Depth Imaging Optical Coherence Tomography Research Articles

OCT biomarkers related to subthreshold micropulse laser treatment effect in central serous chorioretinopathy

BackgroundTo identify the OCT biomarkers related to the anatomical outcomes in eyes with central serous chorioretinopathy (CSCR) after subthreshold micropulse laser (SML) treatment.MethodsPatients with CSCR underwent SML were enrolled in this retrospective study. Only patients who underwent enhanced depth imaging optical coherence tomography (EDI-OCT) examination before and after SML were selected. Patients were divided into two groups based on whether subretinal fluid (SRF) absorbed or not after SML. Group 1 was the SRF resolved group, and Group 2 was the SRF non-resolved group. Factors including age and gender, duration of symptoms, CSCR history, the height of SRF at baseline, retinal pigment epithelium (RPE) /inner choroid alterations, as well as subfoveal choroidal thickness (SFCT) of the affected eye and the fellow eye before and after SML were recorded and compared between two groups. Longitudinal change of SFCT of a subgroup of patients were analyzed.ResultsA total of 58 eyes of 58 patients were involved in this study. SRF of 31 eyes got completely absorbed, and SRF of 27 eyes was retained after SML. Logistic regression analysis revealed baseline SFCT of the affected eye (OR = 1.007, 95% CI: 1.001–1.012, P = 0.019) and RPE/inner choroid alterations (OR = 25.229, 95% CI: 2.890–220.281, P = 0.004) were correlated with SML efficacy. Thirty-three eyes of 33 patients were enrolled in the subgroup analysis. A significant difference of SFCT changes between two groups were demonstrated (P = 0.001). The difference of SFCT between baseline and three months after SML was also related to SRF resolution (OR = 0.952, 95% CI: 0.915–0.990, P = 0.014).ConclusionBaseline SFCT, change of SFCT at 3-month after treatment, and RPE/inner choroid alterations were the OCT biomarkers related to SRF resolution after SML treatment.

Management of primary choroidal lymphoma presenting as extensive serous retinal detachment and salmon patch of bulbar conjunctiva: a case report

BackgroundWe describe the outcome of ultra-low-dose radiotherapy plus intravitreal methotrexate and rituximab injections for a patient with primary choroidal lymphoma who presented with nodular conjunctival salmon patches and extensive serous retinal detachment.Case presentationA 34-year-old Iranian man presented with a nodular patch of bulbar conjunctiva in the right eye, and 1+ vitritis. A nearly complete shallow serous retinal detachment, retinal folds, and multifocal yellow choroidal infiltrates were seen during a fundus examination of the right eye. Enhanced depth imaging optical coherence tomography revealed macular retinal folds and an uneven, undulating, “seasick” appearance of the choroidal surface with choriocapillaris compression, intraretinal and subretinal fluid, and clusters of optically dense material at the outer retinal level. An incisional biopsy of the conjunctival lesion confirmed the diagnosis of primary choroidal lymphoma with epibulbar involvement. The patient was treated with ultra-low-dose “boom-boom” radiation (4 Gy delivered in two fractions over two consecutive days) as well as intravitreal methotrexate and rituximab injections. After a year, the lesions had completely disappeared, with no adverse effects or recurrence.ConclusionUltra-low-dose (boom-boom) radiotherapy combined with intravitreal chemotherapy and/or immunotherapy may be an effective treatment for primary choroidal lymphoma with anterior epibulbar extension and diffuse subretinal fluid with favorable response and minimal side effects.

Effect of bariatric surgery on macular and peripapillary choroidal structures in young patients with morbid obesity

ObjectiveTo examine the effect of bariatric surgery on the macular and peripapillary choroid in the late postoperative period in young patients with morbid obesity and compare them with a healthy control group. MethodsThis prospective controlled study included 50 eyes of 25 young patients with morbid obesity and 50 eyes of 25 age and sex-matched healthy controls. Sleeve gastrectomy was performed on all patients with obesity. Preoperative and 6-month postoperative macular and peripapillary choroidal thickness, total choroidal area (TCA), luminal area (LA), and choroidal vascularity index (CVI) were performed. Results were compared with healthy controls by using enhanced depth imaging optical coherence tomography. ResultsChoroidal thickness and CVI values were smaller in patients with obesity in both macular and peripapillary areas compared with the healthy control group (both p < 0.001). There was a statistically significant increase in the macular and peripapillary choroidal thickness of patients with obesity when the preoperative and the postoperative 6-month values after bariatric surgery were compared (both p < 0.001). Also, it was found that bariatric surgery increased TCA and LA values in the macular and all sectors of peripapillary areas (all p < 0.001), and CVI values in the temporal and nasal peripapillary sectors (p = 0.007, p = 0.012, respectively). ConclusionsBariatric surgery was found to increase the macular and peripapillary choroidal thickness and the nasal and temporal peripapillary CVI values in young patients with morbid obesity in the late period. To the best of our knowledge, the current study has shown for the first time that bariatric surgery affects peripapillary choroid and CVI values.

