Choroidal Thickness Research Articles

Comparison of macular changes and visual outcomes between femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery for high myopic cataract patients

BackgroundTo evaluate differences in log MAR best-corrected visual acuity (BCVA) improvement and postoperative central foveal thickness (CFT) and choroidal thickness (CT) changes between conventional phacoemulsification surgery (CPS) and femtosecond laser-assisted cataract surgery (FLACS) for high-myopia cataracts.MethodsThis was a retrospective and observational study. One hundred and two eyes of 102 patients with high-myopia cataracts were examined. CPS was performed in 54 eyes, and FLACS was performed in 48 eyes. All eyes underwent logMAR BCVA, CFT and CT of three different sectors preoperatively and one week and six months postoperatively.ResultsThe logMAR BCVA improved significantly after surgery in both groups (both P < 0.001), but no difference was observed in BCVA improvement between the groups (P = 0.554). Moreover, no significant differences were reflected in the changes in CFT, nasal 1 mm CT or temporal 1 mm CT between the two groups, and only subfoveal choroidal thickness (SFCT) in the CPS group decreased significantly compared with that in the FLACS group at any postoperative time (P = 0.003 and 0.026). AL, preoperative logMAR BCVA, and CT of the three regions exhibited a notable correlation with postoperative BCVA (all P < 0.05) according to univariate logistic regression analysis. However, only the AL, preoperative logMAR BCVA and SFCT remained significant in the multivariate model. Postoperative logMAR BCVA revealed a positive correlation with AL and preoperative logMAR BCVA but a negative correlation with SFCT.ConclusionsFLACS was not superior to CPS in improving BCVA but had less impact on SFCT in the treatment of high-myopia cataracts. Eyes with a longer AL, worse preoperative logMAR BCVA and thinner SFCT had a high risk of worse postoperative BCVA.

Choroidal thickness in juvenile open angle glaucoma: insights from a south asian case-control study.

The purpose of this study is to compare choroidal thickness in juvenile open angle glaucoma (JOAG) and healthy controls using spectral domain optical coherence tomography (SD-OCT) and study its correlations. In this case-control study, 56 eyes of 28 JOAG patients and an equal number of controls were recruited. SD-OCT was used to measure the choroidal thickness (ChT), in the macular region at 5 locations: subfoveal, 1500µm and 3000µm nasal and temporal to the foveal center, and in the peripapillary region at 6 locations: up to 1500µm, nasal and temporal to the disc, respectively. The ChT and its correlations with age, intraocular pressure, cup-to-disc ratio, central corneal thickness, mean deviation, and axial length were studied. The average macular ChT in JOAG was 306.30 ± 56.49µm vs. 277.12 ± 64.68µm in controls. The average peripapillary ChT in JOAG was 197.79 ± 44.05µm vs. 187.24 ± 38.89µm in controls. The average total ChT (p = 0.042), the average macular ChT (p = 0.022), the subfoveal ChT (p = 0.022), the ChT 1500µm (p < 0.001), and 3000µm temporal to the fovea (p = 0.002) were significantly thicker in the JOAG group. In the JOAG group, the average macular ChT had a significant negative correlation with age, whereas axial length was positively correlated with the average peripapillary ChT. In this South Asian cohort of JOAG, the average total ChT, average macular ChT, subfoveal ChT, and ChT at 1500µm, and 3000µm temporal to the fovea were significantly thicker when compared to healthy controls.

Correlation between vessel density and thickness in the retina and choroid of severe non-proliferative diabetic retinopathy patients.

