Choroidal Structure Research Articles

Longitudinal changes in choroidal structures among children with low to moderate myopia under orthokeratology treatment.

To explore the longitudinal changes in choroidal features in myopic children with low to moderate myopia under orthokeratology (ortho-k) treatment. Children (n=80) aged 8-12years with spherical equivalent refraction of -1.00 to -6.00D were randomly assigned to the control (single vision spectacles) (n=40) and ortho-k (n=40) groups. OCT images were collected at the baseline, 1-, 6-, 12-, 18-, and 24-month visits. Choroidal structure parameters, including choroidal total area (TA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were calculated. Axial length (AL) was measured as the primary indicator for myopic progression. The analysis followed the intention-to-treat criteria. Compared to the control, ortho-k significantly improved the choroidal structures in choroidal TA and LA at all follow-up points (all P<0.05). Choroidal LA was the primary contributor to TA changes (85.8%[control], 91.4%[ortho-k]), with the most significant improvement within the first 6months. While, the changes in SA and CVI over time were not significantly different between the two groups (all P>0.05). Correlation matrices identified several noteworthy correlations between AL change and choroidal structure features. Further analysis showed a significant interaction effect between baseline choroidal LA and intervention type on subsequent AL change (P for interaction=0.005), suggesting that ortho-k might be more effective in children with larger baseline choroidal LA. This 2-year prospective study demonstrated that ortho-k can improve the choroidal structures, primarily manifested in choroidal LA, although this positive effect diminishes over time. Myopic children with larger baseline choroidal LA might benefit more from ortho-k.

Relationship between the morphology of the posterior pole of the eyeball and changes in choroidal structure and blood flow in myopia.

The eyeball axial length (AL) is an important biological indicator of myopia, which has been widely studied. However, little research has been conducted on the relationship between eye shape and fundus structural changes in myopia. This study aimed to analyze the relationship between the shape of the posterior pole of the eye, and choroidal characteristics by comparing with the relationship between AL and choroidal characteristics. And to investigate the clinical significance of the shape of the posterior pole in the pathophysiological changes related to myopia. In this study, the data of 147 eyes (22 emmetropic and 125 myopic) of participants aged 20-30 years, examined in 2021, were collected. Optical coherence tomography (OCT) was used to analyze the posterior-pole images, choroidal thickness (ChT), choroidal vascular volume (CVV), and three-dimensional choroidal vascular index (3DCVI). The least squares method was used to fit the ellipse that was most consistent with the actual shape of the posterior pole. Multiple stepwise regression analysis was used to investigate the relationships between the fitting posterior-pole vertex curvature (fPVC), and ChT, CVV, and 3DCVI. The mean AL of the participants was 25.15±1.35 mm (22.30-27.92 mm), the mean spherical equivalent was -3.59±2.62 D (+0.5 to -11.75 D), and the mean fPVC was 0.158±0.036 mm-1. The fPVC was positively correlated with the AL (r=0.639, P<0.001)and negatively correlated with the spherical equivalent (r=-0.666, P<0.001). The AL and fPVC were independently negatively correlated with the ChT and CVV in the macular region (0-6 mm). In the peripheral area (6-9 mm), the fPVC (ChT: β=-0.529, P<0.001; CVV: β=-0.441, P<0.001) was more closely associated with the ChT and CVV than the AL (ChT: β=-0.140, P=0.127; CVV: β=-0.127, P=0.190). The 3DCVI may be nonlinearly correlated with the AL and fPVC, and the relationship curve between the fPVC and 3DCVI was clearer than that between the AL and 3DCVI. In addition to the AL, the shape of the posterior pole is related to the ChT and choroidal vascular changes, and more closely related to the peripheral choroid than AL. Our findings provide another perspective for the prevention and monitoring of myopic-related pathological changes in clinical practice.

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,...

Evaluation of retinal and choroidal vascular structures in obsessive-compulsive disorder.

