Enhanced Depth Imaging Spectral Domain Research Articles

Central Serous Chorioretinopathy in Nanophthalmos

Purpose: To report a case of bilateral central serous chorioretinopathy (CSC) occurring in a patient with nanophthalmos with long term follow up Methods: Case Report Results: A 37-year old male presented with diminution of vision in right eye (RE) since 3 days. On examination his best corrected visual acuity (BVCA) was 5/60 in RE and 6/18 in LE His refractive correction was +8.00D sphere. Anterior segment examination revealed small eyes with narrow palpebral fissures, shallow anterior chamber and clear lens. His axial length was 15.94mm in the RE and 15.89mm in the LE respectively. Fundus examination revealed a crowded disc with tortuous vessels in both eyes and the presence of subretinal fluid (SRF) in the macular area in the RE. Multimodal imaging included enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT) and fundus fluorescein angiography (FFA) which revealed features suggestive of thick choroids BE, ink-blot leak on FFA suggestive of acute CSC in the RE and a pigment epithelial detachment (PED) in the left eye. Focal laser in RE lead to SRF resolution and visual improvement. He was on regular follow up and 5 years later he presented with a recurrence of CSC in the RE for which he underwent a repeat FFA guided focal laser. Conclusion: This case highlights the unique coexistence of CSC in the setting of Nanophthalmos and highlights a probable overlapping pathophysiology of choroidal venous overload as well as the importance of multimodal imaging in differentiating the mimicking entities.

An Update on Multimodal Ophthalmological Imaging of Diffuse Choroidal Hemangioma in Sturge-Weber Syndrome.

Sturge-Weber syndrome (SWS) is characterized by facial port-wine stains, leptomeningeal hemangiomas, and prominent ocular manifestations such as glaucoma and diffuse choroidal hemangiomas (DCHs). Imaging modalities are critical for diagnosing and longitudinally monitoring DCHs in SWS. Fundus photography is fundamental in assessing both eyes simultaneously, fluorescein angiography and indocyanine green angiography effectively map the retinal and choroidal circulation, and ultrasonography offers essential structural insights into the choroid and retina. NIR imaging reveals subtle retinal pigment changes, often overlooked in standard fundus examination. Enhanced depth imaging spectral domain optical coherence tomography (EDI-SDOCT) and swept-source OCT (SSOCT) improve the visualization of the choroidal-scleral boundary, essential for DCH characterization. The potential of OCT angiography (OCTA) is under exploration, particularly its role in predicting signs of disease progression or worsening, as well as potential new biomarkers such as the choroidal vascularity index (CVI). The present review aims to provide an update on multimodal imaging of DCHs in SWS.

Analysis of subfoveal choroidal thickness alteration in relation to presence and severity of diabetic retinopathy

To assess alteration in subfoveal choroidal thickness in diabetics with or without diabetic retinopathy (DR) and compare it with severity of DR.All patients attending the ophthalmic OPD fulfilling inclusion and met no exclusion criteria were enrolled in this study. All eyes underwent comprehensive and standardized ophthalmic examination. The SFCT (subfoveal choroidal thickness) was measured using high definition enhanced depth imaging spectral domain optical coherence tomography using Cirrus HD OCT Model 500. The mean SFCT in diabetics was significantly lesser than age matched controls. It was also significantly lesser in diabetics with diabetic retinopathy as compare to diabetics without diabetic retinopathy. The SFCT was significantly decreased with increasing severity of diabetic retinopathy. The mean SFCT was also decreased in diabetic with diabetic macular edema (DME) and PRP treated DR as compared to diabetic without DME and PRP untreated DR respectively. The SFCT could be a marker of severity of diabetic retinopathy. It was decreased in diabetics as compared to nondiabetics and was significantly decreased with increasing severity of DR and in presence of DME. PRP also significantly decreases SFCT.

Choroidal structural changes in patients with early diabetic nephropathy

PurposeTo determine alterations of the choroidal thickness (CT) and the choroidal vascularity index (CVI) in patients with glomerular hyperfiltration, a marker of early diabetic nephropathy (DN). MethodsTwenty-two patients with type 2 diabetes (T2D) with glomerular hyperfiltration (early DN group) and 28 patients with T2D without DN (NDN group) were included in the study. Patients with diabetic retinopathy were excluded. Parameters including subfoveal CT, the subfoveal choroidal vascularity index (CVI), and total CVI were measured using spectral-domain enhanced depth imaging optical coherence tomography method. ResultsThe early DN group included 22 patients and the NDN group comprised 28 patients. The groups were similar in terms of age and sex (p>0.05). The CT values were statistically significantly lower in the early DN group than in the NDN group (p < 0.001). There was no significant difference between the early DN group and the NDN group in terms of total and subfoveal CVI (p>0.05). ConclusionThe choroidal thickness decreased in patients with T2D with glomerular hyperfiltration, but there were no differences in CVI when they were compared with patients with T2D without DN.