To explore the correlation between the vessel density (VD) of the retina and choroid vascular plexuses and the thicknesses of their respective retinal layers and choroid membranes in participants with severe non-proliferative diabetic retinopathy (NPDR). We retrospectively analyzed the data of 42 eyes of 42 participants with diabetes mellitus (DM) and severe NPDR. In addition, 41 eyes of 41 healthy controls were evaluated. Measurements were taken for both groups using optical coherence tomography angiography (OCTA), including the area and perimeter of the foveal vascular zone (FAZ) and the vascular density (VD) in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choroid capillary (CC). These measurements were compared with the retinal thickness (RT) of the inner/intermediate retinal layers and choroidal thickness (CT). The study evaluated the correlation between RT or CT and VD in the respective vascular networks, namely superficial capillary plexus (SCP), deep capillary plexus (DCP), or CC. The inner RT and VD in all plexuses were significantly lower in the severe NPDR group than in the healthy controls. Furthermore, the FAZ area and perimeter were larger in the severe NPDR group. Inner RT was correlated with VD in the SCP group (r=0.67 and r=0.71 in the healthy control and severe NPDR groups, respectively; p<0.05). CT negatively correlated with VD in the CC (r=-0.697 and r=-0.759 in the healthy control and severe NPDR groups, respectively; p<0.05). Intermediate RT significantly correlated with VD in the DCP of the severe NPDR group (r=-0.55, p<0.05), but not in the healthy control group. Retinal or choroidal thickness strongly correlated with VD. Therefore, patients with severe NPDR must consider the distinct anatomical and functional entities of the various retinal layers and the choroid.

Assessing Choroidal Thickness in Pediatric Patients With Unilateral Strabismic Amblyopia by Using Spectral Domain-Enhanced Depth Imaging-Optical Coherence Tomography.

Objective In this study, we aimed to evaluate the choroidal thickness in patients with unilateral strabismic amblyopia by usingspectral domain-enhanced depth imaging-optical coherence tomography (SD-EDI-OCT) (Heidelberg EngineeringGmbH, Heidelberg, Germany). Methods Twenty-five children with strabismic amblyopia and 20 age- and sex-matched healthy controls were included in this study. Seven sections were obtained, each comprising 25 repetitive images from each section at 200-micron intervals, and measurements were taken from nine different points at vertical and horizontal lines (1 and 3 mm from the subfoveal, superior, inferior, temporal, and nasal regions), centered on the fovea, using SD-EDI-OCT. Choroidal thickness values were obtained by measuring the distance between the basal border of the retinal pigment epithelium and the choroidoscleral border. The Mann-Whitney U test was used to compare choroidal thickness between the amblyopic and the control groups. Results The mean ageof children with amblyopia and that of controls were 8.4 ±2.7 and 9.9 ±3.3 years, respectively (p=0.120). The mean subfoveal choroidal thickness was 372.8 ±78.9 μm in amblyopic eyes and 372.4 ±79.3 μm in the fellow eyes, both of which were thicker than the control eyes (310.9 ±76.3 μm;p<0.05 for each). Similarly, the mean values for the choroidal thickness of the amblyopic children at 1 mm nasal (320 ±86 μm), 1 mm superior (363 ±70 μm), and 3 mm superior (336 ±62 μm) were also significantly thicker than those of the corresponding control eyes (p<0.05 for each). There was a negative correlation between the subfoveal choroidal thickness and axial length (r=-0.332, p=0.005). There were no correlations between the choroidal thickness, age, and visual acuity. Conclusions The choroidal thicknesses of strabismic and fellow eyes were similar in patients with strabismic amblyopia. However, the choroidal thickness of both eyes in strabismic children was significantly thicker than those of the healthy controls. Emmetropization may be defective in both eyes of strabismic amblyopic patients.

Choroidal thickness and retinal vascular changes in patients with lichen planus: an inflammatory disease beyond the skin.

Lichen planus (LP) is a common inflammatory condition of unknown etiology that commonly affects the skin and mucous membranes. Optical coherence tomography angiography (OCTA) is a noninvasive technique for identifying early retinal vascular impairment in systemic disease without clinical damage by imaging deep and superficial capillary networks. To assess the impacts of LP on the choroid and assess vascular changes in retinal capillary density using OCTA. This single-center prospective case-control study included 30 therapeutic-naïve LP patients and 30 age and sex-matched healthy individuals. All study subjects underwent a complete ophthalmological examination, including best-corrected visual acuity (BCVA) measurement using a Snellen chart, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement, and fundus examination. They were then examined using spectral domain OCT and choroidal thickness was measured. The vessel density of the superficial and deep capillary networks was measured and assessed using OCTA. Patients had significantly thicker choroidal and retinal thickness than controls, with subfoveal, nasal, and temporal areas showing a significant difference. A significantly higher vascular density in the superficial capillary plexus, particularly in the nasal perifoveal area, was found compared to the control group. Significantly, higher vascular density in the deep capillary plexus in the parafoveal area compared to controls was reported. Significant correlations were found between visual acuity and IOP, and age, duration of disease, and severity of disease. This study is the first to reveal that LP patients exhibit choroidal changes and retinal vascular alterations compared to healthy controls.

