Mean Peripapillary Choroidal Thickness Research Articles

Relationship between the structure and microcirculation of the optic disc region and myopic traction maculopathy in highly myopic eyes

PurposeTo explore the characteristics and influencing factors structural and microcirculatory of optic disc and peripapillary tissue in eyes with myopia traction maculopathy (MTM).MethodsThere were 100 eyes from 77 patients in this study. We used 1:1 matching axial length in myopic eyes. Patients were divided into two groups according to the presence or absence of MTM. Fundus structure parameters were obtained by swept source optical coherence tomography (SS-OCT), and the optic disc microcirculation parameters were obtained by OCT angiography (OCTA).ResultsMTM group were older (P = 0.001) and had poorer Best-corrected Visual Acuity (BCVA) (P = 0.011), the optic disc-fovea distance (DFD) was longer (P < 0.019), optic disc tilt was greater (P < 0.001), area of peripapillary atrophy (PPA) was larger (P < 0.001), and PPA/optical disc area (ONH) was higher (P < 0.001). The peripapillary scleral thickness (PST) was lower in the MTM group (P < 0.001). The mean peripapillary choroidal thickness (PCT) (P < 0.001) and PCT in the 10 orientations were significantly lower in the MTM group than in the NMTM group (all P < 0.01). Vascular density in the nasosuperior (NS) region of the optic disc was significantly lower in the MTM group (P = 0.037). The generalized estimating equation suggested that PPA area (P = 0.028), mean PCT (P = 0.008), superior PCT (P = 0.027), inferonasal PCT (P = 0.040), temporoinferior PCT (P = 0.013), and PST (P = 0.046) correlated with MTM. Age, axial length, optic disc tilt, PPA area, mean PCT, and optic disc central zone (0–2 mm) vascular density (all P < 0.05) were significantly correlated with PST.ConclusionsThe enlarged PPA area and thinner PCT and PST in eyes with MTM are more significant. Lower PST in high myopia was related to abnormalities of PCT and microcirculation.Trial registrationClinical Trial Registration number: ChiCTR2100046590

Peripapillary Choroidal Vascularity and Visual Correlates in Non-Arteritic Anterior Ischemic Optic Neuropathy Using Swept-Source Optical Coherence Tomography.

The peripapillary choroid shares a blood supply with and is directly apposed to the optic nerve, and therefore may contribute to the pathogenesis of non-arteritic anterior ischemic optic neuropathy (NAION). Prior studies evaluating peripapillary choroidal thickness (PCT) or choroidal vascularity index (CVI; the ratio of the perfused area to total choroid area) have produced mixed results. None investigated the relationship between PCT and CVI or demonstrated functional correlates. We hypothesized that greater PCT and lower CVI would correlate with visual function in patients presenting with NAION. Seventeen eyes with NAION (9 acute, 8 non-acute) and 6 unaffected "fellow" eyes in 13 patients, and 18 eyes in 18 age-matched control subjects were imaged using swept-source optical coherence tomography (SS-OCT) prospectively between 2017-2018. Mean PCT and CVI measurements were compared across groups and with respect to corresponding automated perimetric performance at the same visit. Analysis of variance showed significantly greater PCT (NAION: 278 ± 65 μm, Fellow: 221 ± 50 μm, Control: 158 ± 27 μm, p<0.001) and lower CVI (NAION: 0.35 ± 0.03, Fellow: 0.35 ± 0.04, Control: 0.38 ± 0.02, p<0.005) in patients with NAION compared to control subjects. Bonferroni-corrected pairwise comparisons showed greater PCT and lower CVI in NAION-affected eyes compared to control eyes (p values<0.008), and no significant differences in PCT or CVI between NAION and fellow eyes (p values>0.06). PCT was negatively correlated with CVI among unaffected fellow eyes (r=-0.8, p<0.05), but not among acute NAION eyes (r=-0.1, p>0.7), non-acute NAION eyes (r=0.1, p>0.7), or controls (r=-0.3, p>0.2). Nasal CVI was positively correlated with mean deviation scores in non-acute NAION (r=0.8, p<0.02), but not among fellow unaffected eyes (r=0.8, p>0.05) or acutely affected NAION eyes (r=-0.3, p>0.4). Mean and temporal PCT correlated with pattern standard deviation scores among unaffected fellow eyes (r=0.8, p<0.04; r=0.9, p<0.03), but not among acute NAION eyes (r=-0.2, p>0.5; r=-0.1, p>0.7) or non-acute NAION eyes (r=0.1, p>0.7; r=0.05, p>0.9). NAION and unaffected fellow eyes demonstrate increased choroidal thicknesses and reduced vascular density. Perimetric performance is directly associated with vascular density among non-acutely affected eyes with NAION. Ongoing work will provide further insights into these structure-function relationships with pathogenic and pathophysiologic relevance.

