Increase In Choroidal Thickness Research Articles

Increase in choroidal thickness after blue light stimulation of the blind spot in young adults.

Blue light activates melanopsin, a photopigment that is expressed in intrinsically photosensitive retinal ganglion cells (ipRGCs). The axons of ipRGCs converge on the optic disc, which corresponds to the physiological blind spot in the visual field. Thus, a blue light stimulus aligned with the blind spot captures the ipRGCs axons at the optic disc. This study examined the potential changes in choroidal thickness and axial length associated with blue light stimulation of melanopsin-expressing ipRGCs at the blind spot. It was hypothesized that blue light stimulation at the blind spot in adults increases choroidal thickness. The blind spots of both eyes of 10 emmetropes and 10 myopes, with a mean age of 28 ± 6 years (SD), were stimulated locally for 1-minute with blue flickering light with a 460nm peak wavelength. Measurements of choroidal thickness and axial length were collected from the left eye before stimulation and over a 60-minute poststimulation period. At a similar time of day, choroidal thickness and axial length were measured under sham control condition in all participants, while a subset of 3 emmetropes and 3 myopes were measured after 1-minute of red flickering light stimulation of the blind spot with a peak wavelength of 620nm. Linear mixed model analyses were performed to examine the light-induced changes in choroidal thickness and axial length over time and between refractive groups. Compared with sham control (2 ± 1μm, n = 20) and red light (-1 ± 2μm, n = 6) stimulation, subfoveal choroidal thickness increased within 60min after blue light stimulation of the blind spot (7 ± 1μm, n = 20; main effect of light, p < 0.001). Significant choroidal thickening after blue light stimulation occurred in emmetropes (10 ± 2μm, p < 0.001) but not in myopes (4 ± 2μm, p > 0.05). Choroidal thickening after blue light stimulation was greater in the fovea, diminishing in the parafoveal and perifoveal regions. There was no significant main effect of light, or light by refractive error interaction on the axial length after blind spot stimulation. These findings demonstrate that stimulating melanopsin-expressing axons of ipRGCs at the blind spot with blue light increases choroidal thickness in young adults. This has potential implications for regulating eye growth.

Peripapillary pachychoroid syndrome treated with dexamethasone implant: A case report.

To describe a case of peripapillary pachychoroid syndrome (PPS) in a diabetic patient with cystoid macular edema (CME), treated with intravitreal dexamethasone implant (IDI) injection. This report also illustrates the history of the disease after repeated IDI and dexamethasone topical treatment. A case report. A 77-year old male patient with PPS and good diabetic control was treated with dexamethasone implant for CME. After an initial morphofunctional improvement associated with a first IDI, the disease relapsed after the second dexamethasone implant injection. This was associated with a significant increase in both intraretinal fluid and choroidal thickness, with subsequent visual acuity (VA) decrease. At this point, a topical dexamethasone treatment was performed and, despite a morphological improvement, VA worsened compared with baseline, likely because of anatomical damage. In this report, the importance of the recognition of PPS is underlined and the possible occurrence of a "rebound" effect due to repeated IDI is described.

Choroidal Thickness and brolucizumab intravitreal injection: Cause or effect of intraocular inflammation?

Purposeto analyze the structural changes of choroidal thickness in patients with brolucizumab-related exudative vitritis after intravitreal injection, using EDI-OCT. MethodsOne hundred eyes of one hundred patients, affected by exudative age related-macular degeneration treated with brolucizumab intravitreal injection between January 2022 and august 2023 at Eye clinic of University of Federico II Naples, were enrolled. All eyes underwent macular examination using Enhanced Deep Imaging-OCT (Spectralis, Heidelberg Engineering inc.) preoperatively and at each postoperative check (1, 3, 6, 12 months). Anterior segment evaluation at slit lamp before and after injection was performed. ResultsOf the 100 treated eyes, 4 showed inflammatory signs related to exudative vitreitis, with inflammation signs at slit lamp examination and confirmed by OCT and B scan ecography. EDI-OCT revealed, in all of these 4 patients, a significant increase of choroidal thickness compared to baseline. Conclusionchoroidal thickness could be correlated in the inflammatory response generated in patients undergoing treatment with brolucizumab.