Myopia Is an Ischemic Eye Condition: A Review from the Perspective of Choroidal Blood Flow.

Myopia is a common refractive error that affects a large proportion of the population. Recent studies have revealed that alterations in choroidal thickness (ChT) and choroidal blood flow (ChBF) play important roles in the progression of myopia. Reduced ChBF could affect scleral cellular matrix remodeling, which leads to axial elongation and further myopia progression. As ChT and ChBF could be used as potential biomarkers for the progression of myopia, several recent myopia treatments have targeted alterations in ChT and ChBF. Our review provides a comprehensive overview of the recent literature review on the relationship between ChBF and myopia. We also highlight the importance of ChT and ChBF in the progression of myopia and the potential of ChT as an important biomarker for myopia progression. This summary has significant implications for the development of novel strategies for preventing and treating myopia.

Differences in imaging biomarkers between patients with intermediate and advanced non-neovascular age-related macular degeneration (AMD) in the University of Colorado AMD registry.

To quantify and compare the different prevalence rates of specific retinal imaging biomarkers in patients with intermediate AMD (iAMD) and advanced non-neovascular AMD (nnAMD). Cross-sectional study of patients with iAMD and advanced nnAMD. Imaging studies were reviewed for qualitative imaging biomarkers. Choroidal thickness measurements were obtained subfoveally and in 1000 um and 2000 um intervals away from the fovea. The Chi-squared test and Fisher's exact test were used to compare rates of imaging biomarkers among the two cohorts. P-value of <0.05 was considered significant. 376 eyes of 197 patients with iAMD and 187 eyes of 97 patients with advanced nnAMD were recruited. There were significantly lower rates of the following imaging biomarkers in the iAMD compared with the advanced nnAMD cohorts: soft drusen (66.0% vs. 84.2%, p = 0.001), calcified drusen (4.3% vs. 40.0%, p < 0.0001), RPD (26.2% vs. 53.3%, p < 0.0001), ORT (0.5% vs. 46.9%, p < 0.0001), RP (1.1% vs. 46.3%, p < 0.0001), pigment migration (53.2% vs. 100%, p < 0.0001), and iRORA (17.9% vs. 80.2%, p < 0.0001). In the iAMD cohort, choroidal thickness was significantly greater at 188 µm (SD: 60) and 194 µm (SD: 69), compared to the advanced nnAMD with measurements of 153 µm (SD: 68), and 161 µm (SD: 76). This difference was statistically significant (p < 0.0001 and p = 0.0002). Our results highlight significant differences in imaging biomarkers between both cohorts. Key biomarkers, such as iRORA, RPD, pigment migration, and thinner choroidal thickness, were associated with advanced nnAMD. Identifying these biomarkers early may help target patients who could benefit from new treatments, potentially delaying vision loss.

Three-year outcome of photodynamic therapy combined with VEGF inhibitor for pachychoroid neovasculopathy.

Long-term results of photodynamic therapy (PDT) combined with vascular endothelial growth factor (VEGF) inhibitors for pachychoroid neovasculopathy (PNV) are not yet clear. This study is a retrospective, observational case series. We retrospectively examined untreated PNV cases (22 cases, 22 eyes, mean age of 71.0years) who underwent PDT therapy in combination with VEGF inhibitors followed by additional treatments with pro re nata protocol. Visual acuity, number of treatments, and time to recurrence were examined. In addition, foveal choroidal thickness and choroidal vascularity index (CVI) were evaluated in 13 of 22 patients who were followed up with SpectralisOCTR from baseline. Fifteen (68%) cases had polyps at baseline. LogMAR visual acuity averaged 0.24 ± 0.20 (range, - 0.079 to 0.82) at baseline and significantly improved after 1, 2, and 3years (p = 0. 004, 0.0003, 0.002, respectively). Fourteen patients (64%) recurred, with an average time to recurrence of 1.8 ± 0.9years. Foveal choroidal thickness decreased significantly after 1year (average from 326μm to 263μm) and remained unchanged up to 3years (255μm). CVI also decreased after 1year (average from 0.62 to 0.61) and remained unchanged until 3years later (0.60). We examined the 3-year course of PDT in combination with the VEGF inhibitor for untreated PNV. Visual acuity was improved, foveal choroidal thickness and CVI were decreased after 3years.