To evaluate the optical coherence tomography-angiography (OCT-A) findings and choroidal vascularity index (CVI) of patients followed with a diagnosis of obsessive-compulsive disorder (OCD) by comparing them with the healthy control group (HCG). This prospective study included 33 patients diagnosed with OCD and 32 HCG patients who followed up for at least 3 months. OCT-A images were obtained to evaluate the microvascular circulation, and enhanced HD line images were obtained for the CVI calculation of all patients. Statistical analysis results revealed that the rates of superficial vascular density in the fovea region and deep vascular density in the parafovea region decreased in the OCD group compared to the HCG group ( P = 0.003 and P = 0.010, respectively). Subfoveal choroidal thickness values of the OCD group were lower than those of the HCG group ( P = 0.008). While total choroidal area and lumen area values were lower in the OCD group than in the HCG group ( P < 0.001 and P < 0.001, respectively); CVI values were similar in both groups ( P = 0.436). The use of the OCT-A device, which is a non-invasive method for detecting retinal and choroidal changes in OCD cases, may provide insight into the pathogenesis of the disease.

How is the posterior ocular segment affected in cesarean section and normal vaginal delivery?

To evaluate the effects of normal vaginal delivery (NVD) and cesarean section (CS) on the retina, optic disc, and choroid in healthy pregnant women by using optical coherence tomography (OCT). This prospectively designed study included 60 healthy pregnant women, of whom 30 underwent NVD and 30 underwent CS. Ophthalmological examinations and OCT scans were performed on all pregnant women during the third trimester and the first postpartum week. The measurements were compared between the two visits within each group. Central retinal thickness, ganglion cell layer and inner plexiform layer (GCL + IPL) thickness, peripapillary retinal nerve fiber layer thickness, and optic disc morphology were determined using OCT scans. Central, nasal, and temporal choroidal thicknesses were manually measured using HD-line OCT. Choroidal vascular parameters were calculated from HD-line OCT scans by using a special image processing module. The ratio of the luminal choroidal area to the total choroidal area was determined as the choroidal vascular index (CVI). In the NVD group, the thinning in the mean and inferior pRNLF, the decrease in the rim area, and the increase in the mean cup/disc and cup volume at the first postpartum week were found to be statistically significant (P < 0.05). In the same group, the CVI was calculated as 0.69 ± 0.02 in the third trimester and 0.66 ± 0.03 in the first postpartum week (P = 0.001). In the CS group, except for the increase in the GCL + IPL thickness, no significant difference was detected in the measurements of the retina, optic disc, and choroid (P < 0.001 and P > 0.05). This is the first study to evaluate the effect of the delivery method on the retina, choroid, and optic disc. In NVD, changes in the choroidal vascular structure and optic disc morphology can be observed in the early postpartum period, which may be attributed to hormonal effects.

The effect of ocular dominance on choroidal structures

ABSTRACT This study aimed to compare the dominant and non-dominant eyes of healthy individuals in terms of CT and CVI values to assess the effect of ocular dominance on choroidal morphology. Three hundred eyes of 150 individuals were included in this study. All patients underwent routine ophthalmological examinations and hole-in-the-card tests to determine the dominant eye. EDI-OCT was used to obtain choroidal images. Choroidal thickness (CT) was measured at three points on the choroid including the subfoveal region (subfoveal choroidal thickness (SFCT)), 1500 μm nasal (NCT) and temporal (TCT) to the fovea. Choroidal vascularity index (CVI), total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured at fovea-centered choroidal area by image binarization via Image J software. While 93(%62) participants were right-eyed, 57(%38) participants were left-eyed. We could not detect any difference in SFCT, NCT, TCT, TCA, LA, SA, and CVI measurements between the dominant and the non-dominant eyes. (p > 0.05 for all). We could not detect any effect of ocular dominance on choroidal structures. These results also support the use of randomized ocular data regardless of which eye is dominant when investigating CVI and CT in scientific research.

