMNV) is one of the most vision-threatening complications. Despite significant advances in understanding the epidemiology, pathogenesis, and natural history of the disease, there is no standard definition of mMNV. Although the sensitivity of mMNV diagnosis increases to 97% with the combined use of fundus fluorescein angiography and optical coherence tomography, multimodal imaging is valuable in differential diagnosis. Intravitreal anti-vascular endothelial growth factor therapy has become the standard and first-line treatment option for mMNV. Continued monitoring of patients is required to assess any progression or recurrence.

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.

Baseline Features in Polypoidal Choroidal Vasculopathy in Caucasian Patients

Introduction: The aim of this study was to investigate demographic, anatomical, angiographic, and functional parameters in patients suffering from polypoidal choroidal vasculopathy (PCV). Methods: Sixty eyes of 60 patients with a definite diagnosis of treatment-naïve exudative unilateral PCV were evaluated in this retrospective study. Fellow eyes and age-matched healthy subjects were enrolled as comparison. All subjects underwent complete ophthalmic evaluation with multimodal imaging assessment, including spectral-domain optical coherence tomography (OCT) and OCT angiography. Main outcome measures in the comparison analysis were central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI), whereas outcome measures for correlation analyses were best corrected visual acuity (BCVA), intraretinal fluid and subretinal fluid (SRF) presence, SRF thickness, vascularized pigmented epithelial detachment height, and PCV outer retina to choriocapillaris flow area. Results: CVI was significantly higher in affected and fellow eyes if compared with the healthy ones (p = 0.049; p = 0.003). Subfoveal choroid resulted to be thicker in the diseased eyes when compared with healthy ones (p = 0.002). A negative correlation was assessed between age and SFCT, CMT, and BCVA. In addition, a significant association between male gender and anatomical and functional parameters has been found with male prevalence at baseline in cases. No association between systemic conditions and PCV features was found. Conclusions: Patients with unilateral PCV show choroidal changes in terms of higher values of CVI, also in fellow eyes, that were negatively related with age. In our cohort of patients, males showed the poorest diagnosis with a baseline lower BCVA and higher CMT when compared with females. PCV was not associated with any systemic condition.

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 1-6mm, and no statistical difference in choroidal vascularity index (CVI) values was detected. The AUC values of choroidal parameters were greater in the inner-6mm area than the outer-6mm 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.

Lifelong Changes in the Choroidal Thickness, Refractive Status, and Ocular Dimensions in C57BL/6J Mouse.

To investigate the changes in choroidal thickness (ChT), refractive status, and ocular dimensions in the mouse eye in vivo using updated techniques and instrumentation. High-resolution swept-source optical coherence tomography (SS-OCT), eccentric infrared photoretinoscopy, and custom real-time optical coherence tomography were used to analyze choroidal changes, refractive changes and ocular growth in C57BL/6J mice from postnatal day (P) 21 to month 22. The ChT gradually increased with age, with the thickest region in the para-optic nerve head and thinning outward, and the temporal ChT was globally thicker than the nasal ChT. Retinal thickness remained stable until 4months and subsequently decreased. The average spherical equivalent refraction error was -4.81 ± 2.71 diopters (D) at P21, which developed into emmetropia by P32, reached a hyperopic peak (+5.75±1.38D) at P82 and returned to +0.66 ± 1.86 D at 22months. Central corneal thickness, anterior chamber depth, lens thickness, and axial length (AL) increased continuously before 4months, but subsequently exhibited subtle changes. Vitreous chamber depth decreased with lens growth. ChT was correlated significantly with the ocular parameters (except for retinal thickness) before the age of 4months, but these correlations diminished after 4months. Furthermore, for mice younger than 4months, the difference in the ChT, especially temporal ChT, between the two eyes contributed most to that of axial length and spherical equivalent refraction error. Four months could be a watershed age in the growth of mouse eyes. Large-span temporal recordings of refraction, ocular dimensions, and choroidal changes provided references for the study of the physiological and pathological mechanisms responsible for myopia.