CVIS: Automated OCT‐scan‐based software application for the measurements of choroidal vascularity index and choroidal thickness

To develop an automated image recognition software for the objective quantification of choroidal vascularity index (CVI) and choroidal thickness (CT) at different choroidal locations on images obtained from enhanced depth imaging optical coherence tomography (EDI-OCT), and to validate its reliability and investigate the difference and correlation between measurements made by manual and software. A total of 390 EDI-OCT scans, captured from 130 eligible emmetropic or myopic subjects, were categorized into four grades in terms of their accessibility to identify the choroidal-scleral interface (CSI) and were further assessed for CT and CVI at five locations (subfoveal, nasal, temporal, superior and inferior) by the newly developed Choroidal Vascularity Index Software (CVIS) and three ophthalmologists. Choroidal parameters acquired from CVIS were evaluated for its reliability and correlation with ocular factors, in comparison to manual measurements. Distribution of difference and correlation coefficient between CVIS and manual measurements were also analysed. Choroidal Vascularity Index Software (CVIS) demonstrated excellent intra-session reliability for CT (ICC: 0.992) and CVI (ICC: 0.978) measurements, compared to the relatively lower intra- and inter-observer reliability of manual measurements. Choroidal Vascularity Index Software (CVIS) and manual assessments had the highest correlation at nasal choroid (CT: r = 0.829, p < 0.001; CVI: r = 0.665, p < 0.001). Choroidal parameters identified with CVIS showed stronger correlations with axial length than manual measurements. This automated software, CVIS, exhibited excellent reliability compared to manual measurements, which are subject to image quality and clinical experience. With its validated clinical relevance, CVIS holds promise to serve as a flexible and robust tool in future vitreoretinal and chorioretinal studies.

Comparison of Retinochoroidal Vascular and Structural Changes after Half-Dose Photodynamic Therapy versus Half-Fluence Photodynamic Therapy Based on Optical Coherence Tomography Angiography in Eyes with Chronic Central Serous Chorioretinopathy

Purpose: The aim of this study is to compare the efficacy of half-fluence photodynamic therapy (PDT) and half-dose PDT on the choroidal structure via perfusion of the retinal plexus and choriocapillaris in eyes with chronic central serous chorioretinopathy (cCSCR). Materials and Methods: This retrospective study included 43 eyes in 43 patients with cCSCR. Patients in group 1 received half-fluence (verteporfin 6 mg m⁻²) PDT and those in group 2 received half-dose (verteporfin 3 mg m⁻²) PDT. Enhanced depth imaging optical coherence tomography and optical coherence tomography angiography (OCTA) images were recorded 1 day before and 3 months after PDT. Total choroidal area (TCA), luminal area (LA), and stromal area (SA) were calculated using Image J software. Results: From baseline to 3 months post PDT TCA decreased from 2.43 ± 0.47 mm² to 2.08 ± 0.59 mm² (p < 0.001), LA decreased from 1.78 ± 0.11 mm² to 1.54 ± 0.26 mm² (p < 0.001), and SA decreased from 0.76 ± 0.33 mm² to 0.53 ± 0.37 mm² (p < 0.001) in group 1. Choriocapillaris vascular density measured via OCTA increased from 37.82 ± 10.99 at the initial visit to 44.96 ± 15.34 at month 3 after half-fluence PDT administered to the fovea (p < 0.001). Deep capillary plexus vessel density was 32.49 ± 11.36 at baseline and increased to 43.27 ± 11.40 at month 3 after half-fluence PDT administered to the fovea (p < 0.001) in group 1. TCA decreased to 2.00 mm² ± 0.51 mm² from 2.39 mm² ± 0.43 mm² (p < 0.001), LA decreased to 1.53 ± 0.29 mm² from 1.74 ± 0.16 mm² (p = 0.019). Although SA decreased from 0.76 ± 0.33 mm² to 0.53 ± 0.37 mm² in group 2, the difference was not significant (p = 0.07). Based on OCTA, choriocapillaris vascular density increased from 43.68 ± 10.38 mm² at baseline to 47.46 ± 6.42 mm² at 3 months after half-dose PDT onto the fovea (p = 0.049). Deep capillary plexus vessel density increased from 34.37 ± 9.36 mm² at the initial visit to 38.17 ± 8.81 mm² 3 months after half-dose PDT onto the fovea (p = 0.046) in group 2. At 3 months, post-PDT subretinal fluid (SRF) was significantly higher resolution in group 1 than in group 2 (p = 0.021). Conclusions: OCTA shows there is a significant increase in deep capillary plexus and choriocapillaris perfusion 3 months after both half-fluence PDT and half-dose PDT. Although there was a significant decrease in LA in both groups, based on OCTA there was a significant decrease in SA, a significant increase in choriocapillaris and deep capillary perfusion in group 1; therefore, the level of SRF resolution at month 3 post PDT might explain its higher incidence in group 1.