Choroidal vascularity index in hydroxychloroquine toxic retinopathy: a quantitative comparative analysis using enhanced depth imaging in spectral domain optical coherence tomography.

To investigate choroidal involvement in eyes of patients treated with hydroxychloroquine (HCQ), by quantifying the choroidal vascularization index (CVI) and other choroidal biomarkers. Vertical Enhanced Depth Imaging spectral domain Optical Coherence Tomography (SD-OCT) scans were performed in eyes with either advanced stage or mild HCQ toxic retinopathy, as well as in healthy age and sex-matched controls. Based on SD-OCT scans, the sub foveal and mean choroidal thickness (ChT) were measured. The CVI, total choroidal area (TCA), luminal choroidal area (LCA) and stromal choroidal area (SCA) were calculated based on a binarization image process. These variables were computed and compared between the three groups (i.e., advanced stage, mild toxicity and healthy controls). Forty-eight eyes of 47 patients under HCQ (26 eyes presented with advanced stage HCQ toxicity, 22 eyes with mild toxicity) and thirty-four eyes of 31 healthy controls were included. Both CVI and ChT were significantly different between the three groups (p < 0.001, p< 0.001). When comparing the advanced stage toxicity group to healthy controls, both the subfoveal and the mean ChT were diminished (p < 0.001). The CVI, TCA, LCA, SCA were significantly lower in the advanced stage of toxicity group when compared to controls (p <0.001, < 0.00001, <0.0001, p= 0.0094 respectively). Our study suggests that eyes with HCQ toxic retinopathy, especially at advanced stages, present with choroidal impairment, giving further pathophysiological insights into the unfolding of this retinal toxicity.

Morphologic Changes in the Lamina Cribrosa Upon Intraocular Pressure Lowering in Patients With Normal Tension Glaucoma.

PurposeThe purpose of this study was to investigate whether the lamina cribrosa (LC) curve changes in response to intraocular pressure (IOP) reduction following administration of topical ocular hypotensive eye drops in eyes with normal tension glaucoma (NTG).MethodsNinety-three eyes of 93 patients with treatment naïve NTG at initial examination and with ≥20% reduction from baseline IOP following administration of topical ocular hypotensive eye drops were included. Serial horizontal B-scan images of the optic nerve head (ONH) were obtained from each eye using enhanced depth imaging spectral domain optical coherence tomography (OCT) before and 1 year after IOP-lowering treatment. The LC curvature in each eye was assessed by measuring the LC curvature index (LCCI) in horizontal OCT B-scan images obtained at three (superior, central, and inferior) locations spaced equidistantly across the vertical optic disc diameter before and after IOP-lowering treatment. We evaluated the OCT detectible change in the LC curvature based on the interval change of LCCI to exceed the intersession standard deviation of 1.96 times and factors associated with the magnitude of the LCCI change in the eyes showing significant LC change.ResultsIOP decreased from 15.7 ± 2.5 mm Hg at baseline to 11.2 ± 1.7 mm Hg after topical glaucoma medication. Among the 93 subjects, 62 (66.7%) eyes showed the significant reduction of the LCCI (interssetional change over 1.5) after the treatment; greater interssessional change of the LCCI after IOP reduction was associated with younger age (P = 0.020) and larger baseline LCCI (P < 0.001).ConclusionsThe OCT detectible changes in LC curvature occurred in response to a modest decrease in the IOP in the naïve NTG eyes. The therapeutic benefit of these changes need to be assessed in longitudinal studies.

