Significant Increase In Choroidal Thickness Research Articles

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

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

Early Postoperative Changes in Macular Choroidal Thickness After Uncomplicated Phacoemulsification in Patients With and Without Glaucoma: A Swept-Source Optical Coherence Tomography Study.

Purpose The objective of this study was to examine the impact of uncomplicated phacoemulsification on macular choroidal thickness (CT) within the first three postoperative months and to investigate its relationship with postoperative cystoid macular edema (CME) in both glaucomatous and healthy subjects, utilizing swept-source optical coherence tomography (SS-OCT). Methods The non-randomized prospective study involved 82 patients, selected via convenience sampling from the First Department of Ophthalmology, Medical School of Athens, "G. Gennimatas" Hospital, Athens, Greece, between May 2018 and May 2022, undergoing phacoemulsification and intraocular lens (IOL) implantation. The inclusion criteria encompassed patients aged 50 years or above, with or without glaucoma. Patients with ocular pathologies that could influence macula or CT measurements were excluded. Data collection focused on retinal and CT variablesof the macular area, measured using SS-OCT. Baseline measurements were established preoperatively, with follow-up assessments at one week, one month, and three months postoperatively to monitor CT and macular edema onset. Results A total of 82 eyes from 82 patients with a mean age of 79.1±8.3 years were included. The study population was divided into a glaucoma group (n=28 eyes) and a control group (n=54 eyes). Our findings indicate a consistently significant increase in macular CT measurements one month after cataract surgery, observed in both glaucomatous and non-glaucomatous eyes. In the first postoperative week, statistically significant changes in CT were observed only in patients with CME. Subsequently, at one-month interval, both patient groups, those with and without CME, exhibited statistically significant changes in CT across all macular sectors. CME was detected in 10 out of 28 eyes in the glaucoma group and in 16 out of 54 eyes in the control group. When evaluating the impact of postoperative CME on groups of glaucomatous and non-glaucomatous eyes, it was observed that glaucomatous eyes exhibited a significantly larger magnitude of change in subfoveal CT (SFCT) (p=0.03) at one month (relative to baseline) compared to non-glaucomatous eyes. There was also a 31% increase in the odds of developing CME for glaucoma patients; this result was not statistically significant (odds ratio {OR}, 1.31; 95% confidence interval {CI}, 0.50-3.47; p=0.57). Conclusions During the early postoperative period, the study revealed a significant increase in CT at one month after phacoemulsification in both glaucomatous and non-glaucomatous eyes. When CME was present, a significantly more pronounced magnitude of change in SFCT was observed at one month in glaucomatous eyes, as opposed to non-glaucomatous eyes. This observation suggests a possible selective susceptibility of glaucomatous eyes in the early postoperative period that requires further research.

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

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

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

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

The effect of systemic and topical ophthalmic medications on choroidal thickness: A review.

The choroid plays an important role in various ocular pathologies and retinal blood supply. There is a knowledge gap on how the choroid is affected by systemic and topical medications. Systemic medications that affect microvasculature elsewhere in the body can also affect the microvasculature of the choroid. This review summarizes current knowledge on associations between systemic and topical medications and changes in choroidal thickness (CT). This review included 71 studies on mydriatics/cycloplegics, intraocular pressure (IOP)-lowering therapies, antihypertensives, adrenergic antagonists, statins, corticosteroids, hydroxychloroquine, isotretinoin, hormonal contraceptives, phosphodiesterase inhibitors, antipsychotics, antineoplastic agents, ethanol, caffeine and nicotine. IOP-lowering therapies, atropine eye drops, and systemic administration of β blockers and ethanol are associated with a significant increase in CT. Cyclopentolate and phenylephrine are associated with a CT reduction. Systemic medications that decrease CT include caffeine and nicotine. Tropicamide, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statins, corticosteroids, hydroxychloroquine and hormonal contraceptives have mixed findings. CT increase associated with IOP-lowering therapies is possibly achieved by enhancing aqueous humour flow to the choroid thus elevating choroidal blood flow and thickness. CT changes appear to be independent from systemic blood pressure changes, suggesting that a significant association with an antihypertensive could be due to an idiosyncratic drug property. Statins and candesartan decrease macrophage accumulation and intercellular adhesion molecule 1 expression in the choroid. The choroid and its response to various disease processes and systemic medication can be further investigated to improve patient care, particularly in patients with choroid and retina pathologies.