Automatic Segment and Quantify Choroid Layer in Myopic eyes: Deep Learning based Model

ABSTRACT Purpose To report a rapid and accurate method based upon deep learning for automatic segmentation and measurement of the choroidal thickness (CT) in myopic eyes, and to determine the relationship between refractive error (RE) and CT. Methods Fifty-four healthy subjects 20–39 years of age were retrospectively reviewed. Data reviewed included age, gender, laterality, visual acuity, RE, and Enhanced Depth Imaging Optical Coherence Tomography (EDI-OCT) images. The choroid layer was labeled by manual and automatic method using EDI-OCT. A Mask Region-convolutional Neural Network (Mask R-CNN) model, using deep Residual Network (ResNet) and Feature Pyramid Networks (FPN) as a backbone network, was trained to automatically outline and quantify the choroid layer. Results ResNet 50 model was adopted for its 90% accuracy rate and 6.97 s average execution time. CT determined by the manual method had a mean thickness of 258.75 ± 66.11 µm, a positive correlation with RE (r = 0.596, p < .01) and significant association with gender (p = .011) and RE (p < .001) in multivariable linear regression analysis. Meanwhile, CT determined by deep learning presented a mean thickness of 226.39 ± 54.65 µm, a positive correlation with RE (r = 0.546, p < .01) and significant association with gender (p = .043) and RE (p < .001) in multivariable linear regression analysis. Both methods revealed that CT decreased with the increase in myopic RE. Conclusions This deep learning method using Mask-RCNN was able to successfully determine the relationship between RE and CT in an accurate and rapid way. It could eliminate the need for manual process, while demonstrating a feasible clinical application.

Structural alterations of the choroid evaluated using enhanced depth imaging optical coherence tomography in patients with coronavirus disease.

To assess choroidal changes using enhanced depth imaging optical coherence tomography in coronavirus disease (COVID-19). Thirty-two patients with moderate COVID-19 and 34 healthy subjects were included in the study. Choroidal thickness was measured at 3 points as follows: at the subfovea, 1500 mm nasal to the fovea, and 1500 mm temporal to the fovea. The total choroidal area, luminal area, stromal area, and choroidal vascular index were measured with Image-J. All the measurements were performed during the disease and at 4 months after remission. In the patient group, the subfoveal, nasal, and temporal choroidal thicknesses were decreased as compared with those in the controls, but without statistically significant differences (p=0.534, p=0.437, and p=0.077, respectively). The mean total choroidal, stromal, and luminal areas and choroidal vascular index were statistically significantly decreased in the patient group (p&lt;0.001, p=0.001, p=0.001, and p=0.003; respectively). At 4 months after remission, the choroidal structural parameters and choroidal vascular index revealed statistically significant increases as compared with the baseline measurements in the patients with COVID-19 (all p&lt;0.001 and p=0.047, respectively). The choroidal vascular and stromal parameters showed significant transient decreases during the disease course of COVID-19.

Choroidal thickness changes in post-COVID-19 cases.

