OCT Study Research Articles

Exploring retinal layer alterations in mild cognitive impairment: A pilot oct study

Aims/Purpose: In the last decades, retinal alterations have been shown by OCT in Alzheimer's disease (AD), initially affecting the macular region in early AD, and subsequently progressing to the peripapillary retina, pointing out this tissue to be considered for diagnosis and follow‐up in AD. This study aimed to investigate retinal changes in patients with mild cognitive impairment (MCI), an intermediate stage between normal aging and AD, to know if in this preclinical stage there are changes in the retina.Methods: Sixteen healthy subjects and 16 MCI patients were included. All participants underwent comprehensive ophthalmic evaluation and macular OCT (SD‐OCT, Heidelberg, Germany) to assess retinal structure. The thickness of each retinal layer in the macular area was measured using the OCT software, with manual verification and modification of segmentation if necessary. Thicknesses of retinal layers, including retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and retinal pigment epithelium (RPE), were analyzed. The inner and outer macular rings were evaluated according to the standard macular grid of the Early Treatment Diabetic Retinopathy Study (ETDRS). Statistical analysis was performed using two‐way ANOVA with Tukey´s multiple comparison test.Results: Individuals with MCI exhibited significant thinning in the OPL in the inner ring of the superior sector (p < 0.01), along with significant thickening in the ONL in the same area (p < 0.05) compared to controls. Additionally, a trend towards thinning in the inner retinal layers was observed in the MCI group.Conclusions: While in the inner retinal layers it was shown a thinning, it is noteworthy that in the ONL it was shown a thickening. OCT holds promise as a non‐invasive tool for MCI screening. Further research with larger sample sizes is warranted to validate and expand upon these findings.

Assessment of Choroidal thickness in primary open angle glaucoma patients, an OCT study

Assessment of Choroidal thickness in primary open angle glaucoma patients, an OCT study

An OCT Study of Lower Lacrimal Punctal Stenosis

Abstract Purpose To assess the lower lacrimal measurements in stenosis versus non- stenosed punctiusing spectral domain anterior segment optical coherence tomography. Patients and Methods The study included 39 puncti of 21 healthy asymptomatic volunteers attending the general and oculoplastic outpatient clinics (Group I : Control group) and 30 puncti of 17 subjects with a clinical diagnosis of punctal stenosis defined as the punctal diameter less than 0.3 mm measured by slit-lamp biomicroscopy (Group II : Cases group). The punctal diameter was measured by slit-lamp biomicroscopy in all subjects. The external punctal diameter, the inner punctal diameter at 500 µm, the punctal depth and tear meniscus height were measured using anterior segment optical coherence tomography. Results The internal punctal diameter at 500µ (74.92 µm ± 60.99 vs 24.07 µm ± 34.30) showed statistically significant lower measurements in the stenosis group compared to the control group. No statistically significant differences were between the 2 groups otherwise: external punctal diameter (571.44 µm ± 148.78 vs 545.23 µm ± 201.72), punctal depth (824.49 µm ± 354.14 vs 707.63 µm ± 552.80),. (and tear meniscus height (356.19 µm ± 166.83 vs 403.57 µm ± 244.24 Conclusion : Anterior segment optical coherence tomography provides a superior ability to assess the patency of the proximal lacrimal drainage system over the regular routine slit lamp examination. This is probably useful in diagnosis of cases of epiphora with externally non-stenosed puncti and distally patent passages.

Impact of lesion morphology on stent elongation during bifurcation PCI: an in vivo OCT study.

