Peripapillary Choroidal Thickness Research Articles

Choroidal thickness in juvenile open angle glaucoma: insights from a south asian case-control study.

The purpose of this study is to compare choroidal thickness in juvenile open angle glaucoma (JOAG) and healthy controls using spectral domain optical coherence tomography (SD-OCT) and study its correlations. In this case-control study, 56 eyes of 28 JOAG patients and an equal number of controls were recruited. SD-OCT was used to measure the choroidal thickness (ChT), in the macular region at 5 locations: subfoveal, 1500µm and 3000µm nasal and temporal to the foveal center, and in the peripapillary region at 6 locations: up to 1500µm, nasal and temporal to the disc, respectively. The ChT and its correlations with age, intraocular pressure, cup-to-disc ratio, central corneal thickness, mean deviation, and axial length were studied. The average macular ChT in JOAG was 306.30 ± 56.49µm vs. 277.12 ± 64.68µm in controls. The average peripapillary ChT in JOAG was 197.79 ± 44.05µm vs. 187.24 ± 38.89µm in controls. The average total ChT (p = 0.042), the average macular ChT (p = 0.022), the subfoveal ChT (p = 0.022), the ChT 1500µm (p < 0.001), and 3000µm temporal to the fovea (p = 0.002) were significantly thicker in the JOAG group. In the JOAG group, the average macular ChT had a significant negative correlation with age, whereas axial length was positively correlated with the average peripapillary ChT. In this South Asian cohort of JOAG, the average total ChT, average macular ChT, subfoveal ChT, and ChT at 1500µm, and 3000µm temporal to the fovea were significantly thicker when compared to healthy controls.

Eight Years and Beyond Longitudinal Changes of Peripapillary Structures on OCT in Adult Myopia

PurposeTo investigate the long-term changes of peripapillary structures detected by enhanced depth imaging of OCT in adult myopia. DesignObservational case series. MethodsMyopic participants who had undergone a full baseline ophthalmologic examination and followed up with a minimum of 8 years were included. Using enhanced depth imaging of OCT, scans around the optic disc in the follow-up mode which enabled capturing of the same positions were performed in 65 eyes. The peripapillary parameters including the size of border tissue, Bruch's membrane opening (BMO), peripapillary choroidal thickness, and the angle between peripapillary Bruch's membrane and anterior sclera were manually delineated and measured. ResultsThe axial length showed a significant elongation after a mean follow up time of 9.46±0.92 years. The rates of changes were 0.015±0.011 mm/y in the medium myopia group, and 0.057±0.039 mm/y in the high myopia group. At the last visit, the average border tissue length and BMO diameter were increased. The angle between peripapillary BM did not show significant change, while the angle between peripapillary sclera showed significant rise. In multivariate analysis, the border tissue elongation, BMO enlargement, and increased sclera angle were all associated with the change of axial length. The development of BM defect and inward protrusion of sclera on temporal peripapillary region was observed on 8 (34.8%) eyes in the high myopia group, along with an extreme thinning or disappearing of peripapillary choroid. ConclusionA marked longitudinal changes of peripapillary structures including border tissue, BM, choroid and sclera could be observed in adult myopic eyes, which may impact the biomechanical environment around optic nerve head.

Effects of Deep Optic Nerve Head Structures on Bruch's Membrane Opening- Minimum Rim Width and Peripapillary Retinal Nerve Fiber Layer