Choroid Involvement Secondary to Optic Disc Pit Maculopathy: OCT Analysis And Evolution After Surgical Treatment: Choroidal Involvement In Optic Pit Maculopathy

PurposeTo assess choroidal changes associated to optic disc pit maculopathy (ODP-M) and their evolution after surgical treatment. DesignMulticentric retrospective case series. MethodsAnalysis of 42 patients affected by unilateral ODP-M undergoing surgical treatment between 2013 and 2023. Optical coherence tomography (OCT) were performed at baseline and postoperative months 1, 6, 12, 24 and most recent follow-up. Subfoveal choroidal thickness (SFCT) and peripapillary choroidal thickness (PPCT) were measured in ODP-M and fellow eyes. The presence of retinal pigmented epithelium (RPE) atrophy was used to distinguish between “early” and “advanced” disease, and data regarding fluid localization were collected. ResultsBaseline SFCT in ODP-M eyes was significantly higher than fellow eyes (386.8±88.9 vs. 334.4±72.2 μm, p=0.002), differently from PPCT (192.6±47.8 vs. 181.2±45.7 μm, p=0.46). SFCT significantly decreased 1 month post-operatively (mean reduction 36.5 μm, p=0.009) and remained below pre-operative values throughout the follow-up, showed a mean reduction of 79.4 μm at final follow-up (p<0.001). Conversely, PPCT showed no changes between pre-operative and post-operative values (all p>0.05). Nine eyes (21.4%) showed submacular dilated choroidal vessels, correlated with the presence of subretinal fluid (p=0.008) and reducing in caliber after surgical treatment. The 10 eyes (23.8%) with “advanced” disease had lower baseline SFCT and worse BCVA compared to the “early” subgroup, and showed a delayed reduction of choroidal swelling post-operatively. ConclusionSubfoveal choroid may thicken and remodel in response to ODP-M, eventually returning to physiological values after surgical treatment. Moreover, the presence of RPE atrophy may influence retino-choroidal balance. Conversely, PPCT didn't show comparable modifications.

Macular, Choroidal, and Peripapillary Perfusion Changes in Mild and Moderate Traumatic Brain Injury Using Optical Coherence Tomography and Angiography

Macular, Choroidal, and Peripapillary Perfusion Changes in Mild and Moderate Traumatic Brain Injury Using Optical Coherence Tomography and Angiography

Short-term choroidal changes as early indicators for future myopic shift in primary school children: results of a 2-year cohort study

BackgroundTo assess predictive value of short-term choroidal changes for future myopic shift in children.Methods577 eyes of 289 primary school children were prospectively followed for 2 years. Cycloplegic refractions at baseline,...

VEGFA may be a potential marker of myopic choroidal thickness and vascular density changes

To evaluate the changes of choroidal thickness (CT) and blood flow related to myopia, and its effects of vascular endothelial growth factor (VEGFA) on choroidal vessels in myopia. Subjects were included and divided into emmetropia (EM), non-high myopia (Non-HM) and high myopia (HM) groups. we measured choroidal thickness (CT), choriocapillaris vessel density (VD), and VEGFA content in tears in humans (137 subjects for CT, VD and 84 for tear) and detected the role of VEGFA in the choroid in form-deprivation myopia (FDM) in guinea pigs. Twenty-four guinea pigs were divided into control and FDM groups, and the expression changes of choroidal vessels and VEGFA were observed and compared using immunohistochemistry and Western blotting. Twenty-one guinea pigs were divided into control, FDM + Vehicle and FDM + Conbercept groups. The changes of diopter, axis length and choroidal vessels after intravitreal injection of Conbercept were observed. There were significant differences in CT and VD among the three groups (p < 0.05). VEGFA levels in tears were significantly lower in the myopic groups, with a decreasing trend from EM to Non-HM to HM. The choroidal vascular area fraction of FDM decreased compared to the control group. FDM guinea pigs exhibited reduced choroidal vasculature and significant downregulation of VEGFA expression. Following intravitreal injection of conbercept, the FDM + Conbercept group showed greater myopia, longer axial length, and lower choroidal vascular area fraction compared to the control group. VEGFA may participate in the regulation of choroidal blood vessels and blood flow in the progression of myopia. The reduction in VEGFA may accelerates the progression of myopia.

Incidence and prognosis of taxane-induced macular edema: a retrospective study from the Japan Clinical REtina Study Group (J-CREST)

Macular edema is a known side effect of taxane-based anticancer drugs. We retrospectively investigated data from 11 centers between January 2016 and December 2021. Among 14,260 patients, 30 (0.21%) developed macular edema; from these, the number of cases associated with nab-paclitaxel was 16 (0.43%), significantly higher than the number of cases associated with paclitaxel or docetaxel (P < 0.01). Visual acuity (VA) and retinal choroidal change were examined in 27 patients, with a follow-up of at least 3 months. The patients’ mean age was 67.2 years; 14 (51.3%) were male and four (14.8%) had unilateral onset. The mean interval between anticancer drug initiation and the first ophthalmology visit was 290.1 days. Among the 20 patients who discontinued anticancer drugs, VA and edema significantly improved 2 months after discontinuation (LogMAR VA: 0.50 vs. 0.28, central retinal thickness: 472.7 µm vs. 282.5 µm, both P < 0.01). No significant changes were observed in the central choroidal thickness. A correlation was found between duration of taxane treatment and VA immediately before discontinuation of anticancer drugs (β = 0.00050; 95% confidence interval: 0.00036–0.00097; P < 0.05). Although taxane-induced macular edema is reversible, slower anticancer drug discontinuation worsened VA, highlighting the need for regular ophthalmologic evaluation during treatments.

