Enhanced Depth Imaging Research Articles

Choroidal Thickness Increases During Parasympathetic Dominance After Immersion of the Foot in Warm Water.

This study aimed to assess the course of changes in choroidal morphology after immersion of the foot in warm water at 40°C using enhanced depth imaging optical coherence tomography (EDI-OCT). Forty-three right eyes of 43 healthy participants were included. Changes in choroidal morphology were determined using EDI-OCT to evaluate subfoveal choroidal thickness (SCT). Systolic, diastolic, and mean blood pressures (SBP, DBP, and MBP, respectively) were also measured to determine systemic circulatory dynamics at baseline, immediately after immersion (0 min), and 10, 20, and 30 min after immersion. Immediately after immersion, SBP, DBP, and MBP were significantly declined versus baseline. In contrast, the SCT was significantly increased after warm water immersion. However, all these parameters did not change significantly compared to the baseline within 30 min. In the normal eye, parasympathetic nerve activity induced by warming stimuli increases choroidal morphology in response to a decrease in systemic circulatory activity, which normalizes within 30 min. The findings of this study may provide basic data for the prevention and treatment of various choroidal diseases in which sympathetic hyperactivity is involved in the pathogenesis.

Evaluation of Macular Neurovasculature and Choroidal Blood Flow Following Inferior Oblique Myectomy Using Optical Coherence Tomography Angiography.

To evaluate the short-term effects of inferior oblique myectomy on the retinal neurovasculature, choroidal thickness, and choroidal vascularity index at the macula. Patients older than 5 years who were candidates for inferior oblique muscle myectomy surgery participated in the study. Patients with any systemic or ocular disease that could affect the macular neurovasculature were not included in the study. After recording demographic data, including age and gender, and conducting a complete ophthalmic examination, macular optical coherence tomography (OCT), enhanced depth imaging OCT, and OCT angiography imaging (AngioVue software (V.2017.1.0.151; Optovue, Inc) were performed before (1 day to 1 week) and in the specific time intervals (1 week, 1 month, and 3 months) after the surgery for all participants. Eighteen patients (13 male and 5 female) who underwent inferior oblique muscle myectomy, with a mean ± standard deviation age of 24.22 ± 18.14 years, were included in this study. The baseline mean ± standard deviation of subfoveal choroidal luminal area and subfoveal total choroidal area were 0.390 ± 0.03 and 0.539 ± 0.04 mm2, respectively. The changing pattern of the subfoveal choroidal vascularity index and subfoveal choroidal luminal area was statistically significant (P = .013 and .035, respectively). Inferior oblique myectomy can lead to changes in choroid hemodynamics in the short term. However, these changes seem to be temporary. [J Pediatr Ophthalmol Strabismus. 2024;61(4):235-244.].

Advantages and Pitfalls of the Use of Optical Coherence Tomography for Papilledema.

Papilledema refers to optic disc swelling caused by raised intracranial pressure. This syndrome arises from numerous potential causes, which may pose varying degrees of threat to patients. Manifestations of papilledema range from mild to severe, and early diagnosis is important to prevent vision loss and other deleterious outcomes.The purpose of this review is to highlight the role of optical coherence tomography (OCT) in the diagnosis and management of syndromes of raised intracranial pressure associated with papilledema. Ophthalmoscopy is an unreliable skill for many clinicians. Optical coherence tomography is a non-invasive ocular imaging technique which may fill a current care gap, by facilitating detection of papilledema for those who cannot perform a detailed fundus examination.Optical coherence tomography may help confirm the presence of papilledema, by detecting subclinical peripapillary retinal nerve fiber layer (pRNFL) thickening that might otherwise be missed with ophthalmoscopy. Enhanced depth imaging (EDI) and swept source OCT techniques may identify optic disc drusen as cause of pseudo-papilledema. Macular ganglion cell inner plexiform layer (mGCIPL) values may provide early signs of neuroaxonal injury in patients with papilledema and inform management for patients with syndromes of raised intracranial pressure. There are well-established advantages and disadvantages of OCT that need to be fully understood to best utilize this method for the detection of papilledema.Overall, OCT may complement other existing tools by facilitating detection of papilledema and tracking response to therapies. Moving forward, OCT findings may be included in deep learning models to diagnose papilledema.