The current study aimed to evaluate the effects of the coronavirus disease 2019 (COVID-19) on choroidal thickness using enhanced depth imaging optical coherence tomography. This study evaluated the right eyes from 41 post-COVID-19 cases (Group 1) and 41 healthy subjects (Group 2). Choroidal thickness was measured using enhanced depth imaging optical coherence tomography. Post-COVID-19 cases were evaluated within 1 month after a diagnosis of COVID-19. Two experienced ophthalmologists measured the choroidal thickness at the subfovea, temporal, and nasal quadrants at 500-μm intervals up to 1500 μm from the fovea at seven different points. Moreover, central macular thickness and ganglion cell layer thickness were measured via OCT, after which both two groups were compared. Group 1 showed a significantly thicker choroid compared to Group 2 at the subfovea, 500 μm temporal to the fovea, 500 and 1000 μm nasal to the fovea (p=0.011, p=0.043, p=0.009, and p=0.019, respectively). Although other areas measured were also thicker in Group 1, the difference was not significant (p>0.05). Moreover, no significant difference in the central macular thickness and ganglion cell layer thickness were observed between the groups (p>0.05). Choroidal thickness was increased in post-COVID-19 patients, which might be related to inflammation associated with the pathogenesis of COVID-19.

The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy.

To characterize choroidal structure and vasculature after half-dose verteporfin photodynamic therapy (hd-vPDT) in eyes with chronic central serous chorioretinopathy using Enhanced Depth Imaging Optical Coherence Tomography (EDI OCT) and Optical Coherence Tomography Angiography (OCT-A). This prospective case-control study included 10 eyes. Choroid was examined before and at 1 month following hd-vPDT. We measured choroidal thickness (CT) at subfoveal area and at 750 μm nasal and temporal of fovea and thickness of Haller and choriocapillaris/Sattler layers. Whole (WA), luminal (LA) and interstitial area (IA) at EDI-OCT, and perfusion density at OCT-A were analyzed. The unaffected fellow eyes were used for comparisons. Mean CT at subfoveal area and at 750 μm nasal and temporal of fovea, values of Haller and choriocapillaris/Sattler layers and those of WA, LA and IA were reduced, while PD increased at 1 month after hd-vPDT (all p < 0.001). There was a significant (p < 0.05) negative correlation (ρ = -0.658) between PD and post-treatment logMARVA. None of analyzed parameters reached values of unaffected fellow eye. Following hd-vPDT, choroidal thickness with both luminal and interstitial components markedly decreased, while perfusion of choriocapillaris improved.

Journey of choroidal tubercle to choroidal granuloma

Choroidal tubercles may be unilateral or bilateral and appear as a polymorphic yellowish lesion with discrete borders. Tubercles can arise early in the stages of progression of tuberculosis (TB) and are indicative of hematogenous dissemination seen in acute military TB. Choroidal granuloma is seen in chronic TB in response to antitubercular treatment. We report a case of a 14-year old girl who presented with fever, altered sensorium, and irritability for 1 week. Fundus examination revealed bilateral multiple choroidal tubercles. Antitubercular treatment was started after magnetic resonance imaging head and cerebral spinal fluid cytology confirmed the diagnosis of disseminated TB. Enhanced depth imaging optical coherence tomography was done on follow-up visits to see the stages of progression or regression of choroidal tubercle after the treatment. This is a rare case, reporting the transition of choroidal tubercle into choroidal granuloma, which is demonstrated with serial imaging using various modalities.

Assessment of Choroidal Vascularity in Inactive Thyroid Associated Orbitopathy.

The objectives of the study were to evaluate the vascular and stromal structure of the choroid in patients with inactive thyroid associated orbitopathy (TAO) by measuring choroidal vascularity index (CVI) and choroidal thickness (CT) using enhanced depth imaging (EDI) optical coherence tomography (OCT). The choroidal image was taken with EDI mode spectral domain (SD)-OCT. All scans were taken between 9.30 am and 11.30 am to avoid the diurnal variation of CT and CVI. To calculate CVI, macular SD-OCT scans were binarized using the publicly available software ImageJ and luminal area and total choroidal area (TCA) were measured. CVI was calculated as the proportion of LA to TCA. Furthermore, the relation between CVI and axial length, gender, and age was evaluated. This study included 78 individuals with a mean age of 51.4±7.3 years. Group 1 consisted of 44 patients with inactive stage TAO, and Group 2 consisted of 34 healthy controls. Subfoveal CT was 338.92±73.93 µm in Group 1 and 303.97±40.35 µm in Group 2 (p=0.174). The CVI significantly differed between the two groups, which was higher in group 1 (p=0.000). Although CT was not different between groups, CVI which is the indicator of the vascular status of the choroid, was higher in patients with TAO in the inactive stage compared with healthy control subjects.