Evaluation of retinal nerve fiber layer and choroidal structure in obese children and adolescents

Aim: Obesity-related vascular damage and endothelial dysfunction have deleterious effects on the ocular vasculature. It was aimed to examine optical coherence tomography (OCT) parameters in obese and overweight children and to define their relationship with metabolic markers in this study. Methods: The patient group consisted of 26 obese, 24 overweight patients aged between 8 and 18 years. The control group consisted of 25 healthy children with normal body mass index (BMI). This was a cross-sectional observational study. Serum glucose, lipid parameters, and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated. Measurement of choroidal thickness was performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA). Retinal nerve fiber layer (RNFL) thickness was determined by an automatic computer algorithm without the need for user measurement. Results: There were no differences in subfoveal, nasal, temporal choroidal thickness, and RNFL between obese, overweight, and control groups (p&gt;0.05). A positive (linear) moderate relationship was found between RNFL and the HOMA-IR of 26 patients in the obese group (r=0.389) (p=0.049). A positively weak correlation was found between height and RNFL in obese patient group (r=0.264, p=0.028). Conclusion: In the study, RNFL thickness increased as HOMA-IR level increased in obese children and adolescents. RNFL decreased as the height increased in obese children and adolescents. We believe that more comprehensive data about the effect of obesity on RNFL and choroidal thickness will be obtained with prospective studies in which the obese patient group with insulin resistance is taken separately and disease durations are defined, and long-term patient follow-up is performed.

Short-Term Effect of Stimulating the Pterygopalatine Ganglion Via Electroacupuncture on Choroidal Structure in Human Subjects.

Choroidal dysfunction is implicated in various ocular pathologies. The parasympathetic pterygopalatine ganglion (PPG) innervates orbital vessels supplying the choroid. While PPG stimulation has been shown to dilate cerebral blood flow, its effects on the choroid, particularly in human subjects, require further elucidation. This study aimed to investigate the short-term influence of PPG stimulation via electroacupuncture on choroidal structure. In this crossover study, 22 healthy adults received PPG electrical stimulation and sham stimulation for one session each on two separate days in a randomized order. Measurements including choroidal thickness (ChT), choroidal vascularity index (ChVI), central subfield thickness, axial length, anterior chamber depth, and lens thickness were recorded before and at intervals (0, 15, 30, 45, and 60minutes) postintervention. The ChT on the side receiving PPG stimulation demonstrated a sustained increase, peaking at 15minutes poststimulation (17.2µm, P < 0.001) and persisting for up to 60minutes. Conversely, the ChVI exhibited a more immediate response, with a peak increase immediately poststimulation (3.8%, P = 0.003), followed by a gradual return to baseline. ChT and ChVI in the contralateral eye showed a nonsignificant trend to decrease. Additionally, a notable reduction in ipsilateral axial length was observed at specific time points poststimulation. PPG activation via electroacupuncture elicited a short-term increase in ChT and ChVI in the ipsilateral eye compared to sham stimulation, with ChT increases trailing those of ChVI but displaying greater persistence. Electrical stimulation of the PPG can produce a short-term increase in ipsilateral ChT and ChVI.

In vivo volumetric analysis of retinal vascular hemodynamics in mice with spatio-temporal optical coherence tomography.

Microcirculation and neurovascular coupling are important parameters to study in neurological and neuro-ophthalmic conditions. As the retina shares many similarities with the cerebral cortex and is optically accessible, a special focus is directed to assessing the chorioretinal structure, microvasculature, and hemodynamics of mice, a vital animal model for vision and neuroscience research. We aim to introduce an optical imaging tool enabling in vivo volumetric mouse retinal monitoring of vascular hemodynamics with high temporal resolution. We translated the spatio-temporal optical coherence tomography (STOC-T) technique into the field of small animal imaging by designing a new optical system that could compensate for the mouse eye refractive error. We also developed post-processing algorithms, notably for the assessment of (i) localized hemodynamics from the analysis of pulse wave-induced Doppler artifact modulation and (ii) retinal tissue displacement from phase-sensitive measurements. We acquired high-quality, in vivo volumetric mouse retina images at a rate of 113Hz over a lateral field of view of . We presented high-resolution en face images of the retinal and choroidal structure and microvasculature from various layers, after digital aberration correction. We were able to measure the pulse wave velocity in capillaries of the outer plexiform layer with a mean speed of 0.35mm/s and identified venous and arterial pulsation frequency and phase delay. We quantified the modulation amplitudes of tissue displacement near major vessels (with peaks of 150nm), potentially carrying information about the biomechanical properties of the retinal layers involved. Last, we identified the delays between retinal displacements due to the passing of venous and arterial pulse waves. The developed STOC-T system provides insights into the hemodynamics of the mouse retina and choroid that could be beneficial in the study of neurovascular coupling and vasculature and flow speed anomalies in neurological and neuro-ophthalmic conditions.