Recent observations in silico and in vivo reported that, during proximal optimisation technique, drug-eluting stents (DES) elongate, challenging conventional wisdom. The interaction between plaque morphology and radial expansion is well established, but little is known about the impact of plaque morphology on elongation. We aimed to assess the longitudinal mechanical behaviour of contemporary DES in vivo and evaluate the relationship between post-percutaneous coronary intervention (PCI) stent elongation and lesion morphology, as assessed with optical coherence tomography (OCT). Patients treated with OCT-guided PCI to left main or left anterior descending artery bifurcations, between July 2017 and March 2022, from the King's Optical coherence Database Analysis Compendium were included. Patients were excluded if there were overlapping stents, if they had undergone prior PCI, or if there was inadequate image quality. Lesions were characterised as fibrocalcific, fibrous or lipid-rich by pre-PCI OCT. Following stent post-dilatation, stent expansion and final stent length were assessed. The primary outcome was the percentage change in stent length from baseline. Of 501 eligible consecutive patients from this period, 116 were included. The median age was 66 years (interquartile range [IQR] 57-76), 31% were female, and 53.4% were treated for an acute coronary syndrome. A total of 50.0% of lesions were classified as fibrocalcific, 6.9% were fibrous, and 43.1% were lipid-rich. The change in relative stent length was 4.4% (IQR 1.0-8.9), with an increase of 3.1% (IQR 0.5-6.3) in fibrocalcific lesions, 3.3% (IQR 0.5-5.9) in fibrous lesions, and 6.4% (IQR 3.1-11.1) in lipid-rich plaque (p=0.006). In multivariate regression modelling, lipid-rich plaque was an independent predictor of stent elongation (odds ratio 3.689, 95% confidence interval: 1.604-8.484). Contemporary DES elongate following implantation and post-dilatation, and this is significantly mediated by plaque morphology. This is an important consideration when planning a strategy for DES implantation.

Estimating Uncertainty of Geographic Atrophy Segmentations with Bayesian Deep Learning

To apply methods for quantifying uncertainty of deep learning segmentation of geographic atrophy (GA). Retrospective analysis of OCT images and model comparison. One hundred twenty-six eyes from 87 participants with GA in the SWAGGER cohort of the Nonexudative Age-Related Macular Degeneration Imaged with Swept-Source OCT (SS-OCT) study. The manual segmentations of GA lesions were conducted on structural subretinal pigment epithelium en face images from the SS-OCT images. Models were developed for 2 approximate Bayesian deep learning techniques, Monte Carlo dropout and ensemble, to assess the uncertainty of GA semantic segmentation and compared to a traditional deep learning model. Model performance (Dice score) was compared. Uncertainty was calculated using the formula for Shannon Entropy. The output of both Bayesian technique models showed a greater number of pixels with high entropy than the standard model. Dice scores for the Monte Carlo dropout method (0.90, 95% confidence interval 0.87-0.93) and the ensemble method (0.88, 95% confidence interval 0.85-0.91) were significantly higher (P<0.001) than for the traditional model (0.82, 95% confidence interval 0.78-0.86). Quantifying the uncertainty in a prediction of GA may improve trustworthiness of the models and aid clinicians in decision-making. The Bayesian deep learning techniques generated pixel-wise estimates of model uncertainty for segmentation, while also improving model performance compared with traditionally trained deep learning models. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Choroidal manifestations of non-ocular sarcoidosis: an enhanced depth imaging OCT study

BackgroundAlthough choroidal thickening was reported as a sign of active inflammation in ocular sarcoidosis, there has been no research on the choroidal changes in non-ocular sarcoidosis (defined as systemic sarcoidosis without overt clinical signs of ocular involvement). Therefore, this study aimed to investigate choroidal structural changes in patients with non-ocular sarcoidosis.MethodsThis retrospective case–control study was conducted at Asan Medical Center, a tertiary referral center. We evaluated 30 eyes with non-ocular sarcoidosis and their age- and spherical equivalent-matched healthy control eyes. The subfoveal choroidal thickness, area ratio (Sattler layer-choriocapillaris complex [SLCC] area to Haller layer [HL] area), and choroidal vascularity index (CVI, luminal area to choroidal area) were analyzed using enhanced depth imaging in optical coherence tomography. Systemic and ocular factors associated with the choroidal thickness were investigated.ResultsCompared with the healthy control group, the non-ocular sarcoidosis group had significantly thicker subfoveal choroid (total and all sublayers [SLCC and HL]) and lower area ratio. There were no significant differences in the CVIs at all sublayers between groups. In the non-ocular sarcoidosis group, eyes under oral steroid treatment had thinner choroid than eyes under observation. In the control group, eyes with older age and more myopic spherical equivalent had thinner choroidal thickness.ConclusionTotal and all sublayers of the subfoveal choroid were significantly thicker without significant vascularity changes in non-ocular sarcoidosis eyes than in healthy control eyes. The degree of choroidal thickening was disproportionally greater at HL than at SLCC. These characteristic choroidal changes may be the subclinical manifestations in non-ocular sarcoidosis.