Simultaneous evaluation of iris area and subfoveal choroidal thickness in Fuchs uveitis syndrome

Background/aimsTo simultaneously evaluate iris area (IA) and subfoveal choroidal thickness (SFCT) in eyes with Fuchs Uveitis Syndrome (FUS).MethodsWe prospectively recruited a case series of patients with FUS at our institution, simultaneously measuring IA with anterior segment spectral domain optical coherence tomography (SD-OCT) and SFCT with enhanced depth imaging optical coherence tomography (EDI-OCT). Iris images were analyzed by ImageJ software. We tested the differences in intereye IA and SFCT with the healthy eye (HE) using the Wilcoxon test, and clinical interpretation was controlled by intraclass correlation coefficient (ICC) between two masked specialists.ResultsSixteen patients with unilateral FUS were included. Six were female, and the age range was 37 to 67 (median age 48 years, IQR 41–60). ICC of 98.9%, with a lower confidence interval of 97%. Eyes with FUS had a significant thinning of the total iris median area (p < 0.002), restricted to the temporal and nasal areas compared to the HE (p < 0.01 and < 0.001, respectively). SFCT was also significantly thinner compared to the HE (p < 0.0001). A low correlation was found between iris and choroidal thinning in FUS eyes (rs = 0.21; p = 0.4).ConclusionsThis study found reduced iris area and subfoveal choroidal thickness in eyes with FUS compared to the normal fellow eye.

Insights into the pattern of choroidal vascularity index changes in idiopathic macular hole

This retrospective study aimed to investigate the changes in choroidal vascularity index (CVI) before and after surgery for idiopathic macular hole (MH). Enhanced depth imaging optical coherence tomography (EDI-OCT) images were analyzed at baseline and at 1-week, 1-month, and 3-month postoperative visits. A total of 97 patients (97 eyes) were included in the study. At baseline, overall CVI and macular CVI showed negative correlation with axial length (AL) and positive correlation with central corneal thickness (CCT). There were no significant differences in macular CVI or overall CVI between affected and healthy eyes, as well as in subgroup analysis of different stages of macular CVI. Following surgery, there was a significant decrease in CVI at 1 week postoperatively, followed by a gradual recovery to baseline levels over time. The observed changes in CVI may be attributed to factors such as air tamponade, pressure changes, and photoreceptor metabolism. This study provides insights into the pattern of CVI changes associated with MH surgery. The findings suggest that stage 4 MH is associated with decreased macular CVI in affected eyes. These results contribute to a better understanding of the effects of surgery on choroidal blood flow in MH patients.

Optical coherence tomography in papilledema: A probe into the intracranial pressure correlation.

To study the optic nerve head characteristics on optical coherence tomography (OCT) in patients with papilledema and correlate them with intracranial pressure (ICP). A retrospective hospital-based study of 46 eyes of 23 patients with bilateral optic disc edema secondary to increased ICP. The clinical profile and the OCT features in terms of retinal nerve fiber layer thickness (RNFL), ganglion cell inner plexiform layer (GCIPL) thickness, and enhanced depth imaging (EDI) B scan images of the optic nerve head were studied and correlated with the ICP. Papilledema was secondary to idiopathic intracranial hypertension (IIH) ( n = 20), obstructive hydrocephalus ( n = 2), and communicating hydrocephalus ( n = 1). The mean ICP in 20 IIH patients was 347 mmH 2 O. The ICP and RNFL thickness in all four quadrants were found to be weakly positively correlated: superior RNFL r (38) = 0.17, P = 0.30, and nasal RNFL r (38) = 0.30, P = 0.05, inferior RNFL r (38) = 0.29, P = 0.07, and temporal RNFL, r (38) = -0.001, P = 0.99. The GCIPL layer thickness and the ICP were weakly negatively correlated in all sectors: superior (38) = -0.23, P = 0.16, superonasal, r (38) = -0.07, P = 0.67, inferonasal r (38) = -0.08, P = 0.64, inferior r (38) = -0.21, P = 0.19, inferotemporal r (38) = -0.23, P = 0.17, superotemporal, r (38) -0.21, P = 0.20. Descriptive features on the B scan, such as peripapillary hyperreflective ovoid mass-like structures and microcystic spaces, were observed most commonly with an ICP of 251-350 mmH 2 O, and the hyperreflective dots in the RNFL layer and Bruch's membrane inward denting were observed more commonly with an ICP of 351-450 mmH 2 O. The RNFL thickness in all four quadrants had a weak positive correlation, and the GCIPL layer had a weak negative correlation with the ICP. The EDI descriptive features on OCT may vary with ICP.