Prediction of Axial Length From Macular Optical Coherence Tomography Using Deep Learning Model.

The purpose of this study was to develop a deep learning model for predicting the axial length (AL) of eyes using optical coherence tomography (OCT) images. We retrospectively included patients with AL measurements and OCT images taken within 3months. We utilized a 5-fold cross-validation with the ResNet-152 architecture, incorporating horizontal OCT images, vertical OCT images, and dual-input images. The mean absolute error (MAE), R-squared (R2), and the percentages of eyes within error ranges of ±1.0, ±2.0, and ±3.0mm were calculated. A total of 9064 eyes of 5349 patients (total image number of 18,128) were included. The average AL of the eyes was 24.35 ± 2.03 (range = 20.53-37.07). Utilizing horizontal and vertical OCT images as dual inputs, deep learning models predicted AL with MAE and R2 of 0.592mm and 0.847mm, respectively, in the internal test set (1824 eyes of 1070 patients). In the external test set (171 eyes of 123 patients), the deep learning models predicted AL with MAE and R2 of 0.556mm and 0.663mm, respectively. Regarding error margins of ±1.0, ±2.0, and ±3.0mm, the dual-input models showed accuracies of 83.50%, 98.14%, and 99.45%, respectively, in the internal test set, and 85.38%, 99.42%, and 100.00%, respectively, in the external test set. A deep learning-based model accurately predicts AL from OCT images. The dual-input model showed the best performance, demonstrating the potential of macular OCT images in AL prediction. The study provides new insights into the relationship between retinal and choroidal structures and AL elongation using artificial intelligence models.

Association of outer retinal and choroidal alterations with neuroimaging and clinical features in posterior cortical atrophy

BackgroundPosterior cortical atrophy (PCA) is a rare condition characterized by early-onset and progressive visual impairment. Individuals with PCA have relatively early-onset and progressive dementia, posing certain needs for early detection. Hence, this study aimed to investigate the association of alterations in outer retinal and choroidal structure and microvasculature with PCA neuroimaging and clinical features and the possible effects of apolipoprotein E(APOE) ε4 allele on outer retinal and choroidal alterations in participants with PCA, to detect potential ocular biomarkers for PCA screening.MethodsThis cross-sectional study included PCA and age- and sex-matched healthy control participants from June 2022 to December 2023. All participants with PCA completed a comprehensive neurological evaluation. All participants were recorded baseline information and underwent an ophthalmic evaluation. Quantitative analyses were performed using swept-source optical coherence tomography (SS-OCT) and angiography (SS-OCTA). Adaptive optics scanning laser ophthalmoscopy (AO-SLO) was performed in some patients. In participants with PCA, the influence of APOE ε4 on outer retinal and choroidal alterations and the correlation of outer retinal and choroidal alterations with PCA neuroimaging and clinical features in participants with PCA were investigated.ResultsA total of 28 participants (53 eyes) with PCA and 56 healthy control participants (112 eyes) were included in the current study. Compared with healthy control participants, participants with PCA had significantly reduced outer retinal thickness (ORT) (p < 0.001), choriocapillaris vessel density (VD) (p = 0.007), choroidal vascular index (CVI) (p = 0.005) and choroidal vascular volume (CVV) (p = 0.003). In participants with PCA, APOE ε4 carriers showed thinner ORT (p = 0.009), and increased choriocapillaris VD (p = 0.004) and CVI (p = 0.004). The PCA neuroimaging features were positively associated with the ORT, CVI and CVV. Furthermore, differential correlations were observed of PCA clinical features with the CRT, CVV and CVI.ConclusionsOur findings highlighted the association of outer retinal and choroidal alterations with PCA neuroimaging and clinical features in participants with PCA. Noninvasive SS-OCT and SS-OCTA can provide potential biomarkers for the diagnosis and management of PCA, improving awareness of PCA syndrome among ophthalmologists, neurologists, and primary care providers.