Correlations between peripapillary retinal nerve fiber layer thickness and macular thickness in different stages of primary open-angle glaucoma, an OCT study

Correlations between peripapillary retinal nerve fiber layer thickness and macular thickness in different stages of primary open-angle glaucoma, an OCT study

Случай центральной серозной хориоретинопатии после взрывной травмы

Relevance. Over the past decade, clinical cases of central serous chorioretinopathy after an eye injury have increasingly appeared in the press. Purpose. Currently, there are no cases of description of central serous chorioretinopathy after an explosive injury in the literature available for review. Presenting our clinical case, we will try to fill this gap. Methods. A 41-year-old man with concomitant injuries was admitted to inpatient treatment at a multidisciplinary clinic after a close detonation of a high-powered explosive device. At the end of the second week from the moment of injury, against the background of an improvement in the general well-being of the patient, the «flickering spot» in front of the gaze of the left eye began to actively disturb. On the 21st day after injury, both eyes were examined using an optical coherence tomograph with a rocking source (OCT) DRI OCT Triton by Topcon (Japan). In the lower quadrants on the edge of the macula of the left eye, a serous detachment of the neuroepithelium was detected with dimensions of 5310×5253 μm and a maximum height of 706 μm with two detachments of the retinal pigment epithelium. On the 28th day from the moment of injury, during the control OCT study, flattening was noted, but with an increase in the area of serous detachment of the neuroepithelium and the preservation of detachments of the retinal pigment epithelium. In connection with the professional requirements for the patient's state of health, delimiting laser coagulation of the retina was performed against the background of the treatment of concomitant pathology. Results and discussion. On the 33rd day after the injury, complete adherence of the serous detachment of the neuroepithelium and detachments of the retinal pigment epithelium was noted with the disappearance of the patient's complaints. Conclusion. The presented clinical case is of great interest, since eye trauma and, in particular, explosive trauma are quite rare causes of the development of central serous chorioretinopathy. Key words: clinical case, serous chorioretinopathy, neuroepithelial detachment, pigment epithelium detachment, blast injury, post-traumatic retinopathy, eye injury

Features of blood supply of urethral tissues in women with primary urethral pain syndrome

Introduction. Primary urethral pain syndrome (PUPS) is a part of chronic primary pelvic pain syndrome with predominant localisation of pain in the urethra. The pathogenesis of PUPS has not been adequately studied and there are no unified guidelines for the prevention and treatment of this condition. It is known that one of the main factors in the development of chronic pain is a violation of regional blood flow.Objective. To identify the features of blood supply of urethral tissues, as well as to assess the concomitant changes in the connective tissue in patients with PUPS.Materials &amp; methods. The study included 98 patients: 78 patients with primary urethral pain syndrome (group "PUPS"), without clinical manifestations of inflammation; 20 patients with stones of the upper urinary tract without pyelonephritis, in which the urethra is taken as the norm (group "N"). The hemodynamics of the urethral tissues was studied using transvaginal ultrasound (TVUS) and laser Doppler flowmetry (LDF). Changes in the blood supply to organs often lead to disruption of tissue structure; therefore, in vivo cross-polarisation optical coherence tomography (CP OCT) and ex vivo nonlinear confocal microscopy were included in the study.Results. In the PUPS group, the LDF method revealed a violation of the neurogenic regulation of the tone of the microcirculatory vascular wall of the urethral tissues with a predominance of passive regulatory components. The analysis of the LDF parameters by the method of principal components made it possible to establish the division of data into several clusters, which indicates a different pathogenesis of microcirculation disorders in the tissues of the urethra. The TVUS method in the PUPS group revealed an increase in resistance to blood flow in the blood vessels of the urethra and paraurethral plexus, blood stasis in the veins of the small pelvis in 19% of patients. Violation of the urethral blood flow leads to structural changes in tissues: using nonlinear microscopy, it was found that with PUPS in the urethral connective tissue, collagen fibres are quantitatively larger relative to elastic ones, they are more uniform in thickness, and have a co-directional arrangement. These data correlate with the results of an intravital CP OCT study, during which fibrosis of the subepithelial connective tissue structures was revealed.Conclusion. TVUS and LDF made it possible to reveal the presence of microcirculatory and, as a result, structural changes in urethral tissues in vivo. The inclusion of these methods in the diagnostic algorithm will provide more information about the main links in the pathogenesis of PUPS.