Impact of multifocal gas-permeable lens designs on short-term choroidal response, axial length, and retinal defocus profile.

To investigate the impact of multifocal gas permeable contact lens (MFGPCL) in various add power and distance/near area allocation on short-term changes of choroidal thickness (ChT), axial length (AL), and retinal defocus profile in young adults. Seventeen young adults (2 males and 15 females; age 23.17±4.48y) were randomly assigned to wear two designs binocularly with a one-week washout period in between. Total of four MFGPCL designs were assessed. All designs were distance-center that varied in two add power (+1.50 and 3.00 D) and/or two distance zone (DZ) diameters (1.50 and 3.00 mm; design A: DZ 1.5/add 3.0, B: DZ 1.5/add 1.5, C: DZ 3.0/add 3.0, D: DZ 3.0/add 1.5). ChT, AL, and peripheral refraction data were collected on each subject at baseline, on days 1 and 7 of MFGPCL daily wear. ChT was assessed in four quadrants using a spectral-domain optical coherence tomography. AL was shortened by -26±44 µm with lens C, -18±27 µm with lens D, -13±29 µm with lens A, and -8±30 µm with lens B (all P<0.05). A significant overall increase in ChT was observed with all 4 designs (lens A: +6±6 µm, B: +3±7 µm, C: +8±7 µm, and D: +8±7 µm). Temporal and superior choroid exhibited more choroidal thickening associated with MFGPCL. All designs induced significant relative peripheral myopia (RPM) beyond the central 20° across the horizontal meridian in both nasal and temporal fields (P<0.05). MFGPCLs show a significant influence on ChT and AL, which are associated with significant increase in RPM after short-term wear. The reliability and feasibility of quantifying short-term changes in ChT support its use as a promising marker for the long-term efficacy of myopia-controlling treatments.

Choroidal thickness measurement in central serous chorioretinopathy using swept source optical coherence tomography: an observational study

Background: Central serous chorioretinopathy (CSCR) is a common retinal condition with an increased risk of recurrence. Traditional approaches have made choroidal visualization challenging, but recent advances in optical coherence tomography (OCT) innovation have permitted the collection of more accurate choroidal visualizations. This study aimed to measure choroidal thickness in eyes with active CSCR as well as in the unaffected opposite eyes of these same individuals. Methods: This research was conducted at the ophthalmology division in Ghazi Al-Hariri hospital from the 1st of October 2019 until the 31th of March 2020. A total of 49 people, corresponding to 65 eyes, were included in the study. Among these participants, 16 individuals presented with central serous chorioretinopathy (CSCR), affecting a total of 32 eyes. The CSCR individuals were further split into two groups: "group A" consisted of 20 eyes with active CSCR, and "group B" encompassed the remaining 12 unaffected opposite eyes. Additionally, 33 individuals who were age and gender-matched served as controls assigned as "group C". Results: The choroid exhibited a substantial rise in thickness across each of the nine sectors in group A as compared to group C. Similarly, group B showed a significant increase in choroidal thickness in relation to group C. The mean subfoveal choroidal thickness (SFCT) was measured as follows: 474.55μm, 437.5μm, and 292.03μm among groups A, B, and C, correspondingly. These differences were identified as clinically significant for both A vs. C and B vs. C. Conclusions: This study's findings indicate a thickening of the choroid in both eyes exhibiting active CSCR, as well as in the unaffected opposite eyes of those with the disease.

Suppressive effect of nitric oxide synthase (NOS) inhibitor L-NMMA acetate on choroidal fibrosis in experimental myopic guinea pigs through the nitric oxide signaling pathway