Peripapillary Choroid Thickness as a Predisposing Factor for Nonarteritic Anterior Ischemic Optic Neuropathy: A Semiautomated OCT Study.

PurposeThe purpose of this study was to investigate the correlations between peripapillary choroidal thickness (PCT) and nonarteritic ischemic optic neuropathy (NAION) by using semiautomated optic coherence tomography (OCT).MethodsA total of 35 NAION eyes, 29 unaffected fellow eyes, and 40 eyes from an age-matched control group were recruited. Enhanced-depth imaging OCT was performed after the resolution of disc edema. PCT was measured using a customized semiautomated MATLAB program. Regression models adjusted for multiple variables were used to inspect the correlation between mean PCT and NAION.ResultsThe mean PCT in NAION eyes, unaffected fellow eyes, and the control group was 197.09 ± 38.09, 196.52 ± 38.47, and 153.53 ± 29.92 µm, respectively. The mean PCT was significantly thicker both in NAION-affected eyes and fellow eyes compared with the control group (P < 0.001). No significant difference existed between NAION-affected eyes and unaffected fellow eyes. The PCT of the superior quadrant was significantly thicker than that of the inferior quadrant in all three groups. In the multivariate logistic regression, PCT was the only predisposing factor for NAION. However, the value of the PCT was not correlated with final visual outcomes.ConclusionsWith a semiautomated program to alleviate the missing measurements, our study demonstrated significantly thicker PCT in both NAION-affected and unaffected eyes of patients, which indicated that peripapillary pachychoroid is a predisposing factor for NAION but may not be a prognostic factor for visual outcomes.Translational RelevanceAccurate measurement of PCT by using semiautomated OCT illustrates the correlation between choroidal vasculature and NAION.

Changes in peripapillary and subfoveal choroidal thickness in patients with central retinal vein occlusion.

PurposeWe sought to evaluate changes of mean peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) over 12 months in patients with unilateral central retinal vein occlusion (CRVO).MethodsOur retrospective, observational study included 19 patients with treatment-naïve, unilateral CRVO who completed at least 12 months of follow-up period. Mean PCT and mean SFCT in CRVO-affected eyes and unaffected contralateral eyes were measured at each follow-up visit, and then compared. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline×100%) were determined. We also investigated the predictive factors for visual outcome in the CRVO-affected eyes.ResultsIn the CRVO-affected eyes, mean PCT was 146.7±41.9 μm at baseline, and 106.5±24.2 μm at 12 months (P < 0.001). Mean PCT of the contralateral eyes was 129.8±42.6 μm at baseline and 124.6±39.7 μm at 12 months (P = 0.089). Mean SFCT of CRVO-affected eyes was 225.8±77.9 μm at baseline, and 199.4±66.6 μm at 12 months (P = 0.009). Mean SFCT of the contralateral eyes was 218.4±83.0 μm at baseline, and 208.4±78.1 μm at 12 months (P = 0.089). Δ PCT was -41.6±25.3 μm in the CRVO-affected eyes, and -5.2±5.8 μm in the contralateral eyes (P<0.001). % PCT was -24.9±14.0% in the CRVO-affected eyes, and -4.0±0.4% in the contralateral eyes (P = 0.001). Δ SFCT was -26.4±24.6 μm in the CRVO-affected eyes, and -9.5±16.7μm in the contralateral eyes (P = 0.016). % SFCT was -10.4±9.8% in the CRVO-affected eyes, and -3.4±6.4% in the contralateral eyes (P = 0.015). Among the various factors, BCVA at baseline (β = 0.797, P = 0.001) and % SFCT (β = 0.712, P = 0.001) were significantly associated with visual outcome at 12 months in the CRVO-affected eyes.ConclusionBoth peripapillary and subfoveal choroidal thickness reduced significantly over 12 months in the CRVO-affected eyes, but not in the contralateral eyes. In addition, the absolute reduction amount and reduction ratio of PCT and SFCT were significantly greater in the CRVO-affected eyes than the contralateral eyes.