Asymptomatic retinal dysfunction in a patient with alpha-methylacyl-CoA racemase deficiency.

To present a case of a young female patient with asymptomatic retinal dysfunction associated with alpha-methylacyl-CoA (AMACR) racemase deficiency. Retrospective analysis of the medical notes of a single patient. Detailed slit-lamp examination was completed by Optos colour fundus photography and enhanced depth imaging optical coherence tomography (EDI-OCT). Genetic testing was conducted to establish the diagnosis, and the patient was also referred to the Department of Neurology for further assessment. Dilated fundoscopy and ophthalmic imaging revealed bilateral retinal pigment epithelium abnormalities that could be associated with a genetic retinal disorder. Indeed, genetic testing showed that this lady was homozygous for AMACR (OMIM 604489; Gene ID 23600) variant NM 014324.6: c.154T>C; p.(Ser52Pro). She had no detectable neurological deficit. AMACR deficiency is a rare genetic condition that can potentially contribute to retinal dystrophy through various mechanisms. Additionally, it may lead to a wide spectrum of systemic signs and symptoms. Interestingly, in contrast to other reported studies, our patient was completely asymptomatic, with no evidence of systemic disorders.

Choroidal macrovascular and capillary alterations in eyes with idiopathic epiretinal membranes.

To evaluate the choroidal vascular alterations and effect of surgical treatment in the setting of idiopathic epiretinal membranes. The structure of the choroid was studied in 33 patients with unilateral idiopathic epiretinal membrane using optical coherence tomography with enhanced depth imaging and optical coherence tomography angiography. Eyes with epiretinal membrane underwent 25-gauge vitrectomy with epiretinal membrane and internal limiting membrane peeling. The choroidal vascularity index, Haller layer/choroidal thickness ratio, and choriocapillaris flow density were used to evaluate changes in choroidal structure after surgery and compare with the healthy fellow eyes. The choroidal vascularity index and Haller layer/choroidal thickness ratio of the eyes with epiretinal membrane were higher than those of the fellow eyes at baseline (p=0.009 and p=0.04, respectively) and decreased postoperatively compared with preoperative values (p=0.009 and p=0.001, respectively). The choriocapillaris flow of eyes with epiretinal membrane was lower than that of the fellow eyes at baseline (p=0.001) and increased after surgery compared with the preoperative value (p=0.04). The choroidal vascularity index, Haller layer/choroidal thickness ratio, and choriocapillaris flow values of the healthy fellow eyes were comparable at baseline and final visit. In eyes with epiretinal membrane, the final choroidal vascularity index correlated with the final choriocapillaris flow (r=-0.749, p=0.008) in the multivariate analysis. Idiopathic epiretinal membrane appears to affect the choroidal structure with increased choroidal vascularity index and Haller layer/ choroidal thickness ratio and decreased choriocapillaris flow. These macrovascular (choroidal vascularity index and Haller layer/choroidal thickness) and microvascular (choriocapillaris flow) alterations appear to be relieved by surgical treatment of the epiretinal membranes.

Lamina Cribrosa Thickness in Patients with Branch Retinal Vein Occlusion: A Cross Sectional Comparative Evaluation Using Enhanced Depth Imaging Optical Coherence Tomography

Abstract Background: Retinal vein occlusion (RVO) is one of the most common causes of retinal vascular disease, second to diabetic retinopathy. We aimed to compare the lamina cribrosa thickness (LCT) of patients with unilateral branch RVO (BRVO) versus healthy individuals. Materials and Methods: This was a hospital-based, prospective, cross-sectional, and comparative study. Participants were newly diagnosed RVO cases (n = 25) and apparently normal age-matched healthy controls (n = 25). All the participants underwent systemic and comprehensive ophthalmic examination, including refraction and enhanced depth imaging optical coherence tomography. Relevant parameters were compared between the groups using the independent t-test. Statistical significance thresholds were set at a P &lt; 0.05. Results: The mean age of cases (66.7% female) and controls (52% female) was 55.9 ± 7.4 and 59.4 ± 7.0 years, respectively, (P = 0.089). The mean LCT of the affected eyes in cases (176.6 ± 28.3 μm) was significantly lower compared to the unaffected eyes of cases (200.6 ± 33.1 μm, P = 0.008) and control eye (230.9 ± 36.9 μm, P = 0.001). Conclusions: A thinner lamina cribrosa (LC) was observed in both eyes of unilateral RVO patients compared with healthy, nonglaucomatous subjects’ eyes. The role of LCT as a local mechanical factor in the pathogenesis of BRVO and their relationship to systemic factors merits further investigation.