Myopia is one of the most prevalent eye diseases that seriously threaten the eyesight of children and adolescents worldwide. However, the pathogenesis is still unclear, and effective drugs are still scarce. In the present study, the guinea pigs were randomly divided into a normal control (NC) group, a lens-induced myopia (LIM) group, a NOS inhibitor (L-NMMA) injection group, and a NOS inhibitor solvent phosphate-buffered saline (PBS) group and the animals received relevant treatments. After 2- and 4-week different treatments, we noted that the refraction and choroidal thickness in the LIM group decreased compared with the NC group, whereas the ocular axial length increased significantly, and the choroid showed a fibrotic trend. The expression of NOS1, NOS3, TGF-β1, COLI, and α-SMA at gene and protein levels was increased significantly in the choroid (all P < 0.05). After intravitreal injection of NOS inhibitor L-NMMA, we found that compared with the LIM group, the refraction and the choroidal thickness significantly increased, whereas the axial length reduced significantly, accompanied by an increase of choroidal thickness and an improvement of choroidal fibrosis. The expression levels of choroidal NOS1, NOS3, TGF-β, COLI, and α-SMA were significantly reduced (all P < 0.05). In conclusion, the trend of choroidal fibrosis in LIM guinea pigs is positively correlated with the increase in axial length. The NOS inhibitor L-NMMA can alleviate the process of choroidal fibrosis in myopic guinea pigs by inhibiting NO signaling pathway.

Ocular rigidity and choroidal thickness changes in response to microgravity: A case study

PurposeTo evaluate ocular rigidity and choroidal thickness changes in response to microgravity and the Valsalva maneuver in a private astronaut. MethodsOphthalmological examination and Optical Coherence Tomography were performed before, during, and after space flight. Choroidal thickness was measured at all time points at rest and during the Valsalva maneuver. Ocular rigidity was obtained before and after flight using a non-invasive method enhanced with deep learning-based choroid segmentation. ResultsOcular rigidity decreased after space flight compared to baseline. There was an increase in average choroidal thickness during the Valsalva maneuver compared to the resting condition before, during, and after space flight, and such increase was greater when the Valsalva maneuver was performed during space flight. Conclusions and importanceThe data indicates biomechanical changes to ocular tissues because of space flight and greater choroidal thickness increase. The findings could lead to a better understanding of space flight-associated neuro-ocular syndrome and may have repercussions for short duration missions in a nascent industry.

Ocular repercussions in COVID-19 patients: structural changes of the retina and choroid

ABSTRACT Background Neurotropic capabilities of SARS-COVs allow viruses to reach the central nervous system by hematogenous neuronal dissemination. The human retina, as an extension of the Central Nervous System, may have some neurodegenerative and/or vascular modifications related to COVID-19. Objectives To evaluate choroidal and inner neural layers in participants previously recovered from COVID-19 compared to the control group using optical coherence tomography. Methods With a cross-sectional approach, the sample (n = 96), constituted by patients who have recovered from COVID-19 (n = 56) and healthy participants control group (n = 40) were ophthalmologically characterized. The neurodegenerative and vascular histological assessment was performed using SD-OCT and the mean thickness was measured in Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. Retinal nerve fiber layer, Ganglion cell layer and subfoveal choroidal thickness were obtained through semi-automatic measurement. Results A total of 40 controls (27 women [67.5%]) and 56 COVID-19 participants (34 women [60.8%]) were included in this first report. There were retinal thickness significant differences in nearly all inner ETDRS subfields: nasal 3 mm (p = .025), I3 (p = .049), and temporal 3 mm (p = .009). Also, a decrease in neural layers was found in the nasal 3 mm (p = .049) and temporal 3 mm (p = .029) during ganglion cell layer assessment. The peripapillary retinal nerve fiber layer thickness was thinner in the COVID-19 group in superior temporal (p = .019), nasal (p = .002), inferior temporal (p = .046) and global (p = .014). Concerning the subfoveal choroidal measurement, an increase was observed in the COVID-19 group (p = .002). Conclusion Participants who had recovered from COVID-19 showed a non-glaucomatous neuropathy trend pattern. We found differences closer to the classic description of the “bow-tie” observed in other neurological as compressive neuropathies at the chiasma location. OCT assessment also showed an increase in choroidal thickness as a result of vascular changes.