Choroidal and retinal exudative changes following extensive endolaser pan retinal photocoagulation

BackgroundIn this report, we describe a case of proliferative diabetic retinopathy that developed into exudative changes confusing with central serous chorioretinopathy (CSCR) following extensive endolaser pan retinal photocoagulation.Case descriptionA 49-year-old male patient with diabetic retinopathy in both eyes presented with vitreous hemorrhage and 6/60 visual acuity in his left eye. Optical coherence tomography (OCT) scans at presentation revealed serous PEDs in both eyes. On day 10 after vitreoretinal surgery and complete peripheral endolaser PRP for the left eye, there was serous retinal detachment (SRD) and an increase in PED heights, mimicking CSCR. No additional treatment was considered. At the three-week post-operative visit, OCT scans revealed that the SRD had resolved and the PED heights had decreased without rupture. At the final follow-up visit, 12 weeks after surgery, the SRD had not recurred, and the PEDs had stabilized. Despite no additional ocular therapy for the right eye, the serous PED height had decreased. The choroidal thickness (CT) at the fovea at various points during the follow-up visits revealed a reduction in both eyes.ConclusionThis case demonstrated the course of SRD, PED, and CT following extensive PRP. These changes may be associated with intraocular VEGF changes. In the presence of SRD and serous PED, the PED morphology may help differentiate the condition from CSCR. Although caution should be exercised when performing PRP during surgery or as an outpatient procedure, the SRD usually resolves without problem.

Association of choroidal thickness and blood flow features with asymmetric axial lengths in children with unilateral myopic anisometropia

BackgroundConsidering that changes in the choroidal thickness are closely related to ocular growth, we studied the choroidal thickness (CT) and the blood flow features in children with unilateral myopic anisometropia (UMA) as well as investigating the relationship between choroidal changes and myopia.MethodsSubjective refractive, axial length (AL), and biometric parameters were measured in 98 UMA children (age: 8–15 years). CT and choroidal blood-flow features, including the choroidal vessel volume (CVV), choroidal vascularity index (CVI), and choriocapillaris perfusion area (CCPA), were measured through swept-source optical coherence tomography angiography. The macular region was categorized into four concentric circles of diameters 0–1 mm (central fovea), 1–3 mm (parafovea), 3–6 mm (perifovea), and 6–9 mm (extended), and further categorized into superior (S), inferior (I), temporal (T), and nasal (N) quadrants.ResultsThe aforementioned four regions of myopic eyes displayed significantly lower CT, CVV, and CVI than those of non-myopic eyes. CCPA changes differed across different regions of both the eyes (parts of N and T quadrants). There was an inverse association between CT and the interocular AL difference (central and other regions S, T quadrant). No correlation was noted between CVV and CVI with interocular AL difference. CT and CVV were positively correlated in the 0–6-mm macular region of myopic eyes (Spearman correlation coefficient = 0.763, P < 0.001).ConclusionsIn UMA children, CCT and blood flow may be related to myopia progression. A robust correlation between CT and CVV in the 0–6-mm macular region and reduced CT and diminished blood flow indicated an association with myopia.

Choroidal vascular changes in early-stage myopic maculopathy from deep learning choroidal analysis: a hospital-based SS-OCT study