The influence of axial myopia on optic disc characteristics of glaucoma eyes

This study characterizes differences in glaucomatous eyes with and without high axial myopia using custom automated analysis of OCT images. 452 eyes of 277 glaucoma patients were stratified into non (n = 145 eyes), mild (n = 214 eyes), and high axial myopia (axial length (AL) > 26 mm, n = 93 eyes). Optic disc ovality index, tilt and rotation angle of Bruch´s membrane opening (BMO) and peripapillary choroidal thickness (PCT) were calculated using automated and deep learning strategies. High myopic optic discs were more oval and had larger BMO tilt than mild and non-myopic discs (both p < 0.001). Mean PCT was thinnest in high myopic eyes followed by mild and non-myopic eyes (p < 0.001). BMO rotation angle, global retinal nerve fiber layer (RNFL) thickness and BMO-minimum rim width (MRW) were similar among groups. Temporal RNFL was thicker and supranasal BMO-MRW was thinner in high myopic eyes. BMO tilt and PCT showed moderate and temporal RNFL and nasal BMO-MRW showed weak but significant associations with AL in multivariable analyses (all p < 0.05). Large BMO tilt angle and thin PCT are characteristics of highly myopic discs and were not associated with severity of glaucoma. Caution should be exercised when using sectoral BMO-MRW and RNFL thickness for glaucoma management decisions in myopic eyes.

Focal lamina cribrosa defects and significant peripapillary choroidal thinning in patients with unilateral branch retinal vein occlusion.

To investigate the prevalence of focal lamina cribrosa (LC) defects in patients with unilateral branch retinal vein occlusion (BRVO) and to compare ocular characteristics between eyes with and without focal LC defect and those eyes with normal-tension glaucoma (NTG). This retrospective, cross-sectional study included 121 patients. Thirty-nine patients had unilateral BRVO (BRVO group), 36 patients had NTG (NTG group), and 36 patients had vitreous floaters, but no other ocular diseases (control group). In addition to baseline characteristics such as age, sex, refractive errors, the ocular characteristics such as peripapillary choroidal thickness (PCT), retinal nerve fiber layer thickness, and subfoveal choroidal thickness were retrospectively analyzed. Focal LC defects were detected in 20 eyes of 14 patients (38.9%) in the BRVO group, 24 eyes of 15 patients (41.7%) in the NTG group, and none in the control group (P<0.001). In the BRVO-affected eyes, the mean PCT was 102.7±31.1 μm in the eyes with focal LC defects, and 163.1±70.1 μm in the eyes without LC defects (P = 0.009). In the BRVO-affected eyes, the mean PCT was 102.7±31.1 μm in the eyes with focal LC defects, and 163.1±70.1 μm in the eyes without LC defects (P = 0.009). In the NTG group, the mean PCT was 133.1±48.9 μm in the eyes with focal LC defects and 170.8±81.9 μm in those without (P = 0.042). The other baseline and ocular characteristics were not significantly different between the eyes with and without focal LC defects in both the BRVO group and the NTG group. About 40% of the patients with unilateral BRVO had focal LC defect in the BRVO-affected eyes and unaffected fellow eyes, similar prevalence to the patients with NTG. The mean PCT was significantly thinner in the eyes with focal LC defect than those without in the patients with BRVO and those with NTG, suggesting possible pathophysiologic correlation between these two diseases.

Choroidal Thickness in Acute Non-arteritic Anterior Ischemic Optic Neuropathy.