High correlated color temperature artificial lighting impairs retinal pigment epithelium integrity and chloride ion transport: A potential mechanism for choroidal thinning

Among the environmental factors contributing to myopia, the role of correlated color temperature (CCT) of ambient light emerges as a key element warranting in-depth investigation. The choroid, a highly vascularized and dynamic structure, often undergoes thinning during the progression of myopia, though the precise mechanism remains elusive. The retinal pigment epithelium (RPE), the outermost layer of the retina, plays a pivotal role in regulating the transport of ion and fluid between the subretinal space and the choroid. A hypothesis suggests that variations in choroidal thickness (ChT) may be modulated by transepithelial fluid movement across the RPE. Our experimental results demonstrate that high CCT illumination significantly compromised the integrity of tight junctions in the RPE and disrupted chloride ion transport. This functional impairment of the RPE may lead to a reduction in fluid transfer across the RPE, consequently resulting in choroidal thinning and potentially accelerating axial elongation. Our findings provide support for the crucial role of the RPE in regulating ChT. Furthermore, we emphasize the potential hazards posed by high CCT artificial illumination on the RPE, the choroid, and refractive development, underscoring the importance of developing eye-friendly artificial light sources to aid in the prevention and control of myopia.

Clinical and Transcriptional Profiles Reveal the Treatment Effect of Adalimumab in Patients with Initial-Onset and Recurrent Vogt–Koyanagi–Harada Disease

ABSTRACT Purpose We aimed to evaluate adalimumab efficacy in patients with initial-onset or recurrent Vogt–Koyanagi–Harada (VKH) syndrome. Methods A retrospective clinical study was performed to examine the therapeutic effect of adalimumab in 22 VKH patients,16 with initial-onset and six with recurrent VKH. Another 22 patients with initial-onset VKH who did not receive adalimumab were included as controls. The main observational parameters included the central macular thickness (CMT), subfoveal choroidal thickness (SCT), best-corrected visual acuity (BCVA), anterior chamber cell grade (ACC), glucocorticoid dose (GCD), and the development of sunset glow fundus. MRNA sequencing was used to profile the tumor necrosis factor (TNF)-α pathway in peripheral blood mononuclear cells obtained from nine patients with initial-onset VKH disease, six patients with recurrent VKH, and eight healthy controls. Results In the initial-onset group, adalimumab therapy significantly improved the BCVA, CMT, SCT, and ACC. Furthermore, adalimumab significantly decreased GCD in patients with initial-onset. In patients with recurrent VKH, the SCT significantly improved after adalimumab treatment, but no significant changes in BCVA, CMT, and ACC were observed. All six patients experienced relapse during follow-up. The TNF-α pathway exhibited a significant increase in initial-onset VKH when compared with that in both healthy controls and recurrent patients. Conversely, it was suppressed in recurrent VKH when compared with that in the initial-onset or healthy control groups. Conclusions In patients with initial-onset VKH, adalimumab effectively reduces glucocorticoid dependence. However, adalimumab may not be effective for preventing relapse or providing long-term inflammation relief in patients with recurrent VKH.

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.

Systemic Oxidative Stress Level as a Pathological and Prognostic Factor in Myopic Choroidal Neovascularization