Choroid and Retinal Effects of Epilepsy and Epilepsy Subgroups.

The objective were to evaluate structural alterations in the retina and choroid tissue of epilepsy patients and subtypes using enhanced depth imaging optic coherence tomography (EDI-OCT). 46 epilepsy patients and 50 sex- and age-matched control patients were analyzed in the study. Patients' epilepsy types were recorded. The central macular thickness (CMT), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and choroidal thickness (CT) were investigated through the Spectralis-OCT device (SD-OCT). Image-J program was used to calculate the total choroidal area (TCA), the luminal area (LA), stromal area (SA), and the choroidal vascularity index (CVI). CMT, TCA, LA, and SA outcomes were substantially reduced in epilepsy patients than in healthy controls. There was no significant difference between CT, RNFL, GCL, CVI results. There were no statistically significant differences between patients with partial and generalized epilepsy (p>0.05 for each). According to the results of our study, epilepsy disease has effects on the posterior segment of the eye. To the best of our knowledge, our study is the first to evaluate CVI in patients with epilepsy and the epilepsy subgroups.

Evaluation of the Activity of Vogt–Koyanagi–Harada Disease; A Comparison of Indocyanine Green Angiography Scoring, Enhanced Depth Imaging Optical Coherence Tomography, and Choroidal Vascularity Index

Abstract Purpose: To investigate the correlation between choroidal biomarkers using enhanced depth imaging optical coherence tomography (EDI-OCT) and indocyanine green angiography (ICGA) scoring for monitoring the activity of Vogt–Koyanagi–Harada (VKH). Methods: Patients who were not in the acute phase of VKH were recruited. Simultaneous EDI-OCT and ICGA were captured in seven patients only at baseline, in six patients at the 3-month follow-up, and in two patients at both the 6- and 9-month follow-ups. Subfoveal choroidal thickness (SFCT), subfoveal choroidal area (SFCA), and choroidal vascular index (CVI) were measured on EDI-OCT using FIJI software and a denoising system. ICGA scoring was performed. Results: Fifteen subjects with the median of 4-month follow-up were recruited. Forty-eight pairs of EDI-OCT and ICGA were investigated. In univariate analysis, ICGA scores were positively associated with SFCT, and SFCA, but negatively with CVI. The strength of correlation between ICGA scores and SFCT was strong (correlation coefficient: 0.91). In multivariate analysis, only SFCT remained significant (B: 2.4, 95% confidence interval: 1.9–3.0; P &lt; 0.001). Conclusions: SFCT can be an acceptable representative of the subclinical inflammatory activity of VKH. As an alternative to ICGA, SFCT functions better than SFCA and CVI.

Uncommon case of basal linear deposits and its tomographic and indocyanine green angiography findings

Purpose: To report a rare and uncommon case of patient presenting drusen associated to basal linear deposit (BlinD) and macular vitelliform material (VM).Methods: Patient was assessed with multimodal imaging: fundus autofluorescence (FAF), indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI‐OCT). Electroretinogram (ERG) and visually evoked potentials (VEP) along with systemic evaluation were also performed.Results: A 52‐year‐old woman consulted for ophthalmological check‐up, without any complaint. Past history revealed breast cancer treated with chemotherapy and hormone therapy, currently in remission. Visual acuity was 10/10 in the right eye (RE) and 8/10 in the left eye (LE). Slit‐lamp anterior examination was unremarkable. Fundus examination revealed multiple interlaced round yellowish lesions mainly in the posterior pole associated to a pigmented macular lesion on the LE. FAF showed bilateral macular hypoautofluorescent lesions. ICGA highlighted bilateral scattered hypofluorescent spots (SHS) mainly noted in the late phase, distributed throughout the posterior pole, with partial confluence. EDI‐OCT featured the presence of drusenoid retinal pigment epithelium (RPE) elevation along with a thick and distinctive hyperreflective band between the RPE and Bruch's membrane (BM). Associated bilateral hyperreflective VM were also detected. ERG and VPE were unremarkable. Patient underwent systemic evaluation insuring absence of cancer recurrence, choroidal metastases, paraneoplastic syndrome or any systemic disease.Conclusions: BlinD is defined as a deposit located between the RPE and the BM. Recently, this entity has been correlated with SHS seen in late stages on ICGA and might be a precursor sign of age‐related macular degeneration. Associations between drusen and BlinD and between drusen and VM have been previously reported; however, the concomitance of these three features has, to our knowledge, never been reported.