Bacillary layer detachment in a patient with serpiginoid choroiditis.

Bacillary layer detachment in a patient with serpiginoid choroiditis.

Short-term effect of angiotensin converting enzyme inhibitor on choroidal vascularity

PurposeTo determine the effect of angiotensin-converting enzyme (ACE) inhibitors on choroidal vascularity using the binarization method in a group of treatment-naïve hypertensive patients. MethodsThere were 48 treatment-naive hypertensive patients who were diagnosed according to the "2013 European Society of Hypertension/European Society of Cardiology" guideline and started angiotensin-converting enzyme inhibitor perindopril (Coversyl) in the study. As a control group, 48 healthy volunteers were randomly selected among people who attended the outpatient clinic for routine ophthalmological examination. Enhanced-depth imaging optical coherence tomography (EDI-OCT) images were captured at baseline and at 1 month after treatment. Binarization of the EDI-OCT images was performed by Image-J software. The choroidal thickness (CT), total choroidal area, luminal area, stromal area, and choroidal vascularity index (CVI) were measured. ResultsThere was a statistically significant increase in CT at all locations (subfoveal, nasal, and temporal) at 1 month after treatment compared with baseline (for all, p˂0.001). Choroidal structural parameters and the mean CVI were statistically significantly increased at 1 month after treatment (for all, p˂0.001). When compared, there was no statistically significant difference for the vascular parameters between the control group and the patient group at 1 month (for all, p>0.05). ConlusionA statistically significant improvement was demonstrated in the choroidal vascular parameters except for the stromal area after treating with an ACE inhibitor in a group of hypertensive patients.

Changes in choroidal and foveal retinal thickness after cataract surgery: Our results

IntroductionCataract surgery is the most common ophthalmic surgical procedure worldwide. In addition, the retina and choroid are the tissues most susceptible to damage during cataract surgery. However, conflicting results have been found about the relationship between choroidal thickness (CT), retinal thickness (RT), and cataract surgery. AimTo evaluate the changes in CT and foveal retinal thickness (FT) following cataract surgery in standardized conditions. MethodsTwenty eyes from 20 patients who experienced uneventful cataract surgery and twenty eyes from 20 age- and sex-matched healthy volunteers were recruited in the study. Optical coherence tomography measurements were obtained for 1 day, 1 week, and 1 month postoperatively and compared with the preoperative and control values. The main outcome measure was through the mean change in CT and FT. ResultsThe FT values did not change throughout the follow-up. A statistically significant increase in CT at the macular (P = 0.003) and temporal 1 mm region (P = 0.04) was observed at 1 week following the surgery. However, it decreased to nearly preoperative values at 1 month postoperatively. ConclusionAlthough the FT remains stable following uneventful phacoemulsification, the CT changes minimally in the early postoperative period. However, this effect is transient and does not appear to be clinically significant in routine conditions.

Association of Choroidal Thickness with Sleep Deprivation in Night-shift Healthcare Workers

Background: Good vision is an important factor for most night-shift personnel, and the effects of sleep deprivation on visual function must be studied. Up to our knowledge, no study has evaluated the effect of nigh working on choroidal indices. Objectives: In this study, we aimed to investigate the effects of sleep deprivation on choroidal thickness. Methods: This cross-sectional study was conducted on 50 night-shift healthcare workers of the Islamic Republic of Iran (IRI) army medical core. Baseline choroidal thickness was measured for all participants using optical coherence tomography (OCT), and at the same time (10 AM to 2 PM) a day following the night shift, participants underwent a second measurement of choroidal thickness. The awake time before the second measurement was recorded. Results: The mean age ± standard deviation of the participants was 42.55 ± 5.52 that 52% were female. A statistically significant increase in choroidal thickness was recorded following night-shift (P = 0.001). Choroidal thickness following night-shift significantly correlated with age (r = -0.614; p = 0.001), awake time (r = 0.417; P = 0.003) and with baseline thickness of choroid (r = 0.830; P = 0.001). Conclusions: It seems that sleep deprivation may increase choroidal thickness, and the awake time may a predictor of choroidal thickness change after the night shift.