PurposeTo investigate the association of oxidative stress level with myopic choroidal neovascularization (mCNV) and its clinical outcomes. DesignRetrospective case-control study. ParticipantsThis retrospective study included 52 eyes of 52 healthy participants (mean age 62.5 years), 30 eyes of 30 patients (mean age 59.6 years) with high myopia (HM) and no mCNV, and 23 eyes of 23 patients (mean age 61.8 years) with HM and mCNV who received intravitreal anti-vascular endothelial growth factor antibody injections (IVIs) with a pro re nata regimen for 6 months after an initial IVI. MethodsClinical findings, including oxidative stress parameters, such as diacron reactive oxygen metabolites (dROMs), biological antioxidant potential (BAP), and BAP/dROM ratio (B/d ratio), were analyzed. Main Outcome MeasuresClinical features and oxidative stress parameters. ResultsBoth BAP and B/d ratio were significantly lower in the HM/mCNV group than in the HM/no mCNV group (P=0.002 and P=0.012, respectively) or the control group (P=0.001 and P=0.026, respectively). In a multivariate logistic regression analysis (adjusted for age, gender, and axial length), B/d ratio (OR=0.47, P=0.026) was significantly associated with mCNV. Dividing the patients into high and low B/d ratio groups (with a cutoff of 5.2) showed that subfoveal choroidal thickness (SFCT) was lower (P=0.002) and the number of IVI treatments was higher (P=0.029) in eyes with a low B/d ratio than in eyes with a high B/d ratio. In a multiple regression analysis (adjusted for age, gender, and axial length), only B/d ratio was significantly associated with SFCT (β=0.68, P=0.006). ConclusionThe oxidative stress level in eyes with HM differed according to mCNV, SFCT, and the number of IVI treatments. Measuring oxidative stress parameters might be useful in eyes with HM both for assessing the risk of developing mCNV and determining disease activity.

Optical coherence tomography choroidal enhancement using generative deep learning

Spectral-domain optical coherence tomography (SDOCT) is the gold standard of imaging the eye in clinics. Penetration depth with such devices is, however, limited and visualization of the choroid, which is essential for diagnosing chorioretinal disease, remains limited. Whereas swept-source OCT (SSOCT) devices allow for visualization of the choroid these instruments are expensive and availability in praxis is limited. We present an artificial intelligence (AI)-based solution to enhance the visualization of the choroid in OCT scans and allow for quantitative measurements of choroidal metrics using generative deep learning (DL). Synthetically enhanced SDOCT B-scans with improved choroidal visibility were generated, leveraging matching images to learn deep anatomical features during the training. Using a single-center tertiary eye care institution cohort comprising a total of 362 SDOCT-SSOCT paired subjects, we trained our model with 150,784 images from 410 healthy, 192 glaucoma, and 133 diabetic retinopathy eyes. An independent external test dataset of 37,376 images from 146 eyes was deployed to assess the authenticity and quality of the synthetically enhanced SDOCT images. Experts’ ability to differentiate real versus synthetic images was poor (47.5% accuracy). Measurements of choroidal thickness, area, volume, and vascularity index, from the reference SSOCT and synthetically enhanced SDOCT, showed high Pearson’s correlations of 0.97 [95% CI: 0.96–0.98], 0.97 [0.95–0.98], 0.95 [0.92–0.98], and 0.87 [0.83–0.91], with intra-class correlation values of 0.99 [0.98–0.99], 0.98 [0.98–0.99], and 0.95 [0.96–0.98], 0.93 [0.91–0.95], respectively. Thus, our DL generative model successfully generated realistic enhanced SDOCT data that is indistinguishable from SSOCT images providing improved visualization of the choroid. This technology enabled accurate measurements of choroidal metrics previously limited by the imaging depth constraints of SDOCT. The findings open new possibilities for utilizing affordable SDOCT devices in studying the choroid in both healthy and pathological conditions.