Primer Açık Açılı Glokomda Koroid Kalınlığının Ölçülmesi ve Görme Alanı Hasarı ile İlişkisinin Değerlendirilmesi: Vaka Kontrol Çalışması

Objective: To measure the macular and peripapillary choroidal thickness in the primary open-angle glaucoma (POAG), and to investigate the association between the visual field loss and choroidal thickness. Material and Methods: The study enrolled 90 eyes of 50 patients diagnosed with POAG, and 30 eyes of 19 patients as the control group (Group 0). Patients with POAG were divided into 3 groups as mild (Group 1), moderate (Group 2), and severe (Group 3) according to Hodapp, Anderson, Parrish criteria and 30 eyes were included in each group. The macular and peripapillary choroidal thicknesses were compared between the groups through enhanced depth imaging spectral-domain optic coherence tomography. Visual fields were measured by automated perimetry. Results: The peripapillary choroidal thickness in Group 3 with severe glaucomatous injury was significantly thinner when compared with the control group at all peripapillary locations except nasal location. Furthermore, the peripapillary choroidal thickness in Group 3 was significantly thinner than Group 1 at the mean, temporal, superior, superonasal, and inferonasal locations. Macular choroidal thickness did not differ between the groups. The age was inversely correlated with macular and peripapillary choroidal thickness. Conclusion: The peripapillary choroidal thickness was thinner in eyes with severe glaucomatous damage compared to normal and mildly glaucomatous damaged eyes. Treatments that support choroidal circulation may be beneficial in cases with severe POAG.

Choroidal Thickness in Emmetropia: An Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography-Based Study.

Objectives:To investigate and determine the choroidal thickness (CT) in healthy emmetropic Turkish subjects aged between 20 and 40 years using Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography (EDI-OCT).Methods:This study included 194 eyes of 194 healthy emmetropic subjects. All participants underwent a detailed ophthalmologic examination. Axial length (AL) was measured with optical biometry. CT measurements were performed at subfoveal, 1.0 mm temporal, and 1.0 mm nasal using the EDI-OCT. Central macular thickness (CMT) measurements were also performed at the same time. Participants were divided into two groups; Group 1 (age between 20 and 30 years) and Group 2 (age between 31 and 40 years). CT and CMT were compared among two groups.Results:The mean age of all the subjects was 26.61±6.08 years, the mean AL was 23.44±0.72 mm, and the mean spherical equivalent was −0.11±0.28 Diopter. The mean subfoveal, nasal, and temporal CT was 389.27±86.61 μm, 354.54±86.86 μm, and 368.25±78.69 μm, respectively. Subfoveal and nasal CT of female participants were found thinner than male participants (p=0.013 and p=0.008, respectively). CT and CMT were found similar between Group 1 and Group 2.Conclusion:This study showed that mean subfoveal CT and CMT was 389.27±86.61μm and 268.17±18.76 μm, respectively, among healthy emmetropic Turkish subjects. Females had thinner CT in subfoveal and nasal quadrants. In addition, age did not affect CT between 20 and 40 years.

Choroidal thickness changes and choriocapillary circulation analysis in macular holes using optical coherence tomography angiography.

To investigate the changes of subfoveal choroidal thickness (SFCT) and choriocapillary circulation in idiopathic macular holes (IMHs), the fellow eyes, and normal subjects using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), and to explore the role of SFCT and choriocapillary circulation in the pathogenesis of IMH. A case series of 30 patients with unilateral IMH and 30 subjects, with age- and sex-matched, were included. Thirty eyes of 30 patients with unilateral IMH, the unaffected fellow eyes, and 30 eyes of age- and sex-matched healthy patients were studied. SFCT was measured by spectral domain enhanced depth imaging optical coherence tomography (EDI SD-OCT), while vascular density and blood flow area of choriocapillary circulation were obtained by OCTA. The SECT in IMH eyes (236.09±79.25 µm) was lower than that in the unaffected fellow eyes (249.71±86.10 µm) (P=0.040) and healthy control eyes (283.29±64.16 µm) (P=0.001). Also, the SFCT of the unaffected fellow eyes was lower than that of the healthy control eyes (P=0.033). The superficial blood flow area and vascular density of choriocapillary in the macular area were smaller and lower in the IMH eyes (2.84±0.35 mm2, 20.74%±8.26%) than the unaffected fellow eyes (3.19±0.23 mm2, 35.18%±5.20%) and healthy control eyes (3.26±0.24 mm2, 35.20%±6.49%) (P<0.001); however, no difference was observed between the unaffected fellow eyes and healthy control eyes. The SFCT in IMH eyes was lower than that of unaffected fellow eyes and matched control eyes. In addition, the choriocapillary blood flow area and vascular density were smaller and lower than those of the unaffected fellow eyes and normal controls. Our findings suggested that atrophy of choriocapillary might play an important role in the formation of IMH.