PurposeTo compare the choroidal thickness in eyes with acute non-arteritic anterior ischemic optic neuropathy (NAION) with healthy contralateral eye and normal controls.MethodsThirty-eight eyes with NAION, thirty-eight unaffected fellow eyes, and seventy-four eyes from 37 healthy, age- and sex-matched subjects were included in this prospective comparative case-control study. Choroidal thickness was measured by enhanced depth imaging (EDI) of spectral domain optical coherence tomography (SD-OCT). Peripapillary choroidal thickness (PCT) was measured at 1000 and 1500 m from Bruch's membrane opening (BMO). Subfoveal choroidal thickness (SFCT) was measured in central subfoveal area, and 500 microns apart in temporal and nasal sides. Choroidal thickness among NAION eyes, uninvolved fellow eyes, and control eyes were compared.Results The mean of PCT at 1000 m was significantly thicker in NAION and fellow eyes compared to control eyes (169.7 47, 154.4 42.1, and 127.7 49.9 m, respectively, P 0.001 and P = 0.42). The mean PCT at 1500 m was also significantly thicker in NAION and fellow eyes compared to control eyes (178.6 52.8, 162.6 46.1, and 135.1 59 m, respectively, P = 0.007 and P = 0.048). The mean PCT at 1000 and 1500 m was significantly greater in NAION compared to fellow eyes (P = 0.027 and P = 0.035, respectively). The mean of SFCT was significantly thicker in NAION compared to control eyes (P = 0.032); however, there was no significant difference between uninvolved fellow and control eyes (P = 0.248).ConclusionThicker choroidal thickness in acute NAION and uninvolved fellow eyes compared to normal eyes suggests a primary choroidal role in NAION pathophysiology.

Sectoral changes of the peripapillary choroidal thickness in patients with unilateral branch retinal vein occlusion.

To investigate sectoral changes in the mean peripapillary choroidal thickness (PCT) in patients with unilateral branch retinal vein occlusion (BRVO). This retrospective, interventional study included 41 patients with acute, unilateral BRVO without macular edema. All patients completed at least a 6-month follow-up period. The PCT was measured at eight locations (temporal, superotemporal, superior, superonasal, nasal, inferonasal, inferior, and inferotemporal). In addition to calculating the average of all locations, the peripapillary choroidal area was divided into four sectors: superior (average of superotemporal PCT, superior PCT, and superonasal PCT), temporal, inferior (average of inferotemporal PCT, inferior PCT, and inferonasal PCT), and nasal. In the BRVO-affected eyes, the mean PCT was 177.7±69.8 µm (range, 70.1-396.0 µm) at baseline and 127.8±54.8 µm (range, 56.4-312.1 µm) at 6mo (P<0.001). In the non-affected contralateral eyes, the mean PCT was 192.5±60.6 µm (range, 61.4-365.0 µm) at baseline and 165.9±61.1 µm (range, 56.8-326.8 µm) at 6mo (P<0.001). In sectoral analysis, the mean PCT in each sector was significantly reduced in over 6mo in the BRVO-affected eyes (all P<0.001). In the non-affected contralateral eyes, the mean PCT was not significantly changed in any sector over the 6-month follow-up period (superior sector, P=0.143; temporal sector, P=0.825; inferior sector, P=0.192; and nasal sector, P=0.599). Sectoral analysis shows that the mean PCTs in all sectors are reduced significantly over 6mo in the BRVO-affected eyes, but not in the non-affected contralateral eyes.

SIGNIFICANT REDUCTION OF BOTH PERIPAPILLARY AND SUBFOVEAL CHOROIDAL THICKNESS AFTER PANRETINAL PHOTOCOAGULATION IN PATIENTS WITH TYPE 2 DIABETES.

To evaluate changes in peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) after panretinal photocoagulation (PRP) for diabetic retinopathy. This retrospective interventional study included 59 treatment-naive eyes of 33 patients who underwent PRP and completed ≥12 months of follow-up. Peripapillary choroidal thickness and SFCT were measured at baseline and 1, 3, 6, and 12 months post-PRP. Differences between baseline and 12 months (ΔSFCT and ΔPCT) and percentage changes (ΔSFCT or ΔPCT/baseline × 100%) were determined. Mean SFCT was 287.7 ± 76.7 μm (139.0-469.0 μm) at baseline and 225.8 ± 62.0 μm (102.5-379.5 μm) 12 months post-PRP (P < 0.001). Mean PCT was 161.2 ± 16.5 μm (75.3-308.1 μm) at baseline and 128.4 ± 41.8 μm (73.0-212.9 μm) 12 months post-PRP (P < 0.001). ΔSFCT was -61.3 ± 28.7 μm (-139.5 to -17.0 μm), and %SFCT was 21.2 ± 7.2% (6.8% to 36.1%). ΔPCT was -36.4 ± 23.2 μm (-149.1 to 5.4 μm), and %PCT was 22.4 ± 12.0% (2.5% to 62.6%). Diabetic retinopathy severity was the only factor significantly correlated with %SFCT (β = 0.500, P = 0.004) and %PCT (β = 0.152, P = 0.024). Both PCT and SFCT reduced significantly after PRP. Diabetic retinopathy severity was significantly correlated with post-PRP changes of peripapillary and SFCT.