EVALUATION OF CHORIORETINAL VASCULARIZATION WITH OCT AND ANGIO-OCT IN PRIMARY ALDOSTERONISM

Objective: Primary aldosteronism (PA), the most common cause of secondary hypertension, is associated with excess cardiovascular damage and, when unilateral, is amenable to surgical cure. Our objective was to determine whether the chorioretinal microvasculature is also affected. Design and method: Ocular CT-scan (OCT) and angio-OCT images of the superficial and deep retinal plexi were obtained in PA patients at diagnosis, in wash-out from RAAS-confounding drugs (WO), and again during mineralocorticoid receptor antagonist (MRA) therapy and 4-6 months after surgical cure (PS). The images were analysed for choroidal thickness and, upon automated ImageJ processing, for indexes of total vascular area density (VAD) and length fraction (VLF), a surrogate for the number of open vessels. Results: We enrolled 11 patients with PA (51±10 yrs; 27%F); of these, 10 who had unilateral PA underwent curative surgery (p&lt;0.05 for BP, sK+ and ARR). We found that MRA therapy had no effect on any of the investigated parameters. At variance, curative surgery determined a reduction of VAD in both superficial and deep plexi (-6.4% retinal area, p=0.017 and -3.5%, p=0.023, respectively) and of VLF in the superficial plexus (-2.2%, p=0.033). Moreover, choroidal thickness (on average: -21μm, p=0.003 at 2-way ANOVA) decreased after adrenalectomy. Conclusions: OCT and angio-OCT images, which can accurately track changes in choroid- retinal vascularization, highlighted a decrease of retinal microvascular area and choroidal thickness in patients with unilateral PA, who were cured from PA.

SUCCESSFUL TREATMENT OF SEVERE PERIPAPILLARY PACHYCHOROID SYNDROME WITH ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY.

To describe two cases of severe peripapillary pachychoroid syndrome successfully managed with monthly intravitreal aflibercept therapy. Medical and imaging records were retrospectively reviewed. Patients were imaged with ultra-widefield fluorescein, indocyanine green angiography, and fundus autofluorescence. Spectral-domain optical coherence tomography was performed to evaluate macular edema and choroidal thickness. Optical coherence tomography angiography excluded macular neovascularization. This report summarizes two cases of peripapillary pachychoroid syndrome complicated by very severe bilateral macular edema. In all four eyes, the diffuse intraretinal and subretinal fluid remarkably improved or completely resolved after monthly intravitreal aflibercept injections with commensurate improvement of visual acuity. Multimodal imaging documented the significant improvement of fluid and the reduction in choroidal thickening in response to anti-vascular endothelial growth factor therapy in each case. Severe cases of peripapillary pachychoroid syndrome associated with vision loss can be successfully treated with intravitreal aflibercept therapy.

Risk Factors for Focal Choroidal Excavation Concurrent with Chorioretinal Disease: Evaluated by Spectral-Domain OCT

To investigate the risk factors for patients with focal choroidal excavation (FCE) and their correlation with chorioretinal diseases. Retrospective cross-sectional study. Patients with FCE were enrolled, while healthy subjects were recruited for the control group. The study collected demographic information, clinical features, and multimodal images. Parameters of FCE identified using spectral-domain OCT (SD-OCT) were manually measured using built-in software and subsequently analyzed statistically. Subfoveal choroidal thickness (SFCT), subexcavation choroidal thickness (SECT), and the greatest depth and width of each excavation were manually measured using built-in calipers in OCT software. Twenty-one patients (13/8, male/female) with FCE were included in this study. The average age was 45.2 years, and their best-corrected visual acuity (BCVA) was 0.4 logarithm of the minimum angle of resolution (Snellen equivalent, 20/50). Focal choroidal excavation was present in 28 eyes of 21 patients, including isolated FCE (12 eyes) and complicated FCE (16 eyes) with choroidal neovascularization (sCNV), central serous chorioretinopathy, and other conditions. Patients with complicated FCE were significantly older than those isolated FCE (P=0.015). The SFCT of the healthy subjects was significantly less than that of the fellow eyes of the patients with FCE (P<0.01), as was that of the eyes with isolated FCE (P<0.001) and complicated FCE (P<0.001). The width of excavation was wider in eyes with complicated FCE than in those with isolated FCE (P=0.001). Hypertransmission defect (HD) was found beneath 15 excavations and was more prevalent in the complicated FCE group than the isolated FCE group (P=0.023). Focal choroidal excavation appears to be closely related to chorioretinal disorders, and the width of the excavation is a significant indicator for evaluating the risk of chorioretinal diseases. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Comparison of choroidal thickness in healthy pregnant and preeclamptic women in a tertiary eye care center in Central India: A cross-sectional study