Changes in retinal and choroidal blood flow after one or two horizontal rectus muscle surgeries by optical coherence tomography angiography

Purpose To evaluate the retinal and choroidal microvasculature after one or two horizontal rectus muscle surgeries in strabismus patients using swept-source optical coherence tomography angiography (SS-OCTA). Methods 30 eyes of 26 patients who underwent horizontal rectus muscle surgery were included in this study. Group A, A’ and Group B , B’ respectively consisted preoperative and postoperative measurements of patients who underwent one or two horizontal rectus muscle surgeries. We analyzed the vessel density (VD) of the superficial vascular complex (SVC), the deep vascular complex (DVC), the choriocapillary layer (CC), choroidal vascular index (CVI), choroidal thickness (T-Ch) and retinal nerve fiber layer thickness (T-RNFL) preoperatively, and one week postoperatively. Results Only in the nasal sector of the perifoveal zone, the VD in SVC demonstrated a significant increase in Group A’ (p = 0.027). There was a statistically significant difference in the VD changes of SVC between Group A and Group B (p = 0.043). The VD in DVC did not change significantly in the whole macular compared with the preoperative. Moreover, in both Group A’ and Group B’, the VD in CC showed a reduction in a single sector of the parafoveal area (p < 0.05). Group A’ have increased CVI in the nasal sector of the perifoveal region (p = 0.008). In addition, the T-Ch increase in the perifoveal region was more significant in Group B’ than in Group A’ (p < 0.05). Group A’ showed statistically significant decreases in T-RNFL in the foveal and parafoveal regions (p < 0.05). Conclusion This study revealed that the increase in choroidal thickness was more significant after two rectus muscle surgery. In addition, there were microvascular changes in sectional macular regions after strabismus surgery. OCTA is an excellent way to study the impact of strabismus surgery on the macular structure and blood flow.

Short term choroidal microvascular changes following photodynamic therapy in chronic central serous chorioretinopathy

BackgroundCentral serous chorioretinopathy (CSC) is characterized by focal serous detachment of the retina, primarily affecting the macula. Photodynamic therapy (PDT) is the best choice for treatment of chronic and recurrent patients. In this study we aim to evaluate the early effects of the half dose protocol (3 mg/m2 verteporfine) of PDT laser treatment on the micro vasculature of choroid. MethodsAmong thirty-one patients (62 eyes), twenty eyes were in the control group and forty-two eyes received PDT laser treatment. Vision log MAR, CMT (central macular thickness), SRF (sub retinal fluid), BCT (baseline choroidal thickness), CVI (choroidal vascular index), and laser treated area were compared between two groups. ResultsResults show that no strong correlation was detected between the impact of laser treatment and resolution of SRF in the first week in the fovea. The mean best corrected visual acuity (BCVA) of the patients significantly increased from 20/63 at the beginning of the study, according to the Snellen chart, to 20/49 in the first week and 20/38 in the sixth week. PDT can significantly reduce SRF and CMT in 6 weeks compared to the control group. Although there was initially a small, non-statistically significant increase in choroidal thickness and CVI after 1 week, a dramatic decrease occurs after 6 weeks. Therefore, after 6 weeks of PDT laser, all the indicators such as SRF, CMT, choroidal thickness, and CVI significantly reduced. ConclusionPDT laser can significantly reduce SRF and CMT at 1 and 6 weeks and choroidal thickness and CVI at 6 weeks in chronic CSC patients. Also, a larger laser treated area has no impact on the final outcome. Therefore, it seems that the mechanism of PDT in CSC disease is the recovery of choriocapillaris circulation.

Axial Length Control Is Associated With a Choroidal Thickness Increase in Myopic Adolescents After Orthokeratology.

To investigate the changes in choroidal thickness and axial length after orthokeratology in adolescents with low-to-moderate myopia and to explore the relationship between choroidal thickness and axial length variation. Thirty eyes with low-to-moderate myopia were retrospectively studied, and optometric data were collected before and after 6 months of continuous orthokeratology. Axial length and choroidal and foveal thicknesses were measured using optical biometry and enhanced depth imaging-spectral domain optical coherence tomography, respectively. Axial length in the low myopia group increased (P<0.001) after 6 months of orthokeratology, and the variation was greater than that in the moderate myopia group (P<0.05). The subfoveal choroidal thickness in low and moderate myopia groups increased (P<0.01), and the variation was greater in the moderate myopia group (P<0.05). Choroidal thickness in all seven measured spots increased, with the variation of subfovea, nasal 1 mm to fovea, and temporal 1 mm to fovea being statistically significant (P<0.001, P<0.05, and P<0.05). The change in axial length was negatively associated with subfoveal and average choroidal thicknesses (P<0.01). Adolescents with moderate myopia presented better axial length control after 6 months of orthokeratology. The choroidal thickness of low and moderate myopic eyes increased, and the variation was more significant in moderate myopic eyes. The axial length control effects can be associated with an increase in the subfoveal and average choroidal thickness.