PurposeTo explore the effects of deep optic nerve head (ONH) structures on Bruch's membrane opening (BMO)-minimum rim width (MRW) and peripapillary retinal nerve fiber layer thickness (pRNFLT) in healthy eyes. DesignProspective cross-sectional study MethodsTwo hundred five healthy eyes of 141 subjects (mean ± standard deviation of age and axial length (AXL): 46.9±10.0 years and 24.79±1.15 mm) were enrolled. Best fit multivariable linear mixed models identified factors associated with BMO-MRW and pRNFLT. Explanatory variables included age, sex, AXL, BMO and anterior scleral canal opening (ASCO) area and ovality, magnitude of BMO and ASCO shift, peripapillary choroidal thickness, lamina cribrosa (LC) parameters, prelaminar thickness and peripapillary scleral (PPS) angle. ResultsThinner BMO-MRW was associated with older age, smaller ASCO/BMO offset magnitude, larger BMO area, thinner prelaminar thickness, deeper LC, and thinner pRNFLT (p=0.011, <0.001, 0.004, <0.001, <0.001, <0.001 respectively). Thinner pRNFLT was associated with shorter AXL, smaller ASCO area, a more posteriorly bowed PPS, shallower LC and thinner BMO-MRW. (p=0.030, 0.002, 0.035, 0.012, <0.001 respectively) ConclusionsBMO-MRW and pRNFLT were influenced by several deep ONH structures such as BMO and ASCO position shift, BMO or ASCO area, prelaminar thickness, PPS bowing and LC depth in addition to patient characteristics such as age and AXL. The degree and/or direction of associations varied between deep ONH structures and BMO-MRW or pRNFLT. Despite both BMO-MRW and pRNFLT being surrogate parameters for RGC loss, a complex relationship with ONH deep-layer morphology was indicated.

Three-dimensional choroidal vascularity index and choroidal thickness in fellow eyes of acute and chronic primary angle-closure using swept-source optical coherence tomography.

To compare the three-dimensional choroidal vascularity index (CVI) and choroidal thickness between fellow eyes of acute primary angle-closure (F-APAC) and chronic primary angle-closure glaucoma (F-CPACG) and the eyes of normal controls. This study included 37 patients with unilateral APAC, 37 with asymmetric CPACG without prior treatment, and 36 healthy participants. Using swept-source optical coherence tomography (SS-OCT), the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally. Pearson's correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors. The mean subfoveal CVIs were 0.35±0.10, 0.33±0.09, and 0.29±0.04, and the mean subfoveal choroidal thickness were 315.62±52.92, 306.22±59.29, and 262.69±45.55 µm in the F-APAC, F-CPACG, and normal groups, respectively. All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes (P<0.05), while there were no significant differences between the F-APAC and F-CPACG eyes. In the peripapillary region, the mean overall CVIs were 0.21±0.08, 0.20±0.08, and 0.19±0.05, and the mean overall choroidal thickness were 180.45±54.18, 174.82±50.67, and 176.18±37.94 µm in the F-APAC, F-CPACG, and normal groups, respectively. There were no significant differences between any of the two groups in all peripapillary sectors. Younger age, shorter axial length, and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness (P<0.05). The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls. Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG. A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.

Evaluation of Peripapillary Choroidal Thickness, Retinal Nerve Fiber Layer, and Optic Nerve Head Parameters in Patients with Multiple Sclerosis.

The objectives of the study are to assess the peripapillary choroidal thickness (PPCT), retinal nerve fiber layer (RNFL), and optic nerve head (ONH) parameters in multiple sclerosis (MS) patients compared to healthy subjects. One hundred and twenty-eight eyes from 64 patients were included in this cross-sectional study. Eighty-two eyes of 41 MS patients and 46 eyes of 23 healthy subjects were examined. PPCT and RNFL were measured using spectral-domain optical coherence tomography (OCT). PPCT was measured from the four quadrants around the optic disc at a distance of 1 mm (PPCT-1) and 2 mm (PPCT-2) from the edge of the ONH and the beginning of the retinal pigment epithelium. ONH parameters were measured with Heidelberg retinal tomography (HRT-3). Disease duration, the number of episodes, MS subtypes, and Expanded Disability Status Scale (EDSS) scores were recorded. The RNFL measurements and the mean PPCT-1 and PPCT-2 were significantly lower in MS patients compared to healthy individuals. PPCT-1 and PPCT-2 were measured as the thickest in the temporal quadrant, followed by the superior, nasal, and inferior quadrants, respectively, in both groups. When the ONH parameters were evaluated, cup/disc area ratio, cup area, and cup volume values were significantly higher, whereas optic rim volume and rim area values were significantly lower in MS patients compared to healthy subjects (p<0.05). We observed significant changes in RNFL and ONH parameters of MS patients in parallel with disease severity determined by EDSS scores and the presence of optic neuritis. There were significant changes in RNFL thickness, PPCT, and ONH parameters when MS patients were compared with healthy subjects. Assessment of RNFL and PPCT with OCT and ONH with HRT-3 may be useful in the follow-up of MS patients.