Aim: To compare the Subfoveal Choroidal Thickness (SFCT) measured by Enhanced Depth Imaging (EDI) technique of Spectral Domain Optical Coherence Tomography (SD-OCT) in healthy pregnant and preeclamptic women. Methods: Our study was cross-sectional hospital-based study in which healthy pregnant women and women having preeclampsia were selected from Obstetrics and Gynecology department and enrolled in it. The guidelines of the American College of Obstetricians and Gynecologists were used to diagnose the cases of preeclampsia. The study included 100 women (200 eyes) which were grouped into 50 healthy pregnant women (group 1), i.e., n = 100 eyes and 50 preeclamptic women (group 2), i.e., n = 100 eyes. SFCT was measured using the EDI technique of SD-OCT and data were entered in a Microsoft Excel sheet. Statistical analysis was done using Epi Info. Software version 7.2.1.0 (Atlanta, Georgia, US) and the results of both the groups were compared. Results: The mean SFCT in both the eyes of the healthy pregnant group and the preeclamptic group was 318.12 ± 37.12 µm and 209.04 ± 26.73 µm, respectively, with a P-value 0.001 showing a statistically significant difference between both the groups. Conclusion: The SFCT is significantly decreased in preeclamptic pregnant women than in healthy pregnant women.

Myopic maculopathy among Chinese children with high myopia and its association with choroidal and retinal changes: the SCALE-HM study

AimsTo investigate myopic maculopathy in Chinese children with high myopia and its association with choroidal and retinal changes.MethodsThis cross-sectional study included Chinese children aged 4–18 years with high myopia. Myopic...

Safety and Effectiveness of Intravitreal Brolucizumab Injection in Combination With Sub-Tenon's Capsule Triamcinolone Acetonide Injection for Polypoidal Choroidal Vasculopathy During the Loading Phase.

This study evaluated the safety and effectiveness of combining intravitreal brolucizumab injection with sub-tenon's capsule triamcinolone acetonide injection (STTA) during the loading phase for polypoidal choroidal vasculopathy (PCV). In this retrospective observational study, untreated patients with PCV receiving intravitreal brolucizumab injections with STTA during loading at Saitama Medical University Hospital's Eye Center from May 2021 to June 2022 were analyzed. Complete regression rates of polypoidal lesions were assessed using indocyanine green angiography 12 weeks post-treatment initiation. Nineteen patients (19 eyes) participated. Best-corrected visual acuity significantly improved at eight weeks compared to baseline. No significant intraocular pressure increases occurred throughout the loading phase, while central foveal and choroidal thickness significantly reduced at 4, 8, and 12 weeks. Subretinal fluid was present in all patients before treatment, rapidly resolving post-intravitreal brolucizumab injections and STTA, with residual rates of 36.8% (seven eyes) and 5.3% (one eye) at four and 12 weeks, respectively. Intraocular inflammation did not occur during the loading phase, and the complete regression rate of polypoidal lesions was 89.5% (17 eyes). Combining intravitreal brolucizumab injection with STTA during the loading phase may be one treatment option for PCV management.

OPTICAL COHERENCE TOMOGRAPHY ANALYSIS OF RETINAL THICKNESS IN COVID-19 PATIENTS

OBJECTIVE: The aim of this study was to perform Optical Coherence Tomography analysis of retinal changes in patients with COVID-19 infection and compare them with healthy controls. MATERIAL AND METHODS: For this purpose, 42 COVID-19 positive patients (group 1) and 44 healthy adults (group 2), aged between 18 and 68 years, who were admitted to our clinic between October 1, 2020 and May 1, 2021, were included in the study. Central foveal thickness, choroidal thickness (subfoveal) and peripapillary retinal nerve fiber thickness were measured. Measurements were performed at the central fovea and at 1500 μm nasal and 1500 μm temporal points from the central fovea. RESULTS: Age and gender distribution were similar in the groups (p=0.610 and p=0.992, respectively). However, central foveal thickness (p&amp;lt;0.001), subfoveal choroidal thickness (p=0.001) and peripapillary retinal nerve fiber layer thickness (p&amp;lt;0.001) were significantly different between the two groups. CONCLUSIONS: In conclusion, central fovea, subfoveal choroidal and peripapillary retinal nerve fiber layer thickness were higher in polymerase chain reaction positive COVID-19 patients compared to healthy controls. To understand the pathogenesis of systemic and local changes caused by COVID-19, multicenter and long-term studies with a large number of patient subgroups are necessary.