Effects of blue light exposure on ocular parameters and choroidal blood perfusion in Guinea pig

PurposeTo investigate the impact of different duration of blue light exposure on ocular parameters and choroidal blood perfusion in guinea pigs with lens-induced myopia. MethodThree-week-old Guinea pigs were randomly assigned to different light-environment groups. All groups were subjected to 12-h light/dark cycle. The control (NC) group was conditioned without intervention. While lens-induced myopia (LIM) groups had a −10D lens placed in the right eye and 0D in the left eye. The guinea pigs were exposed to increasing periods of blue-light (420 nm) environment for 3,6,9,12 h per day. Changes in refraction, axial length (AL), the radius of corneal curvature (CCR), choroidal thickness (ChT), and choroidal blood perfusion (ChBP)were measured in both LIM-eye and fellow-eye during the second and fourth week of LIM duration. ResultsDuring the first two weeks of the experiment, blue light exposure raised ChBP and ChT, and the effect of suppressing myopia was proportional to the duration of blue light exposure. However, in the fourth week of the experiment, prolonged blue light (12BL) exposure led to a reduction in retinal thickness and the increase in ChT and ChBP ceased. Shorter blue light exposure had a better effect on myopia suppression, with all blue light groups statistically different from the LIM group. ConclusionExposure to blue-light appears to have the potential to improve ChBP and ChT, thereby inhibiting the development of myopia. we speculate that blue-light inhibits the development of myopia for reasons other than longitudinal chromatic aberration (LCA). However,long-term exposure to blue-light may have adverse effects on ocular development. The next step is to investigate in depth the mechanisms by which the rational use of blue light regulates choroidal blood flow, offering new hope for the treatment of myopia.

Measurement of Sub-Foveal Choroidal Thickness in Hyperthyroid Patients with Thyroid Associated Ophthalmopathy, Using Spectral Domain OCT

Background Thyroid associated ophthalmopathy (TAO) is an auto-immune orbitopathy, associated with thyroid dysfunction. It results in compression of the orbital contents, impairment of the blood flow and thus affects the choroidal and retinal microstructure and function. Aim of the Work The purpose of this study is to measure the central choroidal thickness in active and inactive TAO using Optical Coherence Tomography (OCT) and compare it to the control group. Patients and Methods The cross section study was conducted on participants recruited from the ophthalmology clinic of the National Institute of Diabetes and Endocrinology (NIDE). The study included 160 eyes from 80 participants (40 hyperthyroidism patients and 40 control subjects). Data was collected during the period of December 2019 to June 2020. Results There was no significant difference regarding age, gender, vision and IOP between TAO patients (either active or inactive) and normal subjects. Our study showed that there was a significant increase in sub-foveal choroidal thickness in patients with TAO compared to the control group. It also showed a significant increase in sub-foveal choroidal thickness in the active subgroup more than the inactive subgroup. In addition, a decrease in central foveal thickness was found in patients with TAO compared to the control group, but there was no significant difference found between active and inactive subgroups. Conclusion The findings of this study suggest that there is a significant affection of sub-foveal choroidal thickness and central foveal thickness in thyroid-associated-ophthalmopathy (TAO) patients.

Variation of Orthokeratology Lens Treatment Zone (VOLTZ) Study: A 2-year randomised clinical trial.