Subthreshold Micropulse Laser Versus Oral Spironolactone in Chronic Central Serous Chorioretinopathy: A Quasi-Randomized Controlled Trial.

To compare the efficacy and safety of subthreshold micropulse laser (SML) and spironolactone therapy for treating chronic central serous chorioretinopathy (CSC). This was a quasi-randomized controlled trial. Eligible patients were quasi-randomized at a 1:1 ratio to receive SML or oral spironolactone and were assessed at 3months after treatment. A total of 84 patients (90 eyes) were randomly assigned to receive SML (n = 45) or spironolactone (n = 39) initially. At last follow-up, 59.5% of patients in the SML group had complete resolution of subretinal fluid (SRF) compared to 43.6% in spironolactone group (P = 0.362). The mean visual acuity did not significantly improve between the two groups (0.38 ± 0.44 vs. 0.43 ± 0.43 logMAR). The central retinal thickness was decreased from 335.06 ± 120.25µm to 222.15 ± 94.90µm in the SML group and from 308.02 ± 90.69µm to 257.27 ± 102.28µm in the spironolactone group. After treatment, subfoveal choroidal thickness, total choroidal area, and stromal and luminal choroidal area were significantly lower in the spironolactone group as compared to the SML group. During the entire visit, the recurrence rate of SRF was 9.1% in the SML group compared to 35.3% in the spironolactone group. Slight adverse events occurred more frequently in the spironolactone group (0% vs. 16%). Both SML and oral spironolactone were effective and safe treatments to ameliorate retinal anatomical structures for chronic CSC. A lower recurrence rate and fewer adverse effects were observed in the SML group, and better choroidal structure recovery was seen in the spironolactone group. The investigation of SML and oral spironolactone may inform evidence-based clinical decisions for chronic CSC patients.

Choroidal Vascularity and Axial Length Elongation in Highly Myopic Children: A 2-Year Longitudinal Investigation.

To examine the influence of subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) on axial length (AL) elongation over a 2-year period in highly myopic children. In this is prospective, longitudinal, observational study, 163 participants (74%), who were 8 to 18years of age with bilateral high myopia (sphere ≤ -6.0 D) and without pathologic myopia, completed follow-up visits over 2years. All participants underwent baseline and follow-up ocular examinations, including swept-source optical coherence tomography (SS-OCT) and AL measurements. SFCT and CVI were derived from SS-OCT scans using a deep-learning-based program for choroidal structure assessment. The mean age of the participants at baseline was 15.0years (±2.3), with males constituting 47% of the cohort. An inverse relationship was observed between AL elongation and increases in baseline age, baseline SFCT, and CVI, as well as a decrease in baseline AL. Adjusting for other factors, every 10-µm increase in SFCT and each 1% increase in CVI were associated with decreases in AL elongation of 0.007mm (95% confidence interval [CI], -0.013 to -0.002; P = 0.011) and 0.010mm (95% CI, -0.019 to 0.000; P = 0.050), respectively. The incorporation of SFCT or CVI into predictive models improved discrimination over models using only age, gender, and baseline AL (both P < 0.05, likelihood ratio test). Our findings suggest a possible association between a thinner choroid and increased AL elongation over 2 years in children with high myopia, after adjusting for potential baseline risk factors such as age, gender, and initial AL.

Blood Glucose Levels Moderate the Associations Between IGF-1 Levels and Choroidal Metrics in Patients With Diabetes With Acromegaly Without Diabetic Retinopathy.