Evaluation of macular, retinal nerve fiber layer and choroidal thickness by optical coherence tomography in children and adolescents with vitamin B12 deficiency

To investigate macular, Retinal Nerve Fiber Layer (RNFL) and choroidal thickness in children and adolescents with vitamin B12 deficiency and no neurological examination finding. The study group includes of thirty-three children aged 8-17years who were brought to the Pediatric outpatient clinic with the symptoms of fatigue and forgetfulness and whose Vitamin B12 levels were detected < 200pg/ml. The control group was the 30 children and adolescents applied to the same policlinic with various symptoms and whose Vitamin B12 levels were found normal. Children and adolescents with chronic systemic/ocular disease history and myopia or hyperopia more than 4 diopters were not included in both groups. Spectral Domain-Optical Coherence Tomography (SD-OCT) was used for measurements. Mean Macular thickness value was 261.2 ± 17.6 in the Vitamin B12 deficiency group and 267.7 ± 17.4 in the control group. Mean value of Retinal Nerve Fiber Layer (RNFL) thickness was 103.5 ± 7.5 in the Vitamin B12 deficiency group and 104.3 ± 8.9 in the control group. The mean values of Choroidal thickness were 360.1 ± 59.8 and 316.9 ± 95.4 in Vitamin B12 deficiency and control groups, respectively. There was a statistically significant increase in choroidal thickness in Vitamin B12 deficiency group compared to controls. Statistically significant increase in the Choroidal thicknesses of children and adolescents with Vitamin B12 deficiency is important in terms of shedding light on studies that will contribute to a better understanding of the relationship between vitamin B12 and inflammation. This study is an observational study.

How does nepafenac affect the choroidal thickness after uneventful cataract surgery?

To investigate the effects of topical nepafenac on choroidal thickness (CT) following uneventful phacoemulsification surgery (UPS) using enhanced depth imaging optical coherence tomography (EDI-OCT). This prospective study included 45 randomly selected eyes (23 eyes of 23 patients used nepafenac (nepafenac group) and 22 eyes of 22 control patients did not use nepafenac (nepafenac-free group)) undergoing small-incision UPS. All participants underwent full ophthalmologic examination. CT measurements were performed at subfoveal, 1.0 mm temporal, and 1.0 mm nasal using the EDI-OCT preoperatively, 1 day, 1 week, and 1 month postoperatively. The mean subfoveal, nasal, and temporal CT in the nepafenac-free group had changed from 268.95 ± 63.59 μm to 283.36 ± 65.63 μm, 237.22 ± 64.09 μm to 253.09 ± 67.27 μm, and 235.95 ± 75.22 μm to 259.09 ± 63.66 μm preoperatively to 1 month postoperatively, respectively (p < 0.001, p < 0.001, p < 0.001, respectively). The mean subfoveal, nasal, and temporal CT in the nepafenac group had changed from 259.65 ± 55.99 μm to 276.65 ± 59.21 μm, 236.34 ± 55.40 μm to 251.00 ± 62.39 μm, and 247.56 ± 50.88 μm to 261.13 ± 53.73 μm preoperatively to 1 month postoperatively, respectively (p < 0.001, p < 0.001, p < 0.001, respectively). The postoperative CT continued to increase significantly during the follow-up period in two groups. However, compared to the change from baseline to month 1, there was not a statistically significant difference between the groups at subfoveal, nasal, and temporal CT (p: 0.633, p: 0.865, and p: 0.328, respectively). UPS may cause a significant increase in CT. Although increasing in the CT was lower in the nepafenac group than the nepafenac-free group, there was not a statistically significant difference between the groups.