SIGNIFICANT REDUCTION OF PERIPAPILLARY CHOROIDAL THICKNESS IN PATIENTS WITH UNILATERAL BRANCH RETINAL VEIN OCCLUSION.

To evaluate changes in peripapillary choroidal thickness in patients with branch retinal vein occlusion (BRVO) over 12 months, using spectral-domain optical coherence tomography with enhanced depth imaging. This retrospective, interventional case series included 20 treatment-naive patients with unilateral BRVO with at least 12 months follow-up. The peripapillary choroidal thickness was measured over 12 months. In BRVO-affected eyes, the mean peripapillary choroidal thickness was 213.5 ± 51.7 μm (126.1[FIGURE DASH]326.9 μm) at baseline and 129.6 ± 39.3 μm (65.9[FIGURE DASH]197.1 μm) at 12 months. In nonaffected contralateral eyes, the mean peripapillary choroidal thickness was 194.1 ± 39.8 μm (158.5[FIGURE DASH]238.3 μm) at baseline and 156.6 ± 56.2 μm (125.9[FIGURE DASH]213.9 μm) at 12 months. The mean peripapillary choroidal thickness decreased significantly over 12 months in both BRVO-affected and nonaffected eyes (P < 0.001, both eyes). Although the mean peripapillary choroidal thickness was not significantly different between groups at baseline (P = 0.472), it was significantly lower in BRVO-affected eyes than in nonaffected eyes at 12 months (P = 0.036). Peripapillary choroidal thickness decreased significantly over 12 months in BRVO-affected eyes and nonaffected eyes in patients with unilateral BRVO.

Peripapillary choroidal thickness in contralateral eyes after evisceration of diseased eyes.

To evaluate peripapillary choroidal thickness changes in contralateral eyes of patients who had undergone evisceration of their diseased eyes. In this retrospective study, peripapillary choroidal thickness parameters in 34 eyes of 34 patients who had undergone diseased-eye evisceration between March 2014 and May 2016 were evaluated using spectral domain optical coherence tomography. The scans were manually delineated to identify the principal surfaces of Bruch's membrane, the Bruch's membrane opening, and the anterior sclera. Peripapillary choroidal thickness was measured between the Bruch's membrane and the anterior sclera at increasing distance away from the Bruch's membrane opening. The mean peripapillary choroidal thickness values in the contralateral eyes of the patients and those of the control group were compared. The mean peripapillary choroidal thickness was higher in the contralateral eyes of the patients compared with that of normal eyes at all distances from the Bruch's membrane opening. Increased peripapillary choroidal thickness was noted in the contralateral eyes of the patients, potentially resulting in a thicker choroid. Although further investigation is required to determine the cause, these findings indicate the presence of a compensatory factor in the contralateral eyes.

A Longitudinal Analysis of Peripapillary Choroidal Thinning in Healthy and Glaucoma Subjects

To evaluate the rate of peripapillary choroidal thinning in glaucoma patients and healthy controls using spectral domain optical coherence tomography. Cohort study. Participants from the multicenter African Descent and Glaucoma Evaluation Study and Diagnostic Innovations in Glaucoma Study were included. The San Diego Automated Segmentation Algorithm was used to automatically segment and measure peripapillary choroidal thickness (PCT) from circle scans centered on the optic nerve head. The rate of PCT thinning was calculated using mixed effects models. Two hundred ninety-seven eyes with a median follow-up of 2.6 years were included. At baseline, the global mean PCT was significantly thinner in glaucoma patients than healthy control subjects (141.7 ± 66.3μm vs 155.7 ± 64.8μm, respectively; P < .001). However, when age was included in the model, this difference was no longer significant (P= .38). Both healthy controls and glaucoma patients had a significant decrease in mean (95% confidence interval) PCT change over time (-2.18 [-2.97 to-1.40μm/year] and-1.88 [-3.08 to-0.67μm/year], respectively) and mean PCT percent change over time (-3.32% [-4.36 to-2.27μm/year] and-2.85% [-4.64 to-0.99μm/year], respectively). No significant difference was found between healthy control subjects and glaucoma patients in the mean rate of PCT change (P= .28) or PCT percentage change over time (P= .23). The rate of peripapillary choroidal thinning was not significantly different between healthy and glaucoma eyes during this relatively short follow-up period. Longer follow-up is needed to determine whether monitoring the rate of PCT change has a role in glaucoma management.