To compare axial elongation (AE) and treatment zone (TZ) characteristics in children wearing 6 mm or 5 mm back optic zone diameter (BOZD) orthokeratology (ortho-k) lenses over 2 years. Forty-five (6 to <11 years of age) myopic (-4.00 to -0.75 D) children of Chinese ethnicity were randomly assigned to use the two different lens designs (23 and 22 wore the 6 and 5 mm lenses, respectively). Data collection was performed at baseline and every 6-months after commencing lens wear. After 24 months, subjects wearing lenses with a 5 mm BOZD achieved smaller TZ diameter (horizontal: 2.69 ± 0.28 vs. 3.84 ± 0.39 mm; vertical: 2.65 ± 0.22 vs. 3.42 ± 0.34 mm, p < 0.001) and less AE (0.15 ± 0.21 vs. 0.35 ± 0.23, p = 0.005) compared to those using the 6 mm design, with no difference in choroidal thickness (ChT) changes (p = 0.93). A significant increase in ChT, using pooled data analysis, was noted at the 6-month (11.8 ± 19.77 μm, p < 0.001) and 12-month (12.0 ± 23.7 μm, p = 0.004) visits, compared to baseline, indicating a transient change in ChT. Significant associations were noted, using linear mixed models, between AE and the TZ diameters (p < 0.003) after adjusting for baseline data. A very weak association was found between ChT changes and AE, with the effect size close to zero. Smaller BOZD ortho-k lenses resulted in a smaller TZ diameter, which was associated with less AE after 2 years of treatment. The changes in ChT played a very weak role, suggesting that other factors may contribute more to the reduced AE in subjects wearing lenses having a smaller BOZD.

Change in Subfoveal Choroidal Thickness following Cataract Surgery Imaged with Enhanced Depth Imaging Optical Coherence Tomography.

Due to its invasive nature, cataract surgery can lead to inflammatory processes in the posterior segment, which can result in prolonged recovery times, reduced functional outcomes, and late-onset complications. The aim of the current study was to identify wherever phacoemulsification parameters play a role in choroidal thickness change following cataract surgery. This prospective single-center study enrolled 31 patients (31 eyes) scheduled to undergo routine cataract surgery. Patients with previous ocular surgeries, pathologies or general disorders affecting vision were excluded. Patients were examined preoperatively, as well as 1, 4, and 12 weeks after surgery. Corrected distance visual acuity (CDVA), intraocular pressure (IOP) as well as cumulative dissipated energy (CDE), ultrasound time (UT), and fluids used during surgery were recorded. Subfoveal choroidal thickness was measured manually by two masked independent experts using enhanced depth imaging (EDI) optical coherence tomography (OCT). Furthermore, cataract density was automatically calculated using a custom MATLAB script and an anterior segment OCT. Subfoveal choroidal thickness increased significantly (p < 0.001, Student's paired sample t-test) and continuously during the 12-week-long follow-up period. Both the nuclear lens density and the improvement in CDVA correlated significantly with this increase (r = 0.413, p = 0.021 and r = 0.421, p = 0.018, respectively). Neither the CDE (r = 0.334, p = 0.071), the UT (r = 0.102, p = 0.629), the amount of fluid used (r = 0.237, p = 0.27) nor the decrease in IOP (r = - 0.197, p = 0.288) showed any significant correlation with the choroidal swelling. Cataract surgery leads to an increase in subfoveal choroidal thickness. While no statistically significant correlation to the phacoemulsification parameters could be established, this might be because of a selection bias due to the technological constraints of the OCT. Nevertheless, the choroid might play a central role in early- and late-onset complications.

CURRENT VIEW OF THE SPECTRUM OF PACHYCHOROID DISEASES. A REVIEW.

The term "pachychoroid" (greek pachy- [παχύ] - thick) was first used by Warrow et al. in 2013. It is defined as an abnormal and permanent increase in choroidal thickness ≥ 300 μm, which is caused by dilatation of the choroidal vessels of the Haller's layer, thinning of the Sattler's layer and the choriocapillaris layer. Literary research focused on the current view of pachychoroid spectrum diseases, including clarification of the pathophysiological theories of the formation of "pachychoroid". It is assumed that "pachychoroid" disease has an autosomal dominant type of heredity. Depending on the further activity of various exogenous and/or endogenous factors, pachychoroid diseases may appear. According to the current knowledge, the spectrum of pachychoroid disease covers six clinical entities: pachychoroid pigment epitheliopathy, central serous chorioretinopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy, focal choroidal excavation and peripapillary pachychoroid syndrome. In this study, we describe the clinical symptoms and objective findings of focal choroidal excavation and peripapillary pachychoroid syndrome. The current pathophysiological theory of pachychoroid diseases is based on impaired venous outflow from the choroid ("venous overload choroidopathy") and thickening of the sclera in the eyes of affected patients. Pachychoroid diseases should be included in the differential diagnosis of characteristic features observed during multimodal imaging analysis of choroidal changes.