To examine the effects of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) on choroidal structures with different blood glucose levels in patients with diabetes mellitus (DM) with acromegaly without diabetic retinopathy. Eighty-eight eyes of 44 patients with acromegaly were divided into a nondiabetic group (23 patients, 46 eyes) and a diabetic group (21 patients, 42 eyes). Forty-four age- and sex-matched healthy controls and 21 patients with type 2 DM without diabetic retinopathy were also included. Linear regression models with a simple slope analysis were used to identify the correlation and interaction between endocrine parameters and choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascular index (CVI). Our study revealed significant increases in the ChT, LA, SA, and TCA in patients with acromegaly compared with healthy controls, with no difference in the CVI. Comparatively, patients with DM with acromegaly had greater ChT than matched patients with type 2 DM, with no significant differences in other choroidal parameters. The enhancement of SA, LA and TCA caused by an acromegalic status disappeared in patients with diabetic status, whereas ChT and CVI were not affected by the interaction. In the diabetic acromegaly, higher IGF-1 (P = 0.006) and GH levels (P = 0.049), longer DM duration (P = 0.007), lower blood glucose (P = 0.001), and the interaction between GH and blood glucose were associated independently with thicker ChT. Higher GH levels (P = 0.016, 0.004 and 0.007), longer DM duration (P = 0.022, 0.013 and 0.013), lower blood glucose (P = 0.034, 0.011 and 0.01), and the interaction of IGF-1 and blood glucose were associated independently with larger SA, LA, and TCA. As blood glucose levels increased, the positive correlation between serum GH level and ChT diminished, and became insignificant when blood glucose was more than 7.35 mM/L. The associations between serum IGF-1 levels and LA, SA, and TCA became increasingly negative, with LA, becoming significantly and negatively associated to the GH levels only when blood glucose levels were more than 8.59 mM/L. Acromegaly-related choroidal enhancements diminish in the presence of DM. In diabetic acromegaly, blood glucose levels are linked negatively with changes in choroidal metrics and their association with GH and IGF-1. We revealed the potential beneficial impacts of IGF-1 and GH on structural measures of the choroid in patients with DM at relatively well-controlled blood glucose level, which could provide a potential treatment target for diabetic retinopathy.

Investigation of choroidal structure changes after intravitreal anti-VEGF therapy for retinal vein occlusion

BackgroundWe aimed to investigate the effect of retinal vein occlusion (RVO) on the posterior segment structures of the eye and its changes with intravitreal anti-Vascular Endothelial Growth Factor (VEGF) treatment.MethodsThis prospective longitudinal study included 29 eyes of 29 patients with RVO (17 males and 12 females) followed for 6 months. The best corrected visual acuity (BCVA), macula, choroid ticknesses and choroidal vascularity index (CVI) obtained by spectral-domain optical coherence tomography were recorded at baseline and the first, third, and sixth months after the first injection. Results were compared with fellow eyes (non-affected eyes) and age- and sex-matched controls.ResultsBCVA increased significantly in the 6th month, more in the first month of injection (p < 0.05 for each). Central macular tickness, subfoveal choroid tickness, stromal and total area of choroid decreased significantly after injection (p < 0.05 for each). CVI values increased significantly, especially in the 1st month after injection (p < 0.05 for each). In eyes with Branch RVO, there was a significant decrease in the macular thickness of the occlusive areas with treatment, while there was no statistically significant change in the non-occlusive macular thickness.ConclusionObservation of changes in choroidal structure may be useful to assess the activity of RVO and predict the efficacy of anti-VEGF therapy.

Vascular changes of the peripapillary choroidal area in the thyroid orbitopathy.