Peripapillary Pachychoroid in Nonarteritic Anterior Ischemic Optic Neuropathy.

PurposeThis study examined the peripapillary choroidal thickness (PCT) in nonarteritic ischemic optic neuropathy (NAION) in comparison to contralateral eyes and normal eyes.MethodsWe used enhanced depth imaging spectral-domain optical coherence tomography to image the optic nerve head of 20 NAION, 10 contralateral eyes, and 102 normal eyes. Following compensation, the scans were manually delineated to identify relevant surfaces including Bruch's membrane opening (BMO), Bruch's membrane, and anterior sclera. The PCT was defined as the measurement between Bruch's membrane and the anterior sclera and was measured at increasing distance from BMO. Models adjusted for age, BMO area, and axial length were used to compare the mean PCT between NAION and normal eyes, and contralateral eyes and normal eyes. Paired t-tests were used to compare the PCT between NAION and contralateral eyes.ResultsThe mean PCT was thicker in NAION and contralateral eyes when compared with normal eyes at all distances from BMO (P < 0.001). The PCT was not significantly thicker in contralateral eyes when compared with affected NAION eyes. Choroidal thickness was thinnest in the inferior quadrant in all eyes regardless of the group.ConclusionsIncreased peripapillary choroidal thickness was noted in both NAION and contralateral eyes. The thicker choroid may be an associated feature or a result of the disorder. Although further longitudinal study is required to determine causation, these findings may suggest that a thickened peripapillary choroid may be a component of the disk-at-risk clinical phenotype.

Correlation of Peripapillary Choroidal Thickness and Retinal Nerve Fiber Layer Thickness in Normal Subjects and in Patients with Glaucoma

Purpose: This study was designed to compare the normal and glaucomatous eyes regarding retinal nerve fiber layer (RNFL) thickness and peripapillary choroidal thickness (PCT), and to investigate the correlation of RNFL thickness and PCT. Subjects and Methods: Subjects were selected as a convenience sample of those from a tertiary referral practice of glaucoma. Thirty-two glaucomatous eyes were accepted as group 1; 30 normal eyes were accepted as group 2. Groups were compared for RNFL thickness and PCT. Correlations of RNFL thickness and PCT were assessed for each peripapillary location. Results: Mean inferior and superior RNFL thickness in group 1 were significantly lower than the control group; mean thicknesses of temporal and nasal quadrants were not different in the two groups. Mean PCT at 500 µm distance in the inferior, at 1500 µm distance in the superior, at 500, 1000, and 1500 µm distance in the temporal, and at 1000 and 1500 µm distance in nasal quadrants were found to be significantly thinner in the glaucoma group compared with the control group. Retinal nerve fiber thickness was strongly correlated with PCT at all points of inferior quadrants at 500 µm distance in the superior. There was no correlation between RNFL thickness and PCT at any point in the control group. Conclusion: Peripapillary choroidal thickness was thinner in glaucomatous eyes compared with normal eyes. Correlation of PCT and RNFL thickness found in patients with glaucoma did not exist in normal subjects.

Comparison of peripapillary choroidal thickness measurements via spectral domain optical coherence tomography with and without enhanced depth imaging

ABSTRACTObjectives: To compare peripapillary choroidal thickness (PP-CT) measurements using a spectral domain optical coherence tomography (SD-OCT) device with and without enhanced depth imaging (EDI).Methods: Sixty healthy subjects aged from 18 to 40 years were included in this study. PP-CTs were measured in the right eyes by manual segmentation via SD-OCT both with and without EDI. The intraclass correlation coefficient (ICC) for each technique and comparison of PP-CT measurements between two techniques were evaluated. The correlation between retinal nerve fiber layer (RNFL) thickness and PP-CT was also explored on images of SD-OCT without EDI.Results: The PP-CT measurements of 55 subjects were evaluated. The ICC was 0.999 (95% CI: 0.998–1.0, p < 0.001) for SD-OCT with EDI and 0.996 (95% CI: 0.995–0.997, p < 0.001) for SD-OCT without EDI. The mean PP-CT measurements in all regions and the overall mean PP-CT measurements between the two techniques were not different (p > 0.05). Additionally, there was no correlation between RNFL thickness and PP-CT (r = −0.109; p = 0.335).Conclusions: The PP-CT measurements via SD-OCT without EDI were consistent with the measurements via SD-OCT with EDI. Ophthalmologists who do not have access to EDI technology can use images of SD-OCT without EDI to measure the peripapillary choroid for research purposes. However, thicker peripapillary choroids cannot be measured using this technique and require further modifications or newer technologies, such as SD-OCT with EDI