The role of choroidal optical coherence tomography for follow-up of carotid cavernous fistula with anterior drainage.

To evaluate the role of the choroidal vascularity index (CVI) and the tortuosity index (TI), along with choroidal thickness measurements, in follow-up for anteriorly draining carotid cavernous fistulas (CCF) that would otherwise necessitate an invasive carotid angiogram. In this longitudinal observational study, analysis of enhanced depth imaging spectral domain optical coherence tomography (SD-EDI-OCT) images of 22 patients with angiographically proven unilateral CCF with anterior drainage was performed for subfoveal choroidal thickness (SFCT), central foveal thickness (CFT), CVI and TI. Baseline measurements were compared with those taken at the last visit after occlusion of the fistula. Both in the clinically affected and unaffected eyes, there was a significant decrease in CFT (p = 0.015 and p = 0.005, respectively), SFCT (p = 0.000 for both eyes), CVI (p = 0.002 and 0.001, respectively) and all three TI parameters, including inferior (p < 0.001 and p = 0.01, respectively) and superior temporal vein tortuosity index (p = 0.005 and p = 0.02, respectively) as well as total venular tortuosity index (p < 0.001 and p = 0.002, respectively) after successful closure of the fistula compared to first presentation. Changes in all parameters were similar between the D-CCF and I-CCF groups except for CVI. In this first study concerning follow-up of anteriorly draining unilateral CCFs by SD-EDI-OCT, we not only demonstrated involvement of the clinically unaffected eye but also showed that, this modality, utilizing CVI and TI together with choroidal thickness measurements, can be used as a readily available, noninvasive first-line followup method for evaluating occlusion of fistulas by endovascular treatment or spontaneous resolution.

Changes in Choroidal Thickness and Axial Length with Intraocular Pressure Changes After Trabeculectomy

Background: Trabeculectomy is commonly performed in patients with chronic open angle glaucoma when medical therapy fails to control intraocular pressure (IOP). Objective: The aim of the current work was to evaluate choroidal thickness (C.T) changes with Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT) & axial length (AXL) with ophthalmic A-Scan ultrasound after reduction of intraocular pressure (IOP) following trabeculectomy. Patients and Methods: The study was included 20 patients with open-angle glaucoma. The choroidal thickness was measured using enhanced depth imaging spectral domain optical coherence tomography (EDI-SD-OCT) and AXL of eye was measured using A-scan ultrasound before trabeculectomy and 1 month, 3 and 6 months postoperatively. Results: The changes of choroidal thickness before and after 1, 3 and 6 months of the operation found to have high statistically significant increase in SFCT-V, SFCT-V, NCT, TCT, SCT and ICT in 1st month postoperative with mean (217.65±27.03, 218±21.09, 216.9±28.86, 190.35±34.3, 223.1±24.82 and 244.8 ± 23.77) respectively, then they decreased in the 3rd month with mean (198.85 ±27.8, 197.8±23.3, 200.15±27.5, 178.35 ±31.9, 208.75±23.3 and 233.5±21.05) respectively, but it was not less than preoperative, and continued in decreasing in the 6th month with mean (187.3 ± 29.02, 186.95 ± 25.82, 188.95±27.47, 166.45±26.38, 197.7± 23.05 and 223.5±22.66) respectively, but it was not also less than preoperative. Conclusion: It could be concluded that intraocular pressure (IOP) reduction after trabeculectomy caused an increase in choroidal thickness (CT) this reduction of IOP was negatively correlated only with the increase in nasal, temporal, inferior and superior CT 3 mm away from the fovea.

Choroidal macrovessels: multimodal imaging findings and review of the literature

Background/aimsTo describe clinical and multimodal imaging features in a cohort of choroidal macrovessels.MethodsDemographics and multimodal imaging features of 16 eyes of 13 patients with choroidal macrovessels were reviewed. The multimodal...