Changes in Choroidal Vascularity Index (CVI) in Intermediate Uveitis.

PurposeTo investigate the longitudinal changes in choroidal vascularity index (CVI) in eyes with active and quiescent intermediate uveitis using enhanced depth imaging optical coherence tomography (EDI-OCT).MethodsEDI-OCT images of eyes with active and quiescent intermediate uveitis were retrospectively reviewed and binarized using ImageJ software. Choroidal parameters including CVI, total choroidal area (TCA), luminal area (LA), stromal area (SA), and subfoveal choroidal thickness (SCT) were measured and compared between baseline and follow-up visits among eyes with active and quiescent intermediate uveitis.ResultsThirty-eight eyes from 21 patients with active intermediate uveitis and 30 eyes from 17 patients with quiescent intermediate uveitis were included. CVI in eyes with active intermediate uveitis significantly increased from baseline (66.50% ± 3.40%) with resolution of inflammation on follow-up (68.82% ± 3.90%; P < 0.001). In eyes with quiescent intermediate uveitis at baseline eyes, CVI did not significantly change after follow-up (66.34% ± 3.19% to 66.25% ± 3.13%; P = 0.850).ConclusionsCVI significantly increased when active inflammation in intermediate uveitis resolved while CVI remained unchanged at follow-up in quiescent intermediate uveitis.Translational RelevanceCVI may be a useful noninvasive tool to monitor treatment response in intermediate uveitis. Our findings also highlight the involvement of choroidal vasculature in uveitic eyes without any clinical evidence of choroiditis.

Relationship Between Changes in the Choroidal Structure and Blood Flow of the Macula After Trabeculectomy.

PurposeTo elucidate the relationship between changes in the choroidal structure and blood flow of the macula after trabeculectomy.MethodsA prospective study of 30 eyes of 30 patients with glaucoma who underwent trabeculectomy. Enhanced depth imaging optical coherence tomography with choroidal image binarization and laser speckle flowgraphy of the macula were performed at baseline and 1, 3, and 6 months postoperatively. Mixed-effects models with adjustment for confounders were used to analyze longitudinal changes in the mean choroidal thickness (mCT), mean choroidal vascular thickness (mCVT), mean choroidal interstitial thickness (mCIT), and mean blur rate (MBR).ResultsThe decrease in the intraocular pressure (IOP; 45%–51%) and axial length (0.5%–0.8%) and the increase in ocular perfusion pressure (OPP; 34%–38%), mCT (16%–19%), mCVT (16%–20%), mCIT (17%–20%), and MBR (22%–25%) were significant at each postoperative time point (all P < 0.001). In the multivariate analysis, the mCVT changes were positively correlated with the OPP and MBR changes (P = 0.04 and P < 0.001, respectively), whereas the mCIT changes were negatively correlated with IOP changes (P = 0.005). The MBR changes correlated significantly with changes in mCVT but not mCIT (P < 0.001 and P = 0.39, respectively).ConclusionsThickness changes in the intraluminal and extraluminal parts of the choroid were closely associated with changes in blood flow and IOP, respectively, although both parts thickened comparably after IOP reduction by trabeculectomy.Translational RelevanceThe choroid reacts to IOP reduction differently between the intraluminal and extraluminal areas, blood flow dependence in the vascular area, and IOP dependence in the stromal area.

Choroidal Thickness Profile in Chorioretinal Diseases: Beyond the Macula.

Enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source OCT (SS-OCT) have emerged as essential diagnostic tools in the study and management of various chorioretinal diseases. Evidence from early clinical studies using EDI-OCT and SS-OCT indicates that choroidal dysfunction plays a major role in the pathogenesis of chorioretinal diseases. Measurement of choroidal thickness (CT) has already become a major research and clinical method, and CT is considered as an indicator of choroidal status in a variety of ophthalmic diseases. Recently, CT measurement has also been proposed as a non-invasive marker for the early detection and monitoring of various systemic diseases. Among the several possible CT measurement locations, subfoveal CT has rapidly become a reliable parameter for measuring CT in healthy and diseased eyes. Moreover, recent advancements in OCT technology have enabled faster and wider imaging of the posterior part of the eye, allowing the various changes in CT as measured outside the macula to be shown accordingly. In this review, we first provide an overview of the results of clinical studies that have analyzed the healthy macular choroid and that in various chorioretinal diseases, and then summarize the current understanding of the choroid outside the macula. We also examine the CT profile as an index that encompasses both within and outside of the macula. Furthermore, we describe the clinical applications of ultrawide OCT, which enables visualization of the far periphery, and discuss the prospects for the development of more reliable choroidal parameters that can better reflect the choroid's characteristics.