Peripapillary choroidal thickness after intravitreal ranibizumab injections in eyes with neovascular age-related macular degeneration.

BackgroundThe purpose of this study was to investigate peripapillary choroidal thickness (CT) in eyes with neovascular age-related macular degeneration (AMD) and to assess whether peripapillary CT is affected by intravitreal injection of ranibizumab (IVR) in eyes with neovascular AMD.MethodsPeripapillary and subfoveal CT were measured in spectral domain optical coherence tomography images from 39 eyes of neovascular AMD patients and 39 eyes of age-matched controls retrospectively. The patients were treated with 0.5 mg IVR monthly for 3 months and retreated as needed. Peripapillary CT at baseline, 3 months and 6 months was measured at four locations (superior, nasal, inferior and temporal areas).ResultsThe mean peripapillary and subfoveal baseline CTs of the eyes with neovascular AMD (153.3 ± 45.3 μm and 228.6 ± 78.6 μm) were not different from those of the controls (149.0 ± 42.3 μm and 221.4 ± 54.1 μm; P = 0.665 and P = 0.639, respectively). Subfoveal CT decreased at 3 months (213.8 ± 75.8 μm, P < 0.001) and 6 months (215.1 ± 72.8 μm, P = 0.002) following IVR treatment. Mean peripapillary CT did not show significant changes at 3 months (149.6 ± 43.8 μm, P = 0.156) or 6 months (150.0 ± 43.4 μm, P = 0.187). Subanalysis revealed that only temporal peripapillary CT decreased from baseline (167.1 ± 54.5 μm) to 3 months (159.4 ± 50.8 μm, P = 0.010) and was sustained at 6 months (160.6 ± 49.6, P = 0.026). However, superior, nasal and inferior peripapillary CT did not show significant changes after IVR.ConclusionsChanges in peripapillary CT after IVR were limited to the macular area. This result may suggest that IVR does not affect CT outside of the macula in the eyes of patients with neovascular AMD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0203-7) contains supplementary material, which is available to authorized users.

Response to: Comment on "The Impact of Chronic Tobacco Smoking on Retinal and Choroidal Thickness in Greek Population".

We would like to thank Uzun for his observations [1]. Indeed choroidal thickness is influenced by several factors such as age, axial length, corneal curvature, intraocular pressure, systolic blood pressure, ocular perfusion pressure, and time of measurement [2]. Margolis and Spaide reported a 15.6-micron decrease in choroidal thickness every decade [3]; similarly, a 14-micron decrease every decade was reported by Ikuno et al. [4]. Wei et al. noted a thinning in subfoveal choroidal thickness among people around 65 years, estimating this reduction around 4 μm per year of age. Regarding axial length Wei et al. reported that the subfoveal thickness decreases by 15 microns for every increase in myopic refractive error of 1 D or by 32 microns for every increase in axial length of 1 mm [5]. Fujiwara et al. reported that choroidal thickness decreases by 12.7 μm for each decade of life and by 8.7 μm for each diopter of increasing myopia [6]. Gupta et al. supported that peripapillary choroidal thickness on average is decreased by 13.02 μm and 36.72 μm for each millimeter increase in axial length and corneal curvature, respectively. They also noted that each increment of myopic diopter resulted in the reduction of mean peripapillary choroidal thickness by 5.39 μm. On the other hand, they estimated that choroidal thickness augmented by 1.40 μm and 0.74 μm, when the intraocular pressure was increased by a millimeter of mercury or the retinal nerve fibre layer was raised by a micrometer, respectively [7].