Evaluation of optical coherence tomography parameters before and after parenteral iron treatment of patients with iron deficiency anemia

PurposeThe aim of our study is to evaluate the relationship between iron deficiency anemia (IDA), which is a common and often chronic condition in young women, and the optical coherence tomography (OCT) findings, which have become an indispensable part of ophthalmology practice. We aim to identify a new biomarker for anemia evaluation by demonstrating the morphological changes in the eye before and after iron replacement treatment through OCT findings. Methods70 eyes of 35 patients diagnosed with IDA and planned to have parenteral iron replacement were included in the study. Patients were evaluated before treatment and between 4–6 weeks and 12–16 weeks after treatment. During visits, peripapillary and macular choroidal thicknesses and retinal nerve fiber layer (RNFL) thicknesses were evaluated with OCT along with serum hemoglobin(Hb) values. ResultsThe mean age of the patients was 36.80 ± 7.25. All 35 patients (100%) were female. The mean baseline Hb values of the patients increased statistically significantly both after 4–6 weeks and after 12–16 weeks (p < 0.05). A statistically significant difference was found between baseline and third visit in OCT findings in subfoveal, temporal, nasal, peripapillary temporal and peripapillary nasal choroidal thicknesses and total, inferior, nasal and temporal RNFL thicknes (p < 0.05). There was no statistically significant difference between the baseline and the third visit in the central macular thickness and superior RNFL thickness. ConclusionSignificant increases in choroidal and RNFL thickness were detected after parenteral iron replacement in patients diagnosed with IDA. Our results demonstrate that the changes induced by IDA on the retina can be reversed with treatment.

Study of changes in choroidal thickness with severity of diabetic retinopathy and diabetic macular edema in type 2 diabetic patients

: Diabetic retinopathy (DR) is one of the long-term microvascular complications of Diabetes mellitus. Chronic hyperglycemia cause microvascular abnormalities to both retina and choroid. Optical coherence tomography (OCT) is a non-invasive fundus imaging modality, which plays a vital role in revealing the pathogenesis and development of retinal–choroidal diseases.This prospective observational study included 128 eyes of 64 subjects diagnosed with type 2 diabetes and out of 128 eyes, 113 (88%) eyes were found to have DR. Collected data included age, gender, duration of diabetes, glycemic control, comprehensive ocular examination, fundus photography, and CT measurement on OCT.Mean age in the study group was 53.71 ± 9.37 years (45–70 years). Out of 113 eyes, 19 (17%) eyes were diagnosed as mild NPDR, 21 (19%) eyes had moderate NPDR, 36 (31%) eyes had severe NPDR and 37 (33%) eyes had PDR. The average SFCT in MILD NPDR was 310 ± 14.70 μm at 95% CI (1.86), MODERATE NPDR was 316 ± 17.97 μm at 95% CI (2.70), SEVERE NPDR was 326.02 ± 14.05 μm at 95% CI (4.59) and PDR was 298.55 ± 18.75μm at 95% CI. (1.41). The presence of DME significantly affects average SFCT. It was observed that choroidal thickness tends to increase as the severity DR with DME progress.The average SFCT was thicker in patients with increase in severity of DR, and then SFCT decreased in patients with PDR. As the severity of NPDR increased from mild to moderate to severe NPDR, there was increase in sub foveal choroidal thickness. (p&amp;#60;0.05). PDR showed decrease in sub foveal choroidal thickness in comparison to NPDR which is highly statistically significant. p=0.01 (p&amp;#60;0.05). The presence of DME significantly affects average SFCT (p&amp;#60;0.05). It was observed that choroidal thickness tends to increase as the severity DR with DME progress. Thus, Choroidal thickness measurement can help in assessment of DR pathogenesis.