The effect of branch retinal vein occlusion on the vascular structure of the choroid

ObjectiveOur aim is to examine choroidal structural changes in eyes with branch retinal vein occlusion (BRVO). Material and MethodThis retrospective, comparative study included 34 newly diagnosed unilateral BRVO patients and 40 healthy controls. Subfoveal choroidal thickness (SFCT) measurement was performed with enhanced depth imaging optical coherence tomography (EDI-OCT). The images were binarized using the ImageJ software program. Total choroidal area (TCA), stromal area (SA), and luminal area (LA) were calculated from the 1500 µm area. The choroidal vascular index (CVI) was determined as the LA/TCA ratio. All parameter values were compared between the BRVO eye and the fellow eye, and the control group eyes. ResultsEyes with BRVO had a greater SA compared to both fellow and control eyes; hence, the CVI was lower (p < 0.001). LA did not differ between eyes. TCA, although not statistically significant, was larger in eyes with BRVO than in both fellow and control eyes. SFCT was also greater in eyes with BRVO. No correlation was observed between CVI and SFCT and best-corrected visual acuity (BCVA). ConclusionBRVO affects the stromal part of the choroid rather than its vascular structure. SA increases due to choroidal exudation that occurs in response to retinal ischemia, and CVI decreases accordingly.

Choroidal thickness changes and choriocapillary circulation analysis in macular holes using optical coherence tomography angiography.

To investigate the changes of subfoveal choroidal thickness (SFCT) and choriocapillary circulation in idiopathic macular holes (IMHs), the fellow eyes, and normal subjects using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and to explore the role of SFCT and choriocapillary circulation in the pathogenesis of IMH. A case series of 30 patients with unilateral IMH and 30 subjects, with age- and sex-matched, were included. Thirty eyes of 30 patients with unilateral IMH, the unaffected fellow eyes, and 30 eyes of age- and sex-matched healthy patients were studied. SFCT was measured by spectral domain enhanced depth imaging optical coherence tomography (EDI SD-OCT), while vascular density and blood flow area of choriocapillary circulation were obtained by OCTA. The SECT in IMH eyes (236.09±79.25 µm) was lower than that in the unaffected fellow eyes (249.71±86.10 µm) (P=0.040) and healthy control eyes (283.29±64.16 µm) (P=0.001). Also, the SFCT of the unaffected fellow eyes was lower than that of the healthy control eyes (P=0.033). The superficial blood flow area and vascular density of choriocapillary in the macular area were smaller and lower in the IMH eyes (2.84±0.35 mm2, 20.74%±8.26%) than the unaffected fellow eyes (3.19±0.23 mm2, 35.18%±5.20%) and healthy control eyes (3.26±0.24 mm2, 35.20%±6.49%) (P<0.001); however, no difference was observed between the unaffected fellow eyes and healthy control eyes. The SFCT in IMH eyes was lower than that of unaffected fellow eyes and matched control eyes. In addition, the choriocapillary blood flow area and vascular density were smaller and lower than those of the unaffected fellow eyes and normal controls. Our findings suggested that atrophy of choriocapillary might play an important role in the formation of IMH.

Comparison of choroidal structural changes between children born preterm without retinopathy of prematurity and age-matched children born at full term

AimTo evaluate the effect of prematurity on choroidal structure in children born preterm with no history of retinopathy of prematurity (ROP) by comparing them with age-matched healthy children born at full term. MethodsEnhanced depth imaging optical coherence tomography (EDI-OCT) scans of children aged 5 to 9 years with a history of prematurity but no history of ROP, and age-matched full-term healthy children were evaluated, retrospectively. Choroidal thicknesses (CTs) were measured at subfoveal (SFCT), 1000 µm temporal and nasal from the fovea (T1, N1), and 2000 µm temporal and nasal (T2, N2) from the fovea. The EDI-OCT images were binarized to stromal (SA) and luminal areas (LA) using the ImageJ software. The choroidal vascularity index (CVI) was calculated by dividing LA by the total choroidal area (TCA). ResultsTwenty-nine eyes of 15 preterm children and 41 eyes of 26 full-term children were included. Demographic characteristics including axial length (AL), eye side, age, and the sex of the children in the groups were similar (p>0.05). There was no statistically significant difference in the mean CVI, SFCT, N1, and T1 values between the groups (p>0.05); however, the mean T2 and N2 values were significantly higher in the full-term group than in the preterm group (p<0.05). There was a significant positive correlation between the birth week and the T1 (p<0.05) ConclusionPrematurity can affect CT even with no history of ROP. The decreases in CTs were significant at 2000 µm nasal and temporal from the fovea. The impairment of temporal choroidal region was more evident than nasal choroidal region. The mean CVI values were similar between the groups.