TCT-93 Association Between Post-PCI vFFR and OCT Findings: Results From the FAST OCT Study

TCT-93 Association Between Post-PCI vFFR and OCT Findings: Results From the FAST OCT Study

Изменения микроперимерических параметров сетчатки при закрытии макулярного разрыва с сохранением внутренней пограничной мембраны

Purpose. To propose the technique of surgery and to conduct a comparative analysis of the microperimetric parameters of the retina for macular hole (MR) using various techniques. Material and methods. The results of surgical treatment of 90 patients (90 eyes) with a diagnosis of macular hole were analyzed. The patients were divided into two groups: group 1 – patients who underwent ILM peeling; group 2 – patients whose macular hole was closed with the preservation of ILM in the foveolar zone and nasal part. All patients underwent a standard ophthalmological examination and an OCT study. Results. On the 30th day after surgery, there was a statistically significant excess of microperimetric parameters from the nasal part of the macular zone: the upper nasal and lower nasal quadrants, where peeling was not performed (p = 0.032) and (p = 0.034), respectively. Conclusion. When conducting a membrane-preserving peeling technique, the risks of intraoperative damage to the retinal Сlayers are reduced. A higher functional result was obtained in comparison with the group where the standard technique was used. Keywords: microperimetry, macular rupture, peeling of the inner boundary membrane

Effect of cigarettes smoke on bonded polymeric restorations: OCT study

BackgroundUp to date, the effect of cigarette smoke (CS) on the adhesive properties of the restorative materials bonded to tooth structure is still unclear. It is still questionable if it interferes with the durability and clinical success of these restorations. Few numbers of studies reported the assessment of microgaps of dental composite using cross-polarization optical coherence tomography (CP-OCT). The aim of this study was to evaluate the presence of interfacial microgaps between composite resin restoration and the tooth structure with or without exposure to CS under the CP-OCT. Materials and methodsIn this in-vitro study, a standardized round class-V cavities were prepared in twenty extracted, caries-free human molar teeth, and they were divided randomly into two groups (n = 10). Adhesive system (Gluma universal, Kulzer GmbH) was applied followed by filing the prepared cavities with flowable composite restoration (Charisma, Kulzer GmbH). Then, exposure to CS (40 cigarettes/day) was carried out for 14 days and the samples were stored in normal saline solution after each smoke exposure cycle. Next, all samples were immersed in ammoniac silver nitrate for 24 h, followed by immersion in a photo-developing solution for 8 h. Optical comparison was carried out by CP-OCT to assess microgaps percentage between smoke (SG) and non-smoke groups (NSG) at the axial walls (AW) and cavity floor (CF). ResultsIndependent T-test showed that there was a significant difference between the two groups (SG, NSG) in AW microgaps percentage (p = 0.008), while there was no difference in CF (p = 0.15) ConclusionIt can be inferred from the current finding that OCT can be used to predict the adaptability of the bonded restoration under the thermochemical influence. CS has a negative effect on the marginal integrity of the bonded polymeric restorations.