The Influence of Seasonal Allergic Conjunctivitis and Its Treatment on Choroidal Vascular Index

Purpose: To evaluate the the effects of seasonal allergic counjunctivitis (AC) and its treatment upon choroidal structure such as choroidal thickness (ChT) and choroidal vascular index (CVI) through the use of topical antihistamine agents. Methods. The 60 eyes of 30 patients were included in the AC group. Another 30 patients were included in the control group. The choroid was imaged by using enhanced depth imaging optical coherence tomography (EDI-OCT) instrument without pupillary dilation. ChT was defined as the area between the outer hyperreflective border of the RPE and the sclerochoroidal border at the fovea, 750 µm temporal to the fovea and 750 µm nasal to the fovea. Image J was used to measure CVI. With the images obtained from EDI-OCT, the total choroidal area (TCA), luminal area (LA), stromal area (SA), and CVI were calculated using the binarization method. Results. The mean ChT value in the AC group was 358.5 ± 93.8 µm at baseline and 356.8 ± 86.6 µm following 1 month of treatment. Meanwhile, the mean ChT in the control group was 316.6 ± 60.7 µm. The mean CVI value was 66.65 ± 2.98 in the control group, 70.75 ± 3.26 in the AC group at baseline, and 69.50 ± 3.17 following 1 month of treatment. Statistically significant difference was tracked between control and AC group (p = 0.028) and control group and posttreatment values (p=0,031). There were no statistically significant difference between initial AC treatment values and posttreatment values for all of the measurements. Conclusion. ChT and CVI can increase in patients with AC due to inflammation and increased vascular permeability. Although symptoms and signs related to AC may disappear after the treatment, effects in the choroid do not immediately normalize.

Macular choroidal thickness, volume, and vascularity index in patients with systemic sclerosis.

The aim of this study was to investigate choroidal parameters in patients with systemic sclerosis (SSc) using enhanced depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT) and to determine their relationships with clinical variables and ocular features. Thirty-three patients with SSc and 40 controls were enrolled. The groups did not differ with regard to age, sex, and axial length. The mean choroidal thickness and volume were obtained in each conventional Early Treatment of Diabetic Retinopathy Study grid subfield. The choroidal vascularity index (CVI), which provides a quantitative analysis of vasculature by calculating the proportion of the luminal area (LA) to the total choroidal area (TCA), was determined. Lower choroidal thickness and volume were observed in the SSc group. The CVI was significantly higher in SSc patients, whereas the TCA, LA, and stromal area were significantly lower in the SSc group; however, the significant difference of the stromal component was more pronounced than that of the luminal component. Regression analyses did not identify any clinical factors associated with the CVI (except Ca-blocker use), central macular thickness, or volume. No significant differences in choroidal parameters were found within the SSc subtypes (diffuse cutaneous systemic sclerosis (dcSSc) vs. limited cutaneous systemic sclerosis (lcSSc)), or between eyes stratified according to SSc pattern (early, active, or late) using nailfold capillaroscopy (p > 0.05 for all). Our results, with notably higher CVI values, may shed new light on choroidal impairment in patients with SSc. Stromal involvement appeared to dominate the vascular component.

CHOROIDAL VASCULARITY IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY AND ITS ASSOCIATION WITH RISK SINGLE-NUCLEOTIDE POLYMORPHISMS.