Relationship Between Peripapillary Choroid and Retinal Nerve Fiber Layer Thickness in a Population-Based Sample of Nonglaucomatous Eyes

To describe the relationship between peripapillary choroidal thickness and retinal nerve fiber layer (RNFL) thickness in a population-based sample of nonglaucomatous eyes. Population-based, cross-sectional study. A total of 478 nonglaucomatous subjects aged over 40 years were recruited from the Singapore Malay Eye Study (SiMES-2). All participants underwent a detailed ophthalmic examination, including Cirrus and Spectralis optical coherence tomography (OCT) for the measurements of RNFL thickness and peripapillary choroidal thickness, respectively. Associations between peripapillary choroidal thickness and RNFL thickness were assessed using linear regression models with generalized estimating equations. Of the 424 included subjects (843 nonglaucomatous eyes), 60.9% were women, and the mean (SD) age was 66.74 (10.44) years. The mean peripapillary choroidal thickness was 135.59 ± 56.74 μm and the mean RNFL thickness was 92.92 ± 11.41 μm. In terms of distribution profile, peripapillary choroid was thickest (150.04 ± 59.72 μm) at the superior and thinnest (110.71 ± 51.61 μm) at the inferior quadrant, whereas RNFL was thickest (118.60 ± 19.83 μm) at the inferior and thinnest (67.36 ± 11.36 μm) at the temporal quadrant. We found that thinner peripapillary choroidal thickness (PPCT) was independently associated with thinner RNFL thickness globally (regression coefficient [β] = -1.334 μm for per-SD decrease in PPCT, P = .003), and in the inferior (β = -2.565, P = .001) and superior (β = -2.340, P = .001) quadrants even after adjusting for potential confounders. Thinner peripapillary choroid was independently associated with thinner RNFL globally and in the inferior and superior regions. This structure-structure relationship may need further exploration in glaucomatous eyes prior to its application in clinical settings.

Peripapillary choroidal thickness in healthy Turkish subjects.

AimThe objective of the study reported here was to investigate the normal peripapillary choroidal thickness (CT), measured by enhanced depth imaging optical coherence tomography (EDI-OCT), in healthy Turkish volunteers.Materials and methodsIn this prospective cross-sectional study, 57 eyes of 57 healthy Turkish subjects were enrolled. Each participant underwent a comprehensive ophthalmic examination and peripapillary CT measurement using EDI-OCT.ResultsThe mean age of the 25 female and 32 male patients in the study was 30.9±10.6 years (range, 18–56 years). The mean peripapillary CT at the superior, inferior, nasal, and temporal sites was 225±57, 183±47, 220±57, and 233±59 μm, respectively. The inferior peripapillary CT value was significantly lower than the peripapillary CT values (P<0.001 for all), whereas no significant differences were found between the superior, nasal, and temporal peripapillary CT values.ConclusionThe findings of the study revealed that Turkish people had significantly lower peripapillary CT values in the inferior quadrant than in the superior, nasal, and temporal quadrants.

Peripapillary choroidal thickness variation with age and race in normal eyes.

This study examined the association between peripapillary choroidal thickness (PCT) with age and race in a group of African descent (AD) and European descent (ED) subjects with normal eyes. Optic nerve head images from enhanced depth imaging spectral-domain optical coherence tomography of 166 normal eyes from 84 subjects of AD and ED were manually delineated to identify the principal surfaces of Bruch's membrane (BM), Bruch's membrane opening (BMO), and anterior sclera (AS). Peripapillary choroidal thickness was measured between BM and AS at increasing distance away from BMO. The mean PCT was compared between AD and ED subjects and generalized estimating equation (GEE) regression analysis was used to examine the association between race and PCT overall, in each quadrant, and by distance from BMO. Models were adjusted for age, BMO area, and axial length in the regression analysis. Overall, the mean PCT increased from 63.9 μm ± 18.1 at 0 to 250 μm to 170.3 μm ± 56.7 at 1500 to 2000 μm from BMO. Individuals of AD had a greater mean PCT than those of ED at all distances from BMO (P < 0.05 at each distance) and in each quadrant (P < 0.05 in each quadrant). Results from multivariate regression indicate that ED subjects had significantly lower PCT compared to AD overall and in all quadrants and distances from BMO. Increasing age was also significantly associated with a lower PCT in both ED and AD participants. Peripapillary choroidal thickness varies with race and age, as individuals of AD have a thicker peripapillary choroid than those of ED. (ClinicalTrials.gov number, NCT00221923.).