The optic nerve in glaucoma

Purpose: To describe particularities of the optic nerve head of axially highly myopic eyes.Methods: Measurements were obtained from enucleated globes and from population‐based studies.Results: Morphologic optic disc particularities in high axial myopia included enlarged disc size (secondary macrodisc), widening and temporal translocation of the papillary Bruch's membrane (BM) opening, parapapillary gamma and delta zone, elongation and thinning of lamina cribrosa and peripapillary scleral flange, steeper translamina cribrosa pressure gradient, decreased peripapillary choroid thickness, longer distance between peripapillary arterial circle and optic disc, optic cup flattening, presumably a stretching of the lamina cribrosa pores, and peripapillary intrachoroidal cavitations. These changes may be explained by growth of new BM in the retroequatorial region in the process of emmetropization or myopization as “overshooting” of the emmetropization process.Conclusions: The intrapapillary and parapapillary changes in the highly myopic optic nerve head may be reason for the increased susceptibility for glaucomatous optic nerve damage in high axial myopia. The widening of the papillary BM opening and the potential shift of the optic nerve head's 3 layer into temporal direction, both potentially leading to the development of parapapillary gamma zone may be of interest for elucidating the process of emmetropization/myopization.

Comparison of retinochoroidal and optic nerve head microvascular circulation between HIV-positive patients and healthy subjects using optical coherence tomography angiography

To evaluate the retinal, choroidal, and optic disc head microvascular circulation in human immunodeficiency virus (HIV)-infected individuals without retinopathy receiving highly active antiretroviral therapy (HAART) using swept-source optical coherence tomography angiography (SS-OCTA). This cross-sectional study included 100eyes of 100patients with HIV infection but no HIV-related ocular disease and 108 eyes of 108 age- and sex-matched healthy subjects as the control group. SS-OCTA was used to assess foveal avascular zone (FAZ) area, retinal nerve fiber layer thickness (RNFL), choriocapillaris (CC) flow area, outer retinal (OR) thickness, radial peripapillary capillary (RPC) vessel density (VD), ONH VD, and choroidal thickness. No statistically significant difference was found between the two groups except in the foveal VD of the deep capillary plexus (DCP). The foveal VD of the DCP was lower in the HIV-positive group (P=0.011). The mean FAZ area (mm2), perimeter (mm), and CC flow area (mm) values were higher in the HIV-positive group at statistically significant levels (P=0.021, P=0.02, and P=0.039, respectively). However, no statistically significant differences were found between the two groups concerning the OR flow area, subfoveal choroidal thickness, or the VDs of the RPC or ONH. This is the first study in the literature to evaluate the microvascular circulation of the ONH in HIV-positive patients. Although retinal and choroidal microvascular circulation decreased in HIV-positive patients receiving HAART treatment, we found no effect on the microvascular circulation of the ONH or RPC microvascular circulation. Our findings suggest that retinochoroidal microvascular circulation is affected in HIV-positive patients over time.

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

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

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

Assessment of optic disc morphological characteristics and related factors of highly myopic eyes in Chinese school-aged children

