Thinner Choroidal Thickness Research Articles

Choroidal Thickness and Visual Acuity in High Myopia Without Myopic Maculopathy: Insights From a Chinese Population Study.

To evaluate the association of choroidal thickness (ChT) with best-corrected visual acuity (BCVA) in patients with high myopia (HM) and without myopic maculopathy. This study was a retrospective, cross-sectional study of participants aged 7 to 70years with bilateral HM but without myopic maculopathy. Swept-source optical coherence tomography was used to measure ChT at the fovea. A BCVA of logMAR 0.1 was regarded as the benchmark for normal. The association between ChT and BCVA was evaluated by linear regression models with confounders fully adjusted. Subgroup analyses were performed across sex and age groups. A total of 412 eligible participants were enrolled in this study. The mean age, spherical equivalence, and subfoveal (SF) ChT of the included participants were 21.17 ± 9.55years, -9.77 ± 2.40 diopters, and 171.56 ± 61.33µm, respectively. The SF ChT was thinner in participants with abnormal BCVA (normal. 176.74 ± 60.24 µm; abnormal, 139.30 ± 58.63µm). A thinner ChT in all subregions of the posterior pole of the Early Treatment Diabetic Retinopathy Study grid was associated significantly with a worse BCVA after adjusting for age, sex, and axial length (SF ChT: coefficient, × 10-4, -2.64; 95% confidence interval, -4.73 to -0.55; P < 0.05 in all subregions). The strongest correlation was observed in the outer inferior region, where a per 21µm thinning of ChT led to a 0.01 worsening of BCVA. This correlation presented a stronger magnitude in male aged more than 40years. In patients with HM without myopic maculopathy, a thinner ChT was associated independently with a worse BCVA. The findings of this study suggest that thinning ChT should be considered a vital risk factor for irreparable visual acuity impairment.

Factors affecting choroidal circulation parameters in 4–14-year-old Chinese children measured by SS-OCT/OCTA

PurposeTo measure the choroidal circulatory parameters Han Chinese children aged 4–14 years from Southwest China, and to explore the relationships between these parameters and age, axial length (AL), and choroidal thickness (ChT). Methods284 eyes from 142 subjects were included in this cross-sectional study. All participants underwent cycloplegic refraction and IOLMaster500 examination. Swept-source optical coherence tomography (SS-OCT) was used to measure submacular choroidal thickness, choroidal vascular volume (CVV), choroidal stromal volume (CSV), choroidal vascularity index (CVI), and CVV/CSV ratio. ResultsIn this population, the mean CVV was 2.92 ± 0.55 mm3, CSV was 4.69 ± 0.68 mm3, CVI was 38.22 ± 2.46 %, and CVV/CSV ratio was 62.11 ± 6.44 %. Multivariable regression analyses showed that both CVV and CSV were negatively correlated with AL (both P < 0.001) and positively correlated with ChT (both P < 0.001), while age showed no significant correlation with them (both P > 0.05). However, the correlations between CVI and age were not uniform rectilinear. Among participants aged ≤8 years, CVI showed no correlation with age (P > 0.05), while among those aged >8 years, it was positively correlated with age (P < 0.01). CVV/CSV ratio was positively correlated with ChT and age (both P < 0.01). ConclusionAfter the age of 8, age was positively correlated with CVI. ChT was well correlated with CVI. Longer AL and thinner ChT were associated with reduced CVV and CSV, with CVV decreasing more rapidly than CSV.

Assessment of OCT-Based Macular Curvature and Its Relationship with Macular Microvasculature in Children with Anisomyopia.

To evaluate the intraocular differences in optical coherence tomography (OCT)-based macular curvature index (MCI) among children with anisomyopia and to investigate the relationship between MCI and the macular microvasculature. Fifty-two schoolchildren with anisometropia > 2.00 D were enrolled and underwent comprehensive examinations including cycloplegic refraction, axial length (AL), and swept source OCT/OCT angiography. OCT-based MCIs were determined from horizontal and vertical B-scans by a customized curve fitting model in MATLAB R2022 at 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea. Characteristics and topographic variation of MCI was analyzed, and the relationships with microvascularity and its associated factors were investigated. MCI achieved high reliability and repeatability. There were overall larger MCIs in the more myopic eyes than the less myopic eyes in 1-mm-, 3-mm-, and 6-mm-diameter circles at fovea (all p < 0.001). For the topographic variation, horizontal MCI was significantly greater than vertical MCI (all p < 0.001), and was the largest in 6-mm circle, followed by 3-mm and 1-mm circles. Stronger correlation of horizontal MCI with myopic severity than vertical MCI was found. Partial Pearson's correlation found MCI was negatively associated with deep capillary plexus (DCP) vessel density (p = 0.016). Eyes with a higher MCI in a 6-mm circle were more likely to have longer AL (p < 0.001), lower DCP vessel density (p = 0.037), and thinner choroidal thickness (ChT) (p = 0.045). Larger MCI was found in the more myopic eyes of children with anisomyopia and was significantly associated with smaller DCP density, suggesting that MCI was an important indicator of myopia-related retinal microvascularity change, and it could be a valuable metric for myopia assessment in children.