Evaluation of subclinical changes in recently diagnosed pediatric hypertension patients without hypertensive retinopathy: an OCT study.

To investigate subclinical choroidal and retinal changes in recently diagnosed pediatric hypertension (HT) patients. This prospective case-control study consisted of 62 treatment naive HT patients (34 essential HT and 28 renal-induced HT) and 62 control subjects aged 10-16years. All demographic data and ocular parameters were noted. Macula and choroid measurements were acquired by spectral domain optical coherence tomography (SD-OCT). Choroidal measurements were obtained by taking the mean of the measurements taken from 3 nasal and 3 temporal locations at 500µ intervals (mean nasal, mean temporal) in addition to the subfoveal area. All choroidal thickness (ChT) values in HT subjects were significantly lower than in the healthy group (p < 0.001 for all). Also, there was no statistically significant difference between central macular thickness (CMT) and mean macular thickness (MMT) between the two groups. Subfoveal ChT, mean ChT, and CMT values were statistically lower in patients with renal-induced HT compared to essential HT subjects (p < 0.001, p = 0.04, p = 0.014, respectively). No significant correlation was observed between choroidal thicknesses and blood pressure values in essential and renal HT groups except weak correlation between mean temporal ChT and systolic blood pressure (SBP) in renal HT group (r = - 0.464, p = 0.013). This study demonstrated that choroidal thickness decreased even during the subclinical period in treatment naive pediatric HT subjects. In addition, it has been shown that the choroid is more affected in renal-induced HT compared to essential HT group.

Evaluation of lacrimal punctum and tear meniscus in dry eye syndrome: a comparative spectral domain OCT study

Evaluation of lacrimal punctum and tear meniscus in dry eye syndrome: a comparative spectral domain OCT study

The Influence of Eyelid Position and Environmental Conditions on the Corneal Changes in Early Postmortem Interval: A Prospective, Multicentric OCT Study.

In the current study, using portable optical coherence tomography, we evaluated 46 corneas of 23 individuals in a multicenter setting during the first 17 h after death. Twenty-three eyes were kept open, and twenty three were kept closed. Furthermore, the experiment was carried out for 12 samples in summer and 11 in winter. Our data show that postmortem corneal alterations largely depend on the phenomena of dehydration (in particular in open eyes) and swelling of the stroma in closed eyes, probably due in the first phase to hypoxia/anoxia and subsequently to the passage by osmosis of the aqueous humor from the anterior chamber to the corneal tissue. Our findings could have significant repercussions in forensic pathology for estimating the postmortem interval and transplantation to optimize the conservation of the tissue before the explant.

Alterations in the Choroidal Sublayers in Relationship to Severity and Progression of Diabetic Retinopathy: A Swept-Source OCT Study.