Association between serum soluble fms-like tyrosine kinase-1 and the central choroidal thickness during pregnancy: a prospective study

ObjectiveTo investigate the association between serum soluble fms-like tyrosine kinase-1 (sFlt-1) and the choroidal structure during the pregnancy.Methods and analysisThis prospective study enrolled 24 eyes of 12 consecutive healthy pregnant...

Choroidal thickness changes in healthcare professionals wearing surgical masks or FFP2 masks: Pilot study

PurposeTo evaluate the choroidal thickness (CT) with enhanced depth-imaging optical coherence tomography (EDI-OCT) in healthcare professionals using surgical masks or FFP2 (N95) masks. MethodsWe included the 120 eyes of 120 healthy volunteers who were using a surgical mask (Group 1) or FFP2 mask (Group 2) in the study. Spectral domain (SD) OCT was used to measure CT. EDI-OCT was used to measure subfoveal and perifoveal CT. Points 1500 μm nasal (CN1500) and temporal (CT1500) to the foveal center were used to measure perifoveal CT. Oxygen saturation and heart rate were measured with a pulse oximeter. All measurements were performed at 8:30, before wearing the mask, and at 12:30, when the mask was removed for the lunch break. ResultsOf a total of 120 subjects, Group 1 consisted of 60 subjects (mean age 38.50±8.60 (range 24–44) years) and Group 2 also consisted of 60 subjects (mean age 36.60±6.53 (range 26–45) years). Although not statistically significant, CT was seen to have increased at 3 measurement points in Group 1 after using the mask for 4 h: subfoveal CT (CSF) (p = 0.545), CT1500 (p = 0.080), and CN1500 (p = 0.251)). In Group 2, the increase in CSF (p = 0.001) was statistically significant while the increases in CN1500 and CT1500 were not (p = 0.162 and p = 0.058, respectively) after using the mask for 4 h. ConclusionWe found CT to increase after 4 h of mask use, and this increase was more marked in Group 2. The increase in subfoveal CT in particular was statistically significant in Group 2.

Choroidal Thickness Correlates with Clinical and Imaging Metrics of Parkinson's Disease: A Pilot Study.

Parkinson's disease (PD) is marked clinically by motor symptoms and pathologically by Lewy bodies and dopamine neuron loss in the substantia nigra pars compacta (SNc). Higher iron accumulation, assessed by susceptibility MRI, also is observed as PD progresses. Recently, evidence has suggested that PD affects the retina. To better understand retinal alterations in PD and their association to clinical and SNc iron-related imaging metrics. Ten PD and 12 control participants (2 eyes each) from an ongoing PD imaging biomarker study underwent enhanced depth imaging optical coherence tomography evaluation. Choroidal (vascular) thickness and nerve layers were measured in 4 subregions [superior, temporal, inferior, and nasal] and at 3 foveal distances (1, 1.5, and 3 mm). These metrics were compared between PD and control groups. For significantly different metrics, their associations with clinical [levodopa equivalent daily dosage (LEDD), motor and visuospatial function] and SNc susceptibility MRI metrics [R2* and quantitative susceptibility mapping (QSM)] were explored. Compared to control participants, PD participants had a thicker choroid (p = 0.005), but no changes in nerve layers. Higher mean choroidal thickness was associated with lower LEDD (p < 0.01) and better visuospatial function (p < 0.05). Subregion analyses revealed higher choroidal thickness correlated with lower LEDD and better motor and visuospatial measures. Higher mean choroidal thickness also was associated with lower nigral iron MRI (p < 0.05). A small cohort of PD research participants displayed higher choroidal thickness that was related to better clinical performance and less nigral pathology. These intriguing findings warrant further investigation.