Choroidal vasculature act as predictive biomarkers of long-term ocular elongation in myopic children treated with orthokeratology: a prospective cohort study

BackgroundDespite receiving orthokeratology (ortho-k), the efficacy of retarding ocular elongation during myopia varies among myopic children. The current study aimed to investigate the early changes of choroidal vasculature at one month after ortho-k treatment and its association with one-year ocular elongation, as well as the role of such choroidal responses in predicting the one-year control efficacy of ortho-k treatment.MethodsA prospective cohort study was conducted in myopic children treated with ortho-k. Myopic children aged between 8 and 12 years who were willing to wear ortho-k lenses were recruited consecutively from the Eye Hospital of Wenzhou Medical University. Subfoveal choroidal thickness (SFCT), submacular total choroidal luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), choriocapillaris flow deficit (CcFD) were evaluated by optical coherence tomography (OCT) and OCT angiography over a one-year period.ResultsFifty eyes from 50 participants (24 males) who finished one-year follow-ups as scheduled were included, with a mean age of 10.31 ± 1.45 years. The one-year ocular elongation was 0.19 ± 0.17 mm. The LA (0.03 ± 0.07 mm2), SA (0.02 ± 0.05 mm2) increased proportionally after one-month of ortho-k wear (both P < 0.01), as did the SFCT (10.62 ± 19.98 μm, P < 0.001). Multivariable linear regression analyses showed that baseline CVI (β = − 0.023 mm/1%, 95% CI: − 0.036 to − 0.010), one-month LA change (β = − 0.009 mm/0.01 mm2, 95% CI: − 0.014 to − 0.003), one-month SFCT change (β = − 0.035 mm/10 µm, 95% CI: − 0.053 to − 0.017) were independently associated with one-year ocular elongation during ortho-k treatment after adjusting with age and sex (all P < 0.01). The area under the receiver operating characteristic curve of prediction model including baseline CVI, one-month SFCT change, age, and sex achieved 0.872 (95% CI: 0.771 to 0.973) for discriminating children with slow or fast ocular elongation.ConclusionsChoroidal vasculature is associated with ocular elongation during ortho-k treatment. Ortho-k treatment induces increases in choroidal vascularity and choroidal thickness as early as one month. Such early changes can act as predictive biomarkers of myopia control efficacy over a long term. The utilization of these biomarkers may help clinicians identify children who can benefit from ortho-k treatment, and thus has critical implications for the management strategies towards myopia control.

Effect of Phacoemulsification on Sub Foveal Choroidal and Central Macular Thickness as measured by Swept Source Optical Coherence Tomography.

To study the effect of Phacoemulsification on Sub Foveal Choroidal Thickness (SFCT) and Central Macular Thickness (CMT) as measured by Swept Source Optical Coherence Tomography (OCT). This experimental study was conducted at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from April 2021 to February 2022. One hundred eyes of 100 patients with age related cataract underwent uneventful phacoemulsification surgery. Pre-operative SFCT and CMT was measured and compared with SFCT and CMT at one week, one month and three months after surgery using swept source OCT. Mean age of study population was 56.76±8.31 years. Out of 100 patients, 46 (46%) were males and 54 (54%) were females. Mean pre-operative CMT, one week, one month and three months post-operative CMT was 233.95±9.46 μm, 232.88±8.59 μm, 230.38±10.62 μm and 230.67±7.55 μm respectively. Mean pre-operative SFCT, one week, one month and three months post-operative SFCT was 337.14±8.41 μm, 339.14±9.63 μm, 339.39±11.96 μm and 351.39±9.19 μm respectively. The difference of mean change in CMT from baseline at one week, one month and three months post-operatively was not statistically significant. The difference of mean change in SFCT from baseline at one week and one month post-operatively was not statistically significant. However, the difference of mean change in SFCT from baseline at three months post-operatively was statistically significant (p<0.05). Uneventful phacoemulsification surgery does not have any effect on central macular thickness, however there is a significant increase in subfoveal choroidal thickness at three months after surgery.