Choroidal Thickness and Correlations with Intraocular Pressure and Spherical Equivalent in Young Myopic Eyes without Maculopathy

Background: Refractive error is one of the causes of visual impairment worldwide, among which myopia is the most common. Myopia is prevalent worldwide, particularly in East and Southeast Asia, which have myopia prevalence rates of approximately 80-90% and high myopia prevalence rates of 10-20% in young adults. High myopia is closely related to a variety of pathological changes and a higher risk of blinding complication. Purpose: To identify the distribution of choroidal thickness (CT) and to determine whether there are associations between subfoveal choroidal thickness (SFCT) and intraocular pressure (IOP) and spherical equivalent (SE) in young healthy myopes without maculopathy. Methods: A total of 116 young subjects without maculopathy were recruited in this study and underwent comprehensive ophthalmic examinations. Enhanced depth imaging spectral domain optical coherence tomography was performed for CT measurement and assessment. SFCT, as well as CT at 3 mm nasal, temporal, superior and inferior to fovea were measured. Univariable linear regression analysis and Multiple regression analysis were used to study the correlation between SFCT and spherical equivalent (SE) as well as IOP. To assess the CT at each location and explore it’s associated factors. Results: The SFCT of high myopes was notably thinner (197.00±35.21 µm) compared with mild myopes (287.05±68.31 µm) and moderate myopes (251.13±64.40µm). For all three groups, CT at 3 mm nasal was the thinnest (195.21±52.43µm, 168.43±59.24µm, 129.56±30.97µm, respectively.) Univariable linear regression analysis indicated that SFCT decreased by 15.49 µm per diopter in myopic refractive change (P <0.001, R2 = 0.146) and decreased by 17.87 µm per 1mmHg increase inintraocular pressure (IOP) (P < 0.001, R2 = 0.440). Multiple regression analysis indicated that there were significantly correlations between SFCT and spherical equivalent (SE) as well as IOP in mild myopes and moderate myopes, but not in high myopes. Conclusions: A significant difference of the CT distribution was found in the centre region among myopes. However, nasal choroid thinning was the most obvious in all myopia groups. SFCT was significantly correlated with IOP and SE in the myopic population. However, the same correlation was not observed in young highly myopic eyes.

Assessing changes in choroidal vasculature in the eye in Down’s syndrome

AbstractBackgroundChanges of choroidal vasculature in the eye have been reported in Alzheimer’s disease (AD) and this is positively correlated with declining cognitive status. Patients with Down’s syndrome (DS) are at a high risk of developing AD and also show signs of premature ageing. Both AD and ageing have been associated with thinner choroid, measured on optical coherence tomography (OCT) scans, however, there are currently no studies in the literature to evidence whether choroidal thinning occurs in DS. Our study, for the first time, investigated choroidal thickness (CT) in DS using OCT imaging.Method21 DS and 9 controls (Ctrl) were imaged using Enhanced Depth Imaging Spectral Domain OCT (Heidelberg). The choroid was manually segmented, and thickness values calculated using conventional grading grid (ETDRS). Statistical analysis was conducted in SPPS using only the right eye. The analysis was controlled for age, image quality, refractive error and time of the scan as covariates.ResultOCT imaging in DS proved to be challenging due to some participants having difficulties maintaining the fixation for an extended period. In this preliminary cohort the DS group was older than the Ctrl group (39.5±6.9 vs 31.2±6.0 years, p=.004) but there was no difference in gender (χ2=0.7, df=1, p=.376). Sub‐foveal (SF) and Superior‐inner (SI) CT was significantly increased in DS compared to Ctrl (SF: 363.2µm±25.9µm vs 237.3µm±45.8µm, p=.046; SI: 381.8µm±26.2µm vs 253.6µm±46.3µm, p=.044) but no differences were found in other sectors of the ETDRS grid. Increase in SF CT showed a moderate, positive correlation with cognitive status in the 14 participants whose cognitive score was available (ρ=.539, p=.047). Suprachoroidal space (SCS) as a hypo‐reflective band at the choroidal scleral interface, was only visible in DS in 13 (61.9%) out of the 21 participants. Those with SCS were older than those without (41.9±1.7 vs 35.6±2.2 years, p=.040).ConclusionIn this study we found that there is an increase in choroidal thickness in DS which is in contrast to the thinning observed in AD; this might be an anatomical feature of DS or may reflect inflammation. The increased prevalence of SCS in DS is likely to be associated with the accelerated ageing.

Choroidal Thickness in Indigenous Australian Children.