Evaluation of the effect of energy drink consumption on retina and choroid: an optical coherence tomography and optical coherence tomography angiography study

Purpose Evaluation of retinal and choroidal changes after energy drink consumption by optical coherence tomography and optical coherence tomography angiography. Methods and material Forty-two healthy volunteers with neither systemic nor ocular diseases were enrolled in the study. The energy drink (250 mL Red Bull energy drink) was provided to all volunteers. The vascular density of superficial (SCP) and deep capillary plexus (DCP), vascular density in FAZ region, its circumference (PERIM) and vascular density around 300 micron (FD-300), and blood flow in outer retinal and choriocapillaris were measured by OCT-A (AngioVue RTVue XR Avanti, Optovue, Fremont, CA) before and 30 min after consumption of energy drink, in an interval of 1, 2, 3, 6, and 24 h. Central macular thickness (CMT) was measured by OCT (Heidelberg Engineering, Inc., Heidelberg, Germany), whereas choroid thickness (CT) and retinal nerve fibre layer (RNFL) measurements of the optic nerve were measured by enhanced depth imaging OCT. For control comparison, the same measurements were made after drinking 250 mL of water in the same healthy group. The obtained data were statistically analysed. Results Among 42 volunteers enrolled in the study, 25 (59,5%) were males and 17 (40,5%) were females, with an average age of 20,58 ± 0,71. The vascular density measurements of parafoveal and perifoveal deep capillary plexus obtained after energy drink consumption were statistically significant. This increase in vascular density of the deep capillary plexus after energy drink consumption seemed to start after half an hour and continued until measurement at 24th hour. On the other hand, the changes in measurements of vascular density from other regions, the blood flows, FAZ, CMT, CT and RNFL values were not statistically significant. In water consumption measurements; despite a statistically significant increase in choroidal thickness at 30 min and 1 h (p = 0.027, p = 0.045, respectively), no significant difference was found in other parameters between consecutive measurements. Conclusion The consumption of energy drinks acutely leads to changes in retinal vascular density parameters.

Macular Choroidal Thickness Changes in Development, Progression, and Spontaneous Resolution of Epiretinal Membrane

To evaluate the association between macular choroidal thickness and the development, progression, and resolution of epiretinal membrane (ERM). The patients (n = 38) with unilateral ERM eyes with definitive changes on optical coherence tomography (OCT) and healthy fellow eyes were observed retrospectively. ERM eyes were divided into three groups: Development/new-onset group (n = 14), progression group (n = 13), and resolution group (n = 11). In each group, the average changes of macular choroidal thickness over time in ERM eyes were compared with those in the fellow eyes RESULTS: Choroidal thickness significantly decreased from 174.0 μm at baseline to 132.3 μm at event time (P = .001) in the development group, and from 140.0 μm ± 30.0 μm to 120.5 μm (P = .002) in the progression group. Conversely, a significant increase in choroidal thickness was observed in the resolution group (from 205.2 μm to 222.6 μm; P = .004). The fellow eyes showed no significant changes in choroidal thickness in all three groups. Choroidal thinning in newly developed or significantly progressed ERM eyes and choroidal thickening in spontaneously resolved ERM eyes suggest a clinical implication of choroidal changes in ERM. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:627-634.].

Upside-down position leads to choroidal expansion and anterior chamber shallowing: OCT study

BackgroundTo determine whether dynamic changes in choroidal thickness (CT) cause shallowing of the anterior chamber.Methods34 healthy volunteers were enrolled. The participants in our study adopted the upside-down position for 1.5...

Short-Term Effect of Low-Dose Atropine and Hyperopic Defocus on Choroidal Thickness and Axial Length in Young Myopic Adults.

Purpose To examine the interaction between a short period of hyperopic defocus and low-dose atropine upon the choroidal thickness and ocular biometrics of healthy myopic subjects. Methods Twenty young adult myopic subjects had subfoveal choroidal thickness (ChT) and ocular biometry measurements taken before and 30 and 60 min following the introduction of optical blur (0.00 D and −3.00 D) combined with administration of 0.01% atropine or placebo. Each combination of optical blur and drug was tested on different days in a fixed order. Results The choroid exhibited significant thinning after imposing hyperopic defocus combined with placebo (mean change of −11 ± 2 μm, p < 0.001). The combination of hyperopic blur and 0.01% atropine led to a significantly smaller magnitude of subfoveal choroidal thinning (−4 ± 8 μm), compared to placebo and hyperopic defocus (p < 0.01). Eyes treated with 0.01% atropine with no defocus exhibited a significant increase in ChT (+6 ± 2 μm, p < 0.01). Axial length also underwent small but significant changes after treatment with hyperopic blur and placebo and 0.01% atropine alone (both p < 0.01), but of opposite direction to the changes in choroidal thickness. However, the 0.01% atropine/hyperopic blur condition did not lead to a significant change in axial length compared to baseline (p > 0.05). Conclusion Low-dose atropine does inhibit the short-term effect of hyperopic blur on choroidal thickness and, when used alone, does cause a slight thickening of the choroid in young healthy myopic adults.