BackgroundThe objective of this study is to illustrate the changes in the choroidal vasculature in individuals with diffuse chorioretinal atrophy (DCA, early-stage myopic maculopathy) and investigate the association between them.MethodsThis study included 1418 highly myopic eyes from 720 participants aged 18 − 60 years from the Wenzhou High Myopia Cohort Study. These participants underwent comprehensive ophthalmic assessments. Myopic maculopathy classification followed the Meta-PM system, with pathological myopia defined as myopic maculopathy of DCA or severer. Eyes with myopic maculopathy categorized as no macular lesions (C0), tessellated fundus (C1), and DCA (C2) were enrolled in the analysis. Choroidal images were obtained from swept-source optical coherence tomography (SS-OCT), and the images were processed with a deep learning-based automatic segmentation algorithm and the Niblack auto-local threshold algorithm.ResultsDCA was detected in 247 eyes (17.4%). In comparison to eyes with C0, those with C2 exhibited significant reductions in choroidal thickness (ChT), luminal area (LA), and stromal area (SA) across all evaluated regions (all P < 0.001). An increase in choroidal vascular index (CVI) was observed in all regions, except for the nasal perifoveal (N2) and inferior perifoveal (I2) regions (all P < 0.01). Multivariable logistic regression analysis revealed a negative association between the presence of DCA and increases in choroidal LA and SA (odds ratio ≤ 0.099, P < 0.001). Multivariable linear regression analysis showed that the mean deviation of the visual field test was positively associated with LA and SA at the vertical meridian (B = 1.512, P < 0.001 for LA; B = 1.956, P < 0.001 for SA). Furthermore, the receiver operating characteristic curve analyses showed the optimal ChT to diagnose pathological myopia was 82.4 µm in the N2 region, the LA was 0.076 mm2 and the SA was 0.049 mm2, with area under the curves of 0.916, 0.908, and 0.895, respectively.ConclusionsThe results of this study indicated that both the presence of DCA and visual function impairment were associated with reductions in choroidal perfusion and stromal components. Moreover, we established threshold values for choroidal parameters in diagnosing pathological myopia, offering valuable references for clinical diagnosis and management.

Choroidal Changes During and After Discontinuing Long-Term 0.01% Atropine Treatment for Myopia Control.

Few studies have explored choroidal changes after cessation of myopia control. This study evaluated the choroidal thickness (ChT) and choroidal vascularity index (CVI) during and after discontinuing long-term low-concentration atropine eye drops use for myopia control. Children with progressive myopia (6-16years; n = 153) were randomized to receive 0.01% atropine eye drops or a placebo (2:1 ratio) instilled daily over 2years, followed by a 1-year washout (no eye drop use). Optical coherence tomography imaging of the choroid was conducted at the baseline, 2-year (end of treatment phase), and 3-year (end of washout phase) visits. The main outcome measure was the subfoveal ChT. Secondary measures include the CVI. During the treatment phase, the subfoveal choroids in both treatment and control groups thickened by 12-14 µm (group difference P = 0.56). During the washout phase, the subfoveal choroids in the placebo group continued to thicken by 6.6 µm (95% confidence interval [CI] = 1.7 to 11.6), but those in the atropine group did not change (estimate = -0.04 µm; 95% CI = -3.2 to 3.1). Participants with good axial eye growth control had greater choroidal thickening than the fast-progressors during the treatment phase regardless of the treatment group (P < 0.001), but choroidal thickening in the atropine group's fast-progressors was not sustained after stopping eye drops. CVI decreased in both groups during the treatment phase, but increased in the placebo group after treatment cessation. On average, compared to placebo, 0.01% atropine eye drop treatment did not cause a differential rate of change in ChT during treatment, but abrupt cessation of long-term 0.01% atropine eye drops may disrupt normal choroidal thickening in children.

Influence of Carotid Artery Stenting on the Retina and Choroid.

The effect of carotid artery stenting in patients with unilateral carotid artery stenosis on the retina and choroid was evaluated using swept-source optical coherence tomography angiography (SS-OCTA). SS-OCTA examination was conducted before stenting and 4days and 3months after stenting. The retinal nerve fiber layer, ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, superficial vascular complex (SVC), deep vascular complex (DVC), choroidal vascular volume (CVV), and choroidal vascular index were measured. Repeated-measures analysis of variance was performed to assess the impact of carotid artery stenting on optical coherence tomography angiography (OCTA) metrics. At baseline, 303 eyes from 160 patients (61.82 ± 9.98years; 85.29% males) were enrolled. SVC and DVC densities and CVV were lower in ipsilateral eyes (stenosed side) compared to contralateral eyes (all P < 0.05). Four days after stenting, a significant increase was seen in SVC density in ipsilateral eyes (P < 0.05) while a significant increase was seen in CVV in ipsilateral eyes and contralateral eyes (both P < 0.05). Three months after stenting (63 patients with 114 eyes), a significant decrease was seen in the GCIPL thickness of ipsilateral and contralateral eyes (all P < 0.001). Short term after carotid artery stenting, ipsilateral eyes showed a rapid and significant increase in SVC density and CVV. Optical coherence tomography (OCT)/OCTA measurements may have the potential to detect retinal and choroidal changes after stenting. Future research on the long-term effect of stenting on the retina and choroid will be guided by these findings.