PurposeThis study aimed to examine the choroidal thickness profiles in visually normal Australian Indigenous children, given the important role of the choroid in refractive error and a range of ocular diseases.MethodsChoroidal thickness was assessed across the central 5 mm macular region using enhanced depth imaging spectral domain optical coherence tomography, in 250 children enrolled in an elementary school and a secondary school in rural Queensland, Australia. One hundred (40%) of these children identified as Indigenous Australians.ResultsThe subfoveal choroid was significantly thicker in Indigenous children (mean 369 ± 75 µm), compared to non-Indigenous children (355 ± 73 µm; P = 0.03). Subfoveal choroidal thickness was also significantly associated with age (β = +7.6, r2 = 0.105, P = 0.003), and axial length (β = −19.9, r2 = 0.030, P < 0.001). A significantly thicker choroid in Indigenous children was also found in analyses across the central 5 mm macular region (P = 0.008). A significant interaction between Indigenous status and meridian was observed (P = 0.007) with the largest differences between Indigenous and non-Indigenous children being in the nasal and inferonasal meridians.ConclusionsThis study establishes the normative characteristics of macular choroidal thickness in Indigenous Australian children and demonstrates a significantly thicker choroid compared to non-Indigenous children from the same geographic region. These results may have implications for our understanding of factors predisposing or protecting Australian Indigenous people from a range of conditions associated with choroidal thickness.Translational RelevanceThe significantly thicker choroid in Australian Indigenous children should be considered in clinical diagnoses and management of conditions associated with choroidal changes.

Subretinal Deposits in Pre-eclampsia and Malignant Hypertension: Implications for Age-Related Macular Degeneration

To describe the incidence of subretinal deposits that are similar in structure and stage on OCT imaging to subretinal drusenoid deposits (SDDs) in age-related macular degeneration (AMD) in patients with hypertensive choroidopathy secondary to severe pre-eclampsia and malignant hypertension (MHT) and the implications of this ischemic choroidopathy for the pathophysiologic characteristics of SDDs in AMD. Retrospective cross-sectional study. Thirty-three pre-eclampsia patients and 25 MHT patients with serous retinal detachment (SRD) in at least 1 eye were included. Serial multimodal images, including enhanced depth imaging spectral-domain OCT of eyes with hypertensive choroidopathy secondary to pre-eclampsia and MHT, were reviewed at 2 time points, the acute phase (within 4 weeks of initial hypertensive insult) and the recovery phase (beyond 4 weeks). Incidence of SDD-like lesions in patients with hypertensive choroidopathy secondary to pre-eclampsia and MHT. Subretinal drusenoid deposit-like lesions were observed exclusively in eyes with SRD. Serous retinal detachment occurred in 87.87% of eyes of pre-eclampsia patients and in 94% of eyes of MHT patients. Subretinal drusenoid deposit-like lesions occurred in 28.57% of all eyes with SRD, in 32.76% of eyes with SRD from the pre-eclampsia group, and in 23.40% of eyes with SRD from the MHT group. Vascular imaging suggested underlying choroidal ischemia in all patients (12 eyes) in which it was performed. Choroidal ischemia may be the underlying mechanism of SDD-like lesions in patients with pre-eclampsia and MHT choroidopathy. These findings potentially are of utmost importance in understanding the mechanism of the reticular macular disease subtype of AMD. Reticular macular disease is characterized by the known association of choroidal insufficiency and SDD, with choroidal insufficiency postulated, but not proven, to be causative. Pre-eclampsia and MHT choroidopathy seems to be a model for lesions similar to SDD in AMD developing based on choroidal insufficiency and, as such, may offer further insights into the pathoetiologic features of SDD in AMD.

The Application of Enhanced Depth Imaging Spectral-Domain Optical Coherence Tomography in Macular Diseases.

The choroid plays an essential role in the pathogenesis of various posterior segment diseases. However, traditional imaging methods still have limited cross-sectional observation of choroid. Enhanced depth imaging in spectral-domain optical coherence tomography (EDI SD-OCT) uses a closer scanning position to the eye to create an inverted SD-OCT image with the advantage of better depth sensitivity, which can observe choroidal structure and measure choroidal thickness (CT) accurately. At present, more and more choroidal thickness measurements have been made in normal and pathologic states, in order to understand the pathogenesis and differential diagnosis and prognosis of various diseases, especially for macular lesions. This paper would review relevant original literatures published from January 1, 2008, to February 1, 2020, to evaluate the relationship between the changes of CT with EDI SD-OCT and macular diseases.

Optical coherence tomography angiography findings in Huntington's disease.