The aim of this study was to investigate the peripapillary choroidal vascular changes in thyroid orbitopathy (TO). The study included 20 eyes of 10 patients with active TO (aTO), 30 eyes of 15 patients with inactive TO (inaTO) and 30 eyes of 30 healthy subjects. The peripapillary choroidal vascular change was assessed with peripapillary choroidal vascular index (pCVI), peripapillary choroidal luminal area (pLA), peripapillary choroidal stromal area (pSA), peripapillary total choroidal area (pTCA). Compared to the control group, there was a reduction in the nasal and temporal areas of pCVI in both the aTO and inaTO groups (aTO vs control: nasal p = 0.001 and temporal p = 0.004; inaTO vs control: nasal p = 0.007 and temporal p < 0.001), while the inferior area was lower only in the inaTO group (p = 0.001). Compared to the other groups, the inaTO group exhibited a decrease pSA (vs aTO: total p = 0.004, inferior p = 0.02 and vs control: total p = 0.01, inferior p = 0.03), pLA (vs aTO: total p = 0.02, inferior p = 0.02, temporal p < 0.001 and vs control: total p = 0.002, inferior p < 0.001, temporal p < 0.001) and pTCA (vs aTO: total p = 0.009, inferior p = 0.01, temporal p < 0.001 and vs control: total p = 0.003, inferior p = 0.001, temporal p < 0.001). The horizontal area (nasal and temporal area) of the peripapillary choroidal vascular structure may be more sensitive than the vertical area in TO patients. The first affected quadrant of RPC-VD in the active TO may be the inferior quadrant. Structural or vascular choroidal changes may occur during the chronic or post-active phase of the disease.

Comparison of choroidal thickness, superficial and deep retinal vascular indices, and foveal avascular zones: Martial arts athletes vs healthy non-athletes

AimThe study aims to compare choroidal thickness, deep and superficial retinal capillary plexuses, and foveal avascular zone (FAZ) parameters in elite martial arts athletes and a healthy sedentary control group. MethodsThe study included martial arts athletes (32 individuals, 64 eyes) and healthy sedentary persons (43 individuals with healthy sedentary lifestyles, 86 eyes) aged 18–35 years. In this single non-repeated observational and cross-sectional study, choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ measurements were measured using Swept-source optical coherence tomography angiography (SS-OCTA) and compared between groups. ResultsNo statistically significant differences were found (p > 0.05) in age, IOP, AL (axial length), and best-corrected visual acuity (BCVA) parameters between groups. There were no statistically significant differences between the groups in choroidal thickness, superficial and deep retinal capillary plexuses, and FAZ parameters determined by the OCTA method (p > 0.05). ConclusionIn our study, we observed that the retinal and choroidal structures of martial art athletes and healthy sedentary individuals were similar. This observation implies that the putative microvascular effects on the choroid and retina in martial arts, especially those based on the anaerobic energy system, may reflect similar outcomes to those observed in individuals with sedentary lifestyles characterized by healthiness.

Swept-source optical coherence tomography and swept-source optical coherence tomography angiography findings in circumscribed choroidal hemangioma before and after transpupillary thermotherapy

PurposeTo investigate the swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA) findings in circumscribed choroidal hemangioma (CCH) before and after treatment with transpupillary thermotherapy (TTT).MethodsThe clinical records of 21 eyes having CCH imaged with SS-OCT/SS-OCTA between September 2018 and December 2022 were evaluated.ResultsSS-OCT examination in CCH showed dome-shaped appearance (100%), choroidal shadowing (100%), expansion of choroidal structures (100%), subretinal fluid (66.7%), intraretinal edema/schisis (33.3%), retinal pigment epithelium (RPE) atrophy (19.0%), hyperreflective dots (19.0%), and epiretinal membrane (4.8%). Internal arborizing tumor vessels showing hyperreflectivity were observed in the choriocapillaris slab on SS-OCTA in all eyes. In the deep capillary plexus (DCP), flow void changes were seen in 7 eyes with intraretinal schisis/cystoid macular edema. Four CCHs > 2 mm in thickness showed outer retinal involvement due to unmasking of flow in intratumoral vessels related to RPE atrophy. Following TTT/indocyanine green-enhanced TTT (ICG-TTT) of CCH, SS-OCT findings included total/partial resolution of subretinal fluid (57.1%), complete/partial regression of the tumor (52.4%), and RPE atrophy (33.3%). After treatment; loss of choriocapillaris, decrease in tumor vascularity together with increase in the fibrous component and flow void areas were detected on SS-OCTA.ConclusionsSS-OCT/SS-OCTA are useful non-invasive tools for imaging the structural/vascular changes in CCHs managed with TTT or ICG-TTT. On SS-OCTA, hyporeflective spaces localizing to edema/schisis in the DCP and arborizing tumor vessels within a hyporeflective stromal background in the choriocapillaris slab were observed. After TTT/ICG-TTT, a decrease in tumor vessels and an increase in the fibrous component and flow-void areas inside the CCH were detected on SS-OCTA.