PurposeTo examine the association of baseline choroidal sublayers metrics with the risk of diabetic retinopathy (DR) progression over 2 years, with adjustment for confounding factors that affect choroidal measurements.DesignProspective, observational cohort study.ParticipantsOne hundred three eyes from 62 patients with diabetes mellitus (DM).MethodsPatients were followed up at 6-month intervals for at least 2 years. Choroidal metrics including choroidal area, choroidal thickness (CT), and choroidal vascularity index were measured for both (1) the choriocapillaris plus Sattler’s layer and (2) the Haller’s layer within the subfoveal and parafoveal region. Cox proportional models were constructed to estimate the relationship between baseline choroidal metrics and DR progression, adjusted for intereye correlation, established risk factors (i.e., duration of DM, glycated hemoglobin [HbA1c] level, body mass index [BMI], use of insulin, and mean arterial blood pressure [MABP]) and confounding factors of choroidal measurements (i.e., age and axial length). Additional predictive value of choroidal metrics was assessed using the C-statistic.Main Outcome MeasuresHazard ratios (HRs) calculated by Cox proportional hazards model to demonstrate the associations between baseline choroidal metrics and DR progression.ResultsAfter adjusting for age, axial length, and intereye correlation, choroidal metrics in Haller’s layer at baseline that were associated with a higher risk of DR progression included increases in subfoveal choroidal area (HR, 2.033; 95% confidence interval [CI], 1.179–3.505; P = 0.011), subfoveal plus parafoveal choroidal area (HR, 1.909; 95% CI, 1.096–3.326; P = 0.022), subfoveal CT (HR, 2.032; 95% CI, 1.181–3.498; P = 0.010), and subfoveal plus parafoveal CT (HR, 1.908; 95% CI, 1.097–3.319; P = 0.022). These associations remained statistically significant after additionally adjusting for duration of DM, HbA1c level, BMI, use of insulin, and MABP. Addition of these choroidal metrics significantly improved the discrimination for DR progression when compared with established risk factors alone (e.g., duration of DM and HbA1c; increase in C-statistic ranged from 8.08% to 9.67% [P < 0.05]).ConclusionsEyes with a larger choroidal area and CT in Haller’s layer at baseline were associated with a higher risk of DR progression over 2 years.

Evaluation of Newly Introduced Bioactive Materials in Terms of Cavity Floor Adaptation: OCT Study.

Objective. The aim of the present study was to evaluate the adaptation of newly introduced bioactive restorative materials to the cavity floor using cross-polarization optical coherence tomography (CP-OCT). Materials and Methods. Round class V cavities were prepared on the proximal surfaces of sixty non-carious human anterior teeth (0.5 mm depth × 4 mm diameter), which were divided into groups according to the restorative material (n = 15). In the VF group, Vertise flow composite (Kerr, Orange, CA, USA) was used, in the BF group, Beautifil II composite (Shofu, Koyoto, Japan) was used, and in the AB group, ACTIVA BioACTIVE composite (Pulpdent, Watertown, NY, USA) was used. Cavities were restored using the bulk filling technique and cured according to the manufacturers’ instructions. Then, the specimens were immersed in a contrasting agent, and image acquisitions were taken by CP-OCT to calculate the adaptation percentage by using an image analysis software. Results. B-scans showed a diffuse bright band of white pixels at the tooth-resin interface that was interpreted as a micro-gap present between the cavity floor and restorative material. The Kruskal-Wallis test showed a statistically significant difference between all tested groups with the AB group representing the least gap formation, followed by the BF group, and then the VF group, which demonstrated the highest gap formation. Conclusions. In class V cavities, better adaptation to the cavity floor can be obtained when using ACTIVA BioACTIVE more than Vertise flow and Beautifil II composites. In addition, CP-OCT is considered a non-destructive imaging tool that helps in evaluating the quality of the tooth-restoration interface when bioactive composites are used.

Dimensions of the limbus-ciliary sulcus region by OCT and correlation study in a large population.

To assess the dimensions of the limbus-ciliary sulcus region measured by swept-source optical coherence tomography (SS-OCT) and conduct a correlation study in a large healthy population. Centro Internacional de Oftalmología Avanzada, Madrid, Spain. Cross-sectional study. The dimensions of the limbus-ciliary sulcus region were measured in the temporal and nasal quadrants using a SS-OCT. The limbus-sulcus distance (LSD), the posterior iris line-ocular surface to limbus distance (PIOLD), and the angle-to-sulcus distance (ASD) were measured. These distances were then assessed for correlations with factors such as age, sex, refractive error, anterior chamber angle (ACA), ciliary muscle thickness (CMT), conjunctival-Tenon capsule thickness (CTT), and anterior scleral thickness (AST). The mean age of the participants was 41.0 ± 18.2 years (range 5 to 86) and the mean refractive error -0.75 ± 3.3 diopters (range -10 to 7). The LSD could be measured in 93.2% of the participants (625 eyes out of 670 eyes), with a mean of 1.35 ± 0.12 mm (range 0.96 to 1.75) and 1.33 ± 0.12 mm (range 1.05 to 1.68) in the temporal and nasal quadrants, respectively, and a correlation of R = 0.616 (P < .001) between them. PIOLD measured 2.22 ± 0.31 mm (1.42 to 2.98), and ASD was 0.21 ± 0.05 mm (0.01 to 0.40). No correlation was observed between LSD with age, spherical error, sex, or ACA (P ≥ .247). However, LSD exhibited the highest correlation with AST (R = 0.466), followed by CTT (R = 0.309) and CMT (R = 0.259). The SS-OCT allowed for an accurate in vivo measurement of the dimensions of the limbus-ciliary sulcus region.