To evaluate the retinal and choriocapillaris vascular networks in macular region and the central choroidal thickness (CCT) in patients affected by Huntington disease (HD), using optical coherence tomography angiography (OCTA) and enhanced depth imaging spectral-domain OCT (EDI SD-OCT). We assessed the vessel density (VD) in superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) using OCTA, while CCT was measured by EDI SD-OCT. Sixteen HD patients (32 eyes) and thirteen healthy controls (26 eyes) were enrolled in this prospective study. No significant difference in retinal and choriocapillaris VD was found between HD patients and controls while CCT turned to be thinner in patients respect to controls. There were no significant relationships between OCTA findings and neurological parameters. The changes in choroidal structure provide useful information regarding the possible neurovascular involvement in the physiopathology of HD. Choroidal vascular network could be a useful parameter to evaluate the vascular impairment that occurs in this neurodegenerative disease.

Using Enhanced Depth Imaging Optical Coherence Tomography-Derived Parameters to Discriminate between Eyes with and without Glaucoma: A Cross-Sectional Comparative Study

Introduction: New technologies have been developed in order to decrease interpersonal influence and subjectivity during the glaucoma diagnosis process. Enhanced depth imaging spectral-domain OCT (EDI OCT) has turned up as a favorable tool for deep optic nerve head (ONH) structures assessment. Objective: A prospective cross-sectional study was conducted to compare the diagnostic performance of different EDI OCT-derived parameters to discriminate between eyes with and without glaucoma. Material and Methods: The following ONH parameters were measured: lamina cribrosa (LC) thickness and area; prelaminar neural tissue (PLNT) thickness and area; average Bruch’s membrane opening – minimum rim width (BMO-MRW), superior BMO-MRW, and inferior BMO-MRW. Peripapillary retinal nerve fiber layer (pRNFL) thickness was also obtained. Results: Seventy-three participants were included. There were no significant differences between AUCs for average BMO-MRW (0.995), PLNT area (0.968), and average pRNFL thickness (0.975; p ≥ 0.089). However, AUCs for each of these 3 parameters were significantly larger than LC area AUC (0.701; p ≤ 0.001). Sensitivities at 80% specificity were: PLNT area = 92.3%, average BMO-MRW = 97.4%, and average pRNFL thickness = 94.9%. Conclusions: Comparing the diagnostic performance of different EDI OCT ONH parameters to discriminate between eyes with and without glaucoma, we found better results for neural tissue-based indexes (BMO-MRW and PLNT area) compared to laminar parameters. In this specific population, these neural tissue-based parameters (including PLNT area, which was investigated by the first time in the present study) had a diagnostic performance comparable to that of the conventional pRNFL thickness protocol.

SUBFOVEAL CHOROIDAL THICKNESS AND VASCULAR ARCHITECTURE IN FELLOW EYES OF PATIENTS WITH CIRCUMSCRIBED CHOROIDAL HEMANGIOMA.

To evaluate the subfoveal choroidal thickness (SFCT) and vascular architecture in the fellow eyes of patients with circumscribed choroidal hemangioma (CCH). In this retrospective observational study, patients were selected from outpatient ophthalmology clinics at the Memorial Sloan Kettering Cancer Center and Vitreous Retina Macula Consultants of New York. Subfoveal choroidal thickness was measured using enhanced depth imaging spectral domain optical coherence tomography from the outer portion of Bruch membrane to the choroidal-scleral interface. Choroidal vascular architecture was qualitatively examined. The main outcome measure was SFCT in fellow eyes of patients with CCH, which was compared with an age- and gender-matched control group. Thirty-one fellow eyes (15 right eyes and 16 left eyes) of patients with CCH (23 males and 8 females) were examined. The fellow eye had a mean SFCT of 361.2 ± 99.9 μm compared with 252.0 ± 77.6 μm in the control group (P < 0.0001). Vascular architecture was disorganized in 13 (42%) fellow eyes and 1 (3%) control eye (P < 0.0001), with no apparent gradient of vessel sizes or discrete choroidal layers. The normal association between older age and a thinner choroid existed in control eyes but not in fellow eyes. Hemangioma thickness measured by ultrasound and the presence of subfoveal fluid in the CCH eye did not correlate with the fellow-eye SFCT. In patients with CCH, fellow eyes had thicker SFCT when compared with age- and gender-matched control eyes. Choroidal architecture was often irregular, without segmented vascular layers. These findings suggest that inherent choroidal changes may exist in patients with CCH.