ABSTRACT Clinical relevance The morphological characteristics of the optic nerve head (ONH) in myopic eyes are a clinically significant issue, especially for high myopia in school-aged children, and this can be monitored using optical coherence tomography. Background The purpose of this study is to investigate the morphological characteristics of ONH, and the factors associated with peripapillary choroidal thickness in Chinese school-aged high myopia children. Methods A total of 48 patients, possessing 48 high myopia eyes and 48 contralateral low myopia eyes were enrolled. The ONH characteristic parameters, including peripapillary retinal nerve fibre layer thickness, peripapillary choroidal thickness, peripapillary choroidal blood flow density, Bruch’s membrane opening (BMO) characteristic parameters were measured on optical coherence tomography scans. Results Eyes with high myopia had a larger disc size, higher peripapillary atrophy area proportion, larger peripapillary atrophy area, larger BMO minimum rim width, lower peripapillary choroidal thickness compared with those contralateral low myopia eyes (all P < 0.001). The BMO distance and border length were longer, and border tissue angle was smaller in the high myopia eyes. The multivariate regression analysis revealed that border length, axial length, and border tissue angle were independently associated with peripapillary choroidal thickness (all P < 0.05); axial length was associated with peripapillary retinal nerve fibre layer thickness (P = 0.007). Conclusion The peripapillary atrophy area, BMO area, border length, BMO distance, and BMO minimum rim width increased, but peripapillary choroidal thickness, retinal nerve fibre layer thickness decreased with axial elongation of the globe in young myopia children. Longer axial length and border length were positively correlated with lower peripapillary choroidal thickness, and a smaller border tissue angle was positively correlated with lower peripapillary choroidal thickness were found in this study. Monitoring of border length and border tissue angle is essential in the early stages of myopia in children.

Looking beyond the brain: Insights into vascular parkinsonism with optical coherence tomography

BackgroundVascular Parkinsonism (VP) is characterized by rigidity and bradykinesia predominantly affecting the lower limbs. Optical Coherence tomography (OCT) facilitates the visualization of retina and choroid and may help in delineating differential involvement of retina and choroid in patients with VP. In this study, we report the pattern of changes in the retinal and choroidal layers in patients with VP with the help of spectral domain OCT (SD-OCT). MethodsWe adopted a case-control design and evaluated 24 patients with VP with complete history, clinical examination, Montreal Cognitive Assessment (MOCA), Unified Parkinson's Disease Rating Scale (UPDRS) motor part in OFF state, and retinal and choroidal imaging with SD-OCT. The peripapillary retinal nerve fiber layer (RNFL) thickness, peripapillary choroidal layer thickness (PPChT), central macular thickness (CMT) and subfoveal choroid thickness (SFChT) were assessed. Twenty-two age and gender-matched healthy control subjects were also recruited. ResultsThe peripapillary RNFL, in most of the segments and CMT were significantly thinner in patients with VP compared to controls. The subfoveal and peripapillary ChT did not differ significantly between patients and controls. ConclusionThis is the first study that has evaluated the role of OCT in patients with VP and these patients have significant involvement of the retina. In addition to providing pathophysiological insights, OCT parameters may serve as disease biomarkers in VP. This study lays the foundation for carrying out future studies with larger sample sizes and a longitudinal design.

Characteristics of the Peripapillary Structure and Vasculature in Patients With Myopic Anisometropia.

To evaluate the interocular differences of the peripapillary structural and vascular parameters and that of association with axial length (AL) in participants with myopic anisometropia using swept-source optical coherence tomography. This prospective cross-sectional study included 90 eyes of 45 participants. Each participant's eyes were divided into the more and less myopic eye respectively according to spherical equivalent. The β- and γ-parapapillary atrophy (PPA) areas, Bruch's membrane opening distance, border length, and border tissue angle were measured manually. Peripapillary choroidal vascularity index and choroidal thickness (CT) values in superior, nasal, inferior, and temporal were calculated using a custom-built algorithm based on MATLAB. The interocular difference in AL and spherical equivalent was 0.62 ± 0.26 mm and -1.50 (-2.13, -1.25) diopters (D), respectively. The interocular difference in spherical equivalent was highly correlated with that of the AL. The β- and γ-PPA areas were significantly greater in more myopic eyes. The mean and inferior peripapillary choroidal vascularity index and all regions of peripapillary CT were significantly lower in the more myopic eyes. The interocular difference in AL was significantly positively correlated with the interocular differences in γ-PPA area and border length and negatively correlated with the interocular differences in temporal choroidal vascularity index and mean, inferior, and temporal peripapillary CT. There was an independent correlation between the interocular differences in AL and the interocular differences in γ-PPA area, inferior, and temporal peripapillary CT. Significant differences between both groups were detected in most peripapillary parameters, especially in peripapillary CT. The γ-PPA area, border length, and peripapillary CT were significantly correlated with the elongation of AL. The current study characterized and analyzed the peripapillary parameters in myopic anisometropia, which helped to monitor myopic progression.