To analyze the choroidal parameters of patients with chronic central serous chorioretinopathy (cCSC) and the association with central serous chorioretinopathy susceptibility genes. The choroidal vascular index (CVI) was obtained by binarizing spectral domain optical coherence tomography enhanced depth images of patients with cCSC and healthy age-matched controls. Patients with cCSC were genotyped for three central serous chorioretinopathy susceptibility single-nucleotide polymorphisms: rs4844392 ( mir-29b-2/CD46 ), rs1329428 ( CFH ), and rs2379120 (upstream GATA5 ). One hundred three eyes with cCSC and 53 control eyes were included. There was a significant increase in the subfoveal choroidal area in both the affected (2.4 ± 0.6 mm 2 ) and fellow (2.2 ± 0.6 mm 2 ) eyes of patients with cCSC compared with controls (1.8 ± 0.5 mm 2 , P < 0.0001 and P < 0.0001). The CVI was reduced in patients with cCSC 63.5% ± 3.1% compared with controls 65.4% ± 2.3% ( P < 0.001) and also in the affected compared with the fellow eyes 64.6% ± 2.9% ( P < 0.01). There was a significant association between CVI in the cCSC group and presence of the risk single-nucleotide polymorphisms rs2379120 at GATA5 ( P < 0.01). The relative reduction of CVI in patients with cCSC may suggest a persistence of vessel hyperpermeability over dilation in chronic disease. GATA5 is associated with CVI in patients with cCSC and therefore may have a role in choroidal vascularity.

Evaluation of choroidal thickness and retinal nerve fiber layer thickness in Chinese pregnant women and healthy non-pregnant women

PurposeTo evaluate choroidal thickness and retinal nerve fiber layer (RNFL) thickness in different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). MethodsA prospective comparative study included 45 healthy pregnant women in the first trimester, 45 women in the second, 45 women in the third and 45 healthy non-pregnant women as the control group. Macular choroidal thickness was measured at three locations: The subfoveal, 1 ​mm temporal, and 1 ​mm nasal from the fovea with EDI-OCT. Peripapillary choroidal thickness (PPCT) and RNFL thickness parameters were automatically calculated by the Spectralis OCT. ResultsThe subfoveal, temporal and nasal macular choroidal thickness were all significantly thicker in the second trimester, compared with those parameters in the first, the third trimesters and the control group (all P ​< ​0.05). The PPCT was significantly increased in the second trimeter compared with the control group at global, temporal, temporal inferior, nasal and nasal inferior positions (all P ​< ​0.05). The RNFL thickness was also significantly increased in pregnant women at nasal superior and nasal inferior quadrants (all P ​< ​0.05). ConclusionsThe choroidal thickness in pregnant women was found to be thicker than the control group, regardless of macular or optic disc location. Findings of RNFL thickening might indicate subclinical involvement of the central nervous system.

Choroidal vascularity index and choroidal thickness assessment in vitiligo

ABSTRACT Clinical relevance Vitiligo is a skin disease characterised by depigmentation and loss of melanocytes. Melanocyte loss may not be limited to the skin in vitiligo, and various abnormalities may occur in the choroid, which is dense in melanocytes. Background To evaluate structural changes in the choroid by measuring choroidal thickness and vascularity index using optical coherence tomography in patients with vitiligo and comparing them to healthy subjects. Methods This study included 168 participants: 84 with vitiligo (30 females, 54 males) and 84 controls (36 females, 48 males). Choroidal thickness and vascularity index were measured using the enhanced depth imaging mode in spectral-domain optical coherence tomography. The choroidal thickness was measured at the following five points; subfoveal (SF), 500 μm (NCT1) and 1000 μm (NCT2) nasal to the fovea; and 500 μm (TCT1) and 1000 μm (TCT2) temporal to the fovea. The choroidal vascularity index was calculated using the ImageJ software. Results SF (p < 0.001), NCT1 (p < 0.001), NCT2 (p = 0.021), TCT1 (p = 0.001), and TCT2 (p < 0.006) choroidal thicknesses were significantly smaller in the vitiligo group than in the control group. Total choroidal (p < 0.001) and stromal (p < 0.001) areas were significantly smaller in the vitiligo group than in the control group. Choroidal vascularity indices were significantly higher in the vitiligo group than in the control group (p < 0.001). However, luminal areas did not differ significantly between groups (p = 0.935). Conclusion Patients with vitiligo should be regularly monitored for choroidal alterations and, if necessary, referred to an ophthalmologist.