Evaluation of choroidal thickness in different stages of diabetic retinopathy

Purpose: to assess changes of choroidal thickness (CT) in diabetic patients in different stages of diabetic retinopathy and diabetic macular edema using spectral domain optical coherence tomography. Patients and methods: One hundred and sixty three subjects were enrolled: 113 diabetic patients (186 eyes) and 50 normal individuals as controls. Eyes were divided into two groups according to age; group A from 35 to 50 years and group B from 51 to 65 years. Both groups classified according to retinopathy grade: DR1 (no DR), DR2 (mild- moderate nonproliferative diabetic retinopathy (NPDR)), DR3 (severe NPDR), DR4 (untreated proliferative diabetic retinopathy (PDR)) and DR5 (previously treated PDR). All participants underwent full ophthalmic examination, stereoscopic color fundus photography, and spectral domain optical coherence tomography (RS-3000; Nidek). Spectral domain optical coherence tomography examination consisted of linear scans, 6 mm in length, centered onto the fovea, and macula multi scans. Choroidal thickness was measured manually at the fovea and at 500, 1000, and 1500 um distance along all scans in the macula. Results: Mean age was not significantly different between patients with diabetes and controls. In the macular area, CT was significantly lower in the nasal quadrant versus all other quadrants (P, 0.0001), in both groups. No significant CT difference was found between controls and diabetic eyes without detectable DR. Diabetic macular edema did not influence CT. In early NPDR (mild and moderate) and treated PDR the mean choroidal thickness was significantly decreased than control. In severe NPDR and treated PDR, the mean subfoveal choroidal thickness was not different than control. There was a statistically significant increase in choroidal thickness in PDR when compared with the mild NPDR group (P=0.027). DME was associated with a non-statistically significant increase in choroidal thickness compared with eyes without DME (P=0.13). Conclusion: Choroidal thickness is reduced in diabetic eyes. Subfoveal choroidal thickness increased with the severity of diabetic retinopathy but showed no statistically significant association with the presence of DME. Spectral domain optical coherence tomography clearly confirms in vivo previously reported histopathologic observations. The role of choroid in the pathophysiology of DR needs to be adequately investigated.

Daily morning light therapy is associated with an increase in choroidal thickness in healthy young adults

Ambient light exposure is one environmental factor thought to play a role in the regulation of eye growth and refractive error development, and choroidal thickness changes have also been linked to longer term changes in eye growth. Therefore in this study we aimed to examine the influence of a 1-week period of morning light therapy upon choroidal thickness. Twenty two healthy young adult subjects had a series of macular choroidal thickness measurements collected with spectral domain optical coherence tomography before, and then following a 7-day period of increased daily light exposure. Increased light exposure was delivered through the use of commercially available light therapy glasses, worn for 30 minutes in the morning each day. A significant increase in subfoveal choroidal thickness (mean increase of +5.4 ± 10.3 µm) was found following 7-days of increased daily light exposure (p = 0.02). An increase in choroidal thickness was also observed associated with light therapy across the central 5 mm macular region. This study provides the first evidence in the human eye that daily morning light therapy results in small magnitude but statistically significant increases in choroidal thickness. These changes may have implications for our understanding of the impact of environmental factors upon eye growth.

The interaction between homatropine and optical blur on choroidal thickness.