Peripapillary choroidal vascularity index and thickness in patients with systemic sclerosis

IntroductionPatients with systemic sclerosis (SSc) present an increased risk of developing glaucomatous optic neuropathy (GON). We investigated peripapillary choroidal parameters and peripapillary retinal nerve fiber layer (RNFL) thickness using spectral domain optical coherence tomography (SD-OCT) to determine the relationships of these factors with clinical variables.MethodsA total of 33 patients with SSc were enrolled and compared to 40 controls. After obtaining circular scans around the optic disc, the global and quadrant peripapillary choroidal thickness (pCT) and RNFL thickness were measured. Additionally, the peripapillary choroidal vascularity index (pCVI), which allows for a quantitative analysis of the choroidal vasculature, was determined.ResultsNo significant differences were found in pCT and RNFL thickness between patients with SSc and controls, or within SSc subtypes (diffuse cutaneous systemic sclerosis (dcSSc) compared to limited cutaneous systemic sclerosis (lcSSc)) (p &amp;gt; 0.05). The pCVI was significantly lower in patients with SSc than in control subjects (64.25 ± 1.94 vs.65.73 ± 2.12, p &amp;lt; 0.001).ConclusionOur results suggest that the statistically significant decrease in pCVI in patients with SSc compared to the control group is probably due to a decrease in the vascular layer, which would partially explain an increased risk of GON in patients with SSc.

Impact of obesity on peripapillary choroidal thickness, macular choroidal thickness, and lamina cribrosa morphology

BackgroundObesity is known to be a significant risk factor for many ocular diseases. In order to understand the mechanism of obesity-related ocular diseases, we examined the lamina cribrosa morphology, peripapillary choroidal thickness (PPCT), and macular choroidal thickness (MCT) in obese women using optical coherence tomography (OCT). MethodsThis comparative cross-sectional study included the right eyes of 72 obese women and 63 healthy women classified based on body mass index (BMI). Each participant underwent a thorough ophthalmological examination and enhanced depth (EDI) OCT imaging, including measurements of PPCT from a total of 12 regions, MCT from a total of 7 regions, Bruch's membrane opening (BMO), lamina cribrosa thickness (LCT), lamina cribrosa depth (LCD), intraocular pressure (IOP), and central corneal thickness (CCT). ResultsThe mean age and BMI of the obese group were 32.36±7.38 years and 35.11±4.39 kg/m², while those of the control group were 31.64±7.78 years and 20.88±1.72 kg/m² (p = 0.658, and p<0.001, respectively). PPCT N1000, PPCT N1500, PPCT S1500, and PPCT T1500 were statistically significantly thinner in the obese group than the control group (p values were 0.039, 0.012, 0.027, and 0.036, respectively). IOP and CCT were significantly higher in the obese group than the control group (p = 0.016, and p = 0.019, respectively). There was no statistically significant difference between the two groups in terms of MCT, BMO, LCT, and LCD. ConclusionWe discovered thinning in the PPCT, which indicates microvascular abnormalities in the optic disc head. Microvascular alteration in the peripapillary region may be a potential initial event in the pathogenesis of several obesity-related ocular diseases, especially glaucoma.

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.

POTENTIAL TREATMENT FOR PERIPAPILLARY PACHYCHOROID SYNDROME.