Optic Disc Drusen Prevalence in Patients With Retinitis Pigmentosa: A Cross-Sectional Study.

Studies of patients with retinitis pigmentosa (RP) have reported an increased prevalence of optic disc drusen (ODD) compared with the ODD prevalence in the general population. The diagnostic gold standard method for identifying ODD is enhanced depth imaging optical coherence tomography (EDI-OCT), but this modality has not previously been used systematically for identifying ODD in patients with RP. This study aimed to estimate the prevalence of ODD in patients with RP using EDI-OCT. In this cross-sectional study, 40 patients with clinically diagnosed RP aged 18 years or older were included. All patients underwent an ophthalmic examination, including kinetic perimetry, EDI-OCT of the optic nerve head, and fundus photography. Genetic testing with a next-generation sequencing panel of retinal dystrophy genes was performed on the RP patients without a prior genetic diagnosis. Twelve patients (30.0%) had at least one ODD. Six patients had bilateral ODD. No significant differences between patients with and without ODD were found according to age, refraction, best-corrected visual acuity, Bruch membrane opening, or visual field. The genetic variation causing RP was found in 11 of 12 cases in the ODD group and in 17 of 28 cases in the group without ODD. We found the prevalence of ODD in patients with RP to be 30.0%. This is 15 times higher than in the general population and much higher than previously estimated in most studies, potentially indicating that the 2 conditions might be pathogenically related.

The Association Between Choroidal Thickness and Meniere's Disease: A Cross-Sectional Study.

To evaluate and compare choroidal thickness (CT) between patients with Meniere's disease (MD) and a control group. This case-control analytical study was conducted on 37 subjects with MD and 37 healthy subjects. Subfoveal CT (SCT), large choroidal vessel (LCV) layer thickness, and mean subfoveal LCV thickness/mean SCT ratio were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) in the eyes on the MD side (ipsilateral), the contralateral eyes, and the control group. A statistically significant difference was observed in the mean SCT values between the ipsilateral and control groups after adjustment for age, sex, and migraine (p = 0.04). Moreover, there was a statistically significant difference between the mean subfoveal LCV thickness values and the mean subfoveal LCV thickness/mean SCT ratio between the ipsilateral and control groups (p = 0.006, and p < 0.001, respectively). Patients with a duration of disease over three years had a greater mean subfoveal LCV thickness/mean SCT ratio (67.35 ± 11.56 and 60.66 ± 11.27, respectively), which was statistically insignificant (p = 0.08). We found a thicker choroid and Haller layer, and a greater subfoveal LCV thickness/SCT ratio on the MD side compared to the controls. Furthermore, patients with a greater duration of disease had a lower subfoveal LCV thickness/SCT ratio. These findings may reflect the role of the trigeminal vascular system (TVS) and neurovascular pathophysiology in MD patients. More extensive studies are required to reach more definitive conclusions about the association between CT and MD. 4 Laryngoscope, 134:1889-1893, 2024.

Choroidal Morphology and Systemic Circulation Changes During the Menstrual Cycle in Healthy Japanese Women.

Changes in systemic circulatory dynamics and choroidal thickness are poorly understood. This study aimed to investigate the time course of changes in choroidal morphology during normal menstrual cycles in healthy women using enhanced depth imaging optical coherence tomography (EDI-OCT). This prospective study included 15 left eyes of 15 healthy Japanese women (mean age, 20.2 ± 0.8 years) with a normal menstrual cycle. Using EDI-OCT, the subfoveal choroidal thickness (SCT) was manually measured during the late follicular and mid-luteal phases. Intraocular pressure (IOP), systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP), and heart rate (HR) were also evaluated during these phases. SBP, DBP, and MBP were significantly elevated in the mid-luteal phase. The average SCT was significantly decreased in the mid-luteal phase. In contrast, there were no significant changes in IOP or HR. These findings indicate that choroidal thickness decreases during the mid-luteal phase in healthy Japanese women with normal menstrual cycles depending on systemic circulatory dynamics. However, since the difference in the SCT values between the late follicular and the mid-luteal phase is not large (7 μm), the menstrual cycle may have little influence on the interpretation of choroidal thickness data in clinical practice.