Age-related changes in crystalline lens tilt and decentration: swept-source OCT study.

To investigate the age-related tilt and decentration of crystalline lenses using a swept-source optical coherence tomography biometer (SS-OCT) (CASIA2, Tomey Corp.). Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. Cross-sectional study. The direction and magnitude of the crystalline lens were evaluated in 230 participants with ages ranging from 7 to 90 years using SS-OCT. The participants were divided into 4 age groups, and the differences among the groups were analyzed. Multiple linear regression was used to investigate the main factors influencing crystalline lens tilt and decentration. The natural crystalline lens tilted toward the inferotemporal direction with a mean magnitude of 4.3 ± 1.5 degrees (range 0.7 to 8.95 degrees). The mean decentration toward the superotemporal direction was 0.17 ± 0.12 mm (range 0.03 to 1.15 mm). There was mirror symmetry between the right and left eyes. There were statistically significant differences in the crystalline lens tilt and decentration among the age groups. Multiple linear regression showed that changes in crystalline lens tilt depended on angle α (P < .01) and anterior chamber depth (ACD; P = .008), whereas crystalline lens decentration depended on angle κ (P = .003), age (P < .01), and angle α (P = .002). Although there was a statistically significant difference in crystalline lens tilt and decentration among age groups, the variation in the crystalline lens position was partially affected by age. The crystalline lens tilt was greater in eyes with wider angle α and shallower ACD, whereas crystalline lens decentration was greater in younger eyes with wider angles κ and α.

Posterior choroidal boundary morphology and segmentation errors influence on choroidal thickness assessment in diabetic patients - a swept-source OCT study.

Objective: to evaluate the choroidal morphology and choroidal thickness (CT) in normal and diabetic subjects and to compare the differences between automated segmentation (AS) and manual segmentation (MS) of the choroid. Methods: in this observational cross-sectional study we included 48 eyes: 24 normal eyes (group 1), 9 eyes with DM without diabetic retinopathy (DR) (group 2) and 15 eyes with DM and DR (group 3). Swept-source OCT line scans images were analyzed for the presence of the suprachoroidal layer (SCL), choroidal morphology and the CT was measured manually subfoveal and at 750 μ both nasal and temporal to the fovea after AS and MS. SCL was not included in the CT evaluation. CT values were compared between the groups and between the three points of evaluation.Results: SCL was visualized in 21 eyes (43.8%). In diabetic patients, SCL was visible in 11 (45.83%) cases and in nondiabetic patients, in 10 eyes (41.66%). There was a good AS of Bruch’s membrane, which was not further corrected manually. There were statistically significant differences between AS and MS at the level of CSJ for all three locations in all three groups (P ≤ 0.01). After MS, the choroid was statistically significantly thicker. Group 2 and group 3 showed a higher CT thickness. There were no statistically significant differences in the CT between groups in all three locations.Conclusions: Defining posterior choroidal boundary and the applied segmentation method can result in differences in CT measurements. Diabetic patients have altered CT and choroidal morphology. Abbreviations: CT = choroidal thickness, AS = automated segmentation, MS = manual segmentation, CSJ = choroidoscleral junction, SCL = suprachoroidal layer, SCS = suprachoroidal space, DM = diabetes mellitus, DR = diabetic retinopathy, RPE = retinal pigmented epithelium, BM = Buch’s membrane