The purpose of this study was to describe the effect of topical prednisolone on intraretinal fluid in patients with peripapillary pachychoroid syndrome. We selected 11 consecutive patients (17 eyes) with a diagnosis of peripapillary pachychoroid syndrome, who were treated with topical prednisolone (Pred Forte [PF] 10 mg/mL) three times daily for 4 weeks. We tapered off PF among patients who demonstrated a reduction of intraretinal fluid. Of the included 17 eyes, the average follow-up before PF treatment ranged from 6 to 192 months, during which patients experienced no apparent reduction of intraretinal fluid. The baseline mean best-corrected VA (BCVA) was 0.6 (20/33) Snellen. The median subfoveal and peripapillary choroidal thickness were 430 µm and 202 µm, respectively. All patients showed an initial reduction of intraretinal fluid after 4 weeks of topical prednisolone. Six patients (35%) experienced a prolonged reduction of intraretinal fluid when the dosage was reduced to once daily. On tapering off PF, four eyes (24%) experienced a recurrence of intraretinal fluid. Four eyes (24%) experienced elevated intraocular pressure above 26 mmHg. In two eyes, PF was discontinued, on which intraretinal fluid reappeared. The BCVA seemed to be improved in 9 eyes (53%) and remained equal in 4 eyes (24%). In this case series of patients with peripapillary pachychoroid syndrome, we observed a reduction of peripapillary intraretinal fluid after treatment with topical prednisolone for 4 weeks in all 17 eyes. The disappearance of intraretinal fluid seemed to concede with a slight improvement in BCVA for some cases. Thus, topical prednisolone may prove to be a viable treatment option in peripapillary pachychoroid syndrome.

Quantitative evaluation of retinal and choroidal vascularity in systemic lupus erythematosus by SS-OCT/OCTA.

To evaluate changes in retinal and choroidal vascularity using swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (OCTA) in patients with systemic lupus erythematosus (SLE). In this prospective, cross-sectional study, 48 SLE patients and 40 healthy control (group HC) participants were included. The SLE patients were divided into two subgroups: patients with SLE with no ocular disease (group I) and patients with SLE with signs of retinopathy (group II). The superficial vessel density (SVD), deep vessel density (DVD), peripapillary retinal vessel densities (pRVD), choroidal thickness (ChT), and choroidal vascularity including total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were measured using SS-OCT/OCTA. Physical and ophthalmic examinations as well as the assessments of immunological markers were performed. The results of SS-OCT/OCTA were compared between group I, group II, and group HC, while the correlations among the parameters were analyzed. The SVD, DVD, and pRVD were found to be significantly lower in SLE patients than group HC, especially in SLE patients with signs of retinopathy. ChT were found to be significantly higher in group II. CVI was positively correlated with SVD and DVD in the fovea, as well as the foveal and parafoveal thickness. A significant decrease in SVD and DVD in the fovea among subjects positive for anti-dsDNA antibodies was noted. The application of OCTA in the evaluation of microvasculature may be useful in subclinical changes. Retinal microvascular density decreased in patients with SLE with greater severity of SLE. Disturbed retinal circulation was related to SLE disease activity, disease duration, CVI, and being positive for anti-dsDNA antibodies. The study results also suggest that SLE with signs of retinopathy may affect the choroid with increases in LA, SA, TCA, and ChT.

Segmentation Errors and Off-Center Artifacts in SS-OCT: Insight from a Population-Based Imaging Study

Purpose To evaluate the frequency and associated factors of artifacts in swept-source optical coherence tomography (SS-OCT) imaging. Methods This was a population-based cross-sectional study. Individuals aged 35 years or older, residing in the Yuexiu district of Guangzhou, China, were recruited by random cluster sampling. Nearly half of the participants were randomly selected for SS-OCT imaging centered on the optic nerve head. Six types of artifacts in the peripapillary choroidal layer and retinal nerve fiber layer (RNFL) were graded and identified. Univariate and multivariate logistic regression analyses were used to investigate the association between the presence of artifacts and clinical characteristics. Results Out of the 616 eligible individuals who underwent SS-OCT imaging, 18.3% and 13.6% of subjects exhibited at least one artifact in peripapillary RNFL (pRNFL) and peripapillary choroidal thickness (pCT) measurements, respectively, with posterior segmentation error and off-center artifact ranked as the most common artifacts. The presence of artifacts was significantly associated with age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01–1.06; p = .003), refractive error (OR, 0.80; 95% CI, 0.71–0.89; p < .001), and signal strength (OR, 0.95; 95% CI, 0.90–0.997; p = .039) in pRNFL thickness measurement. Similarly, the presence of artifacts in pCT measurement was significantly associated with age (OR, 1.05; 95% CI, 1.03–1.08; p < .001), and refractive error (OR, 0.76; 95% CI, 0.68–0.86; p < .001). Conclusion Nearly one-fifth of the eyes were noted with at least one artifact in the population-scale SS-OCT study. Age was a risk factor for the presence of artifacts and should be considered in clinical settings.