To analyse the short-term interaction between a short period of myopic and hyperopic defocus and the muscarinic antagonist homatropine upon the choroidal thickness and ocular biometrics of healthy subjects. Thirty young adults (15 myopes and 15 emmetropes) aged 18-35years had subfoveal choroidal thickness (ChT) and ocular biometry measurements taken before, 30min, and 60min following the introduction of monocular optical blur (0.00 D, +3.00 D and -3.00 D) combined with administration of either 2% homatropine or placebo (total of six conditions). Each combination of optical blur and drug was tested on different days, 2days apart, in randomised order. For choroidal thickness, we captured three SD OCT images (5mm, cross scans centred at the fovea with 999 A-scans and 50 B-scans) with the Copernicus SOCT HR instrument (www.optopol.com). A masked observer manually segmented the average B-scan images to derive subfoveal choroidal thickness measurements from each measurement session. The choroid exhibited significant thinning after imposing hyperopic defocus (-3.00 D) combined with placebo (-11±3μm, p<0.001). Homatropine prevented the significant choroidal thinning response with hyperopic defocus (+3±2μm), and the magnitude of ChT change was significantly different to placebo and hyperopic defocus (p<0.001). There was a significant increase in ChT after the introduction of myopic defocus (+3.00 D) with placebo (+12±3μm, p<0.0001) and homatropine combined with myopic defocus also caused a similar increase in ChT (+11±3μm; p<0.001). Eyes treated with homatropine alone exhibited a significant increase in ChT (+14±3μm, p<0.0001). There was no evidence of differences in choroidal response between refractive groups. Axial length also underwent small but significant changes (all p<0.01 except homatropine/hyperopic blur and placebo) that were of similar magnitude, but of opposite direction to the changes in choroidal thickness. Homatropine appears to block the thinning effect of hyperopic defocus on choroidal thickness but did not enhance the thickening effect of myopic defocus. The changes in the choroid may relate to the different pathways in the eye's response to myopic and hyperopic blur or reflect an upper limit on the capacity of the choroid to thicken in the short-term.

Choroidal Thickness in Childhood Obesity

To evaluate the effects of obesity on choroidal thickness (CT) in childhood. Forty-four patients with obesity (study group) and 42 healthy children (control group) were enrolled in the study. Subjects underwent a complete ocular examination. The mean CT was measured by enhanced depth imaging optical coherence tomography (EDI-OCT). Body mass index (BMI) was calculated. Mean BMI value was 31.8 ± 1.9 in the study group and 19.8 ± 4.4 in the control group. The mean subfoveal CT value 385.77 µm ± 6.09 µm in the study group and 348.43 µm ± 73.21 µm in the control group. There was a significant difference between the study and control groups with regard to subfoveal CT (P = .017). Subfoveal CT and BMI were positively correlated (r = 0.288; P = .004). CT increases in childhood obesity. Findings revealed that adiposity causes a significant increase in CT, and it may be related to ocular complications. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:10-17.].

Longitudinal change in choroidal thickness after trabeculectomy in primary open-angle glaucoma patients

To investigate longitudinal changes in intraocular pressure (IOP), axial length (AL), and choroidal thickness (ChT) in primary open-angle glaucoma (POAG) eyes after trabeculectomy and to evaluate the parameters that might influence those changes. In this prospective observational study, we recruited 28 patients with POAG (28 eyes) scheduled for trabeculectomy. The average macular ChTs and foveal retinal thicknesses along 6-mm segments centered on the fovea were examined preoperatively and postoperatively (at 1, 3, and 6months) using swept-source optical coherence tomography. The IOP, AL, and mean deviation (MD) of standard automated perimetry (SAP) were also analyzed as independent variables. Results from 16 patients were included in the final analysis. A significant increase in ChT with respect to the preoperative value was observed at every postoperative stage (1month, P<0.001; 3months, P<0.001; 6months, P=0.011), whereas the retinal thickness showed no significant change over the study period. The ChT increase and IOP reduction were sustained throughout the 6-month period without further significant changes. Stepwise multivariate analyses showed significant correlations between the percentage decrease in IOP and the percentage increase in ChT at 1 and 6months postoperatively. The percentage increase in ChT was also significantly correlated with a better MD of the SAP at 1month (β=0.01; P=0.009). The ChT increase following trabeculectomy was sustained at 1, 3, and 6months postoperatively. The percentage increase in ChT was significantly correlated with the percentage change in IOP and (more weakly) with better SAP MD values.