Observation of structural and vascular features of retina and choroid in myopia using ultra-widefield SS-OCTA

BackgroundTo find the relationship between the changes of retinal and choriodal structure/ vascular densities (VD) and the myopia progress.Methods126 eyes of 126 age-matched young participants were divided into three groups: Emmetropia and Low Myopia (EaLM) (33 eyes), Moderate Myopia (MM) (39 eyes), and High Myopia (HM) (54 eyes). Fundus images measuring 12 × 12 mm were captured using ultra-widefield swept-source optical coherence tomography angiography (SS-OCTA). Each image was uniformly divided into nine regions: supra-temporal (ST), temporal (T), infra-temporal (IT), superior (S), central macular area (C), inferior (I), supra-nasal (SN), nasal (N), and infra-nasal (IN). Various structural parameters, including inner retina thickness (IRT), outer retina thickness (ORT), and choroid thickness (CT), were assessed, and the VD of the superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaries (CC), and choroid vessels (ChdV) were quantified.ResultsCT in upper fundus exhibited a significant reduction from EaLM to MM. Additionally, ORT (ST, S. SN, C, N, IT, I, IN), CT (ST, S, SN, T, C, N, IT, I, IN) and VDs of SCP (ST, S, C, I, IN), DCP (ST, S, T, C, I) and ChdV (T, N, I, IN) were statistically diminished in EaLM compared to HM. Furthermore, IRT (N), ORT (N, IN), CT (S, SN, T, C, IT, I) and VDs of SCP (I, IN) and DCP (I) exhibited significant decreases as MM progressed towards HM. Intriguingly, there was a notable increase in the VD of CC (ST, S, T, C, N) as myopia progressed from MM to HM.ConclusionSignificant changes in retinal and choroid structure and vascular density occur as moderate myopia advances to high myopia. Efforts to curb myopia progression to this stage are essential, as the failure to do so may lead to the development of corresponding retinopathy.

Unveiling Key Pathological Indicators for Disease Progression in Vogt Koyanagi Harada Disease and Sympathetic Ophthalmia Through Advanced Choroidal Volume Analysis

ABSTRACT Purpose To evaluate the association between quantitative parameters derived from volume analysis of optical coherence tomography (OCT) data and disease worsening in Vogt-Koyanagi-Harada disease (VKHD) and sympathetic ophthalmia (SO). Methods This retrospective study, conducted at Osaka University Hospital, employed swept-source OCT scans from patients diagnosed with VKHD or SO between October 2012 and January 2021. The choroidal vessel structure was segmented and visualized in three dimensions, generating quantitative vessel volume maps. Region-specific choroidal vessel volume (CVV), choroidal volume (CV), and vessel index (VI) were scrutinized for their potential correlation with disease severity. Results Thirty-five eyes of 18 VKHD and 2 SO patient (8 females, 10 males) were evaluated. OCT-derived CVV maps revealed regional CV alterations in VKHD and SO patients. Two parameters, i.e. CV at 3- and 6-month follow-ups (p = 0.044, p = 0.040, respectively, with area under the ROC curve of 0.70) and CVV at 6 months (p = 0.046, area under the ROC curve of 0.71), were significantly higher in recurrent VKHD and SO compared to effectively treated cases. Conclusions The volume analysis of OCT images facilitates a three-dimensional visualization of choroidal alterations, which may serve as a reflection of disease severity in VKHD and SO patients. Furthermore, noninvasive initial CVV or CV measurements may serve as potential biomarkers for predicting disease recurrence in VKHD and SO.