Clinical Relevance of Choroidal Thickness in Obese and Healthy Children: A Machine Learning Study.

To analyze the effect of macular choroidal thickness (MCT) and peripapillary choroidal thickness (PPCT) on the classification of obese and healthy children by comparing the performance of the random forest (RF), support vector machine (SVM), and multilayer perceptrons (MLP) algorithms. Fifty-nine obese children and 35 healthy children aged 6 to 15 years were studied in this prospective comparative study using optical coherence tomography. MCT and PPCT were measured at distances of 500 μm, 1,000 μm, and 1,500 μm from the fovea and optic disc. Three different feature selection algorithms were used to determine the most prominent features of all extracted features. The classification efficiency of the extracted features was analyzed using the RF, SVM, and MLP algorithms, demonstrating their efficacy for distinguishing obese from healthy children. The precision and reliability of measurements were assessed using kappa analysis. The correlation feature selection algorithm produced the most successful classification results among the different feature selection methods. The most prominent features for distinguishing the obese and healthy groups from each other were PPCT temporal 500 μm, PPCT temporal 1,500 μm, PPCT nasal 1,500 μm, PPCT inferior 1,500 μm, and subfoveal MCT. The classification rates for the RF, SVM, and MLP algorithms were 98.6%, 96.8%, and 89%, respectively. Obesity has an effect on the choroidal thicknesses of children, particularly in the subfoveal region and the outer semi-circle at 1,500 μm from the optic disc head. Both the RF and SVM algorithms are effective and accurate at classifying obese and healthy children.

Factors Affecting Visual Acuity and Central Visual Function in Glaucoma Patients With Myopia

To investigate associated factors including structural parameters of myopia and vessel density (VD) using optical coherence tomography angiography (OCT-A) to visual acuity (VA) and central visual function in glaucoma patients with myopia. Retrospective cross-sectional study METHODS: Sixty-five eyes of 60 glaucoma patients with myopia and without media opacity and retinal lesions were include. Both Swedish interactive thresholding algorithm (SITA) 24-2 and 10-2 visual field (VF) testing were performed. Superficial and deep VD in the peripapillary and macular regions were evaluated using OCT-A; retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured. β-zone peripapillary atrophy (PPA) area, disc torsion, disc-fovea distance, and peripapillary choroidal thickness were measured. Decreased VA was defined as best-corrected VA <20/25. The worse mean deviation of SITA 24-2, thinner GCIPL thickness, and lower deep peripapillary VD were associated with the presence of central VF damage in glaucoma patients with myopia. Thinner GCIPL thickness, lower deep peripapillary VD, and longer disc-fovea distance were associated with decreased VA in logistic regression analysis. Thinner GCIPL thickness, lower deep peripapillary VD, and larger β-zone PPA area were associated with lower VA in linear regression analysis. Deep peripapillary VD showed a positive correlation with GCIPL thickness, whereas there was no relationship between deep peripapillary VD and RNFL thickness. Decreased VA in glaucoma patients with myopia was associated with lower deep peripapillary VD and papillomacular bundle damage. Lower deep peripapillary VD was independently associated with decreased VA along with thinner GCIPL thickness. Therefore, this could be stated that decreased VA in glaucoma patients is related to the damage location and the status of blood flow in the optic nerve head.