Fluid Biomarkers in Optical Coherence Tomography for Visual Outcome in Polypoidal Choroidal Vasculopathy.

Purpose: To investigate the associations between fluid accumulation at different levels in the retina and visual outcome in polypoidal choroidal vasculopathy (PCV). Design: A retrospective observational study. Institutional setting. Study Population: A total of 91 eyes from 91 patients of PCV were included, with 65 receiving intravitreal aflibercept monotherapy and 26 receiving combined intravitreal ranibizumab and photodynamic therapy (PDT). Observation Procedures: Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) examination results were recorded at baseline and 3, 6, and 12 months after treatment. Main Outcome Measures: The correlations between visual outcomes and fluid biomarkers including intraretinal fluid (IRF), subretinal fluid (SRF), serous pigment epithelium detachment (PED), and hemorrhage at fovea were analyzed. Results: No differences in treatment outcomes were noted between patients receiving aflibercept and those receiving combined ranibizumab and PDT. IRF and hemorrhage at baseline predicted poorer vision at 3, 6, and 12 months. The presence of IRF was associated with poorer vision at 6 months and 12 months (p < 0.05 for all). The presence of SRF or PED was not associated with better vision at any time point. No differences in the correlations between fluid markers and visual outcomes were noted between thin and thick subfoveal choroidal thickness groups. Conclusions: For PCV, IRF and hemorrhage at baseline served as surrogates for poor visual prognosis after treatment, and IRF was a biomarker for poor vision during the treatment course. No fluid markers predicted good visual prognosis or had a positive impact on vision at any time point.

Differences in imaging biomarkers between patients with intermediate and advanced non-neovascular age-related macular degeneration (AMD) in the University of Colorado AMD registry.

To quantify and compare the different prevalence rates of specific retinal imaging biomarkers in patients with intermediate AMD (iAMD) and advanced non-neovascular AMD (nnAMD). Cross-sectional study of patients with iAMD and advanced nnAMD. Imaging studies were reviewed for qualitative imaging biomarkers. Choroidal thickness measurements were obtained subfoveally and in 1000 um and 2000 um intervals away from the fovea. The Chi-squared test and Fisher's exact test were used to compare rates of imaging biomarkers among the two cohorts. P-value of <0.05 was considered significant. 376 eyes of 197 patients with iAMD and 187 eyes of 97 patients with advanced nnAMD were recruited. There were significantly lower rates of the following imaging biomarkers in the iAMD compared with the advanced nnAMD cohorts: soft drusen (66.0% vs. 84.2%, p = 0.001), calcified drusen (4.3% vs. 40.0%, p < 0.0001), RPD (26.2% vs. 53.3%, p < 0.0001), ORT (0.5% vs. 46.9%, p < 0.0001), RP (1.1% vs. 46.3%, p < 0.0001), pigment migration (53.2% vs. 100%, p < 0.0001), and iRORA (17.9% vs. 80.2%, p < 0.0001). In the iAMD cohort, choroidal thickness was significantly greater at 188 µm (SD: 60) and 194 µm (SD: 69), compared to the advanced nnAMD with measurements of 153 µm (SD: 68), and 161 µm (SD: 76). This difference was statistically significant (p < 0.0001 and p = 0.0002). Our results highlight significant differences in imaging biomarkers between both cohorts. Key biomarkers, such as iRORA, RPD, pigment migration, and thinner choroidal thickness, were associated with advanced nnAMD. Identifying these biomarkers early may help target patients who could benefit from new treatments, potentially delaying vision loss.

Factors Associated with Success of Switching to Faricimab for Neovascular Age-Related Macular Degeneration Refractory to Intravitreal Aflibercept.

We investigated the factors associated with the success of switching to faricimab for type 1 macular neovascularization (MNV) refractory to intravitreal aflibercept (IVA). This retrospective cohort study included patients with type 1 MNV who were switched to faricimab because they were refractory to IVA at two centers. The primary endpoint was a more than two-week extension of the treatment interval after 6 months. In addition, factors related to the success or failure of extension and visual and anatomical outcomes were assessed. The analysis included 43 eyes from 43 patients. Extended dosing intervals of >2 weeks were identified in 14 eyes (32.6%). A short dosing interval before switching, absence of polypoidal lesions, and thin central choroidal thickness before switching were identified as factors involved in successful extension. For patients with refractory type 1 MNV, switching to faricimab is a safe and potential option to extend existing dosing intervals.

Association Between Choroidal Thickness and Myopic Maculopathy in a Japanese Population: The Hisayama Study

To examine the association between choroidal thickness and myopic maculopathy in a general Japanese population. Population-based cross-sectional study. A total of 2841 residents of a Japanese community aged ≥ 40 years, who consented to participate and had available data of choroidal thickness and fundus photographs, were enrolled in this study. The choroidal thickness was measured by swept-source OCT. Participants were divided into quartiles of choroidal thickness. Myopic maculopathy was defined according to the classification system of the Meta-analysis of Pathologic Myopia Study Group. Main outcome measures were odds ratios (ORs) of choroidal thickness for prevalent myopic maculopathy. The ORs and 95% confidence intervals (CIs) were estimated using a logistic regression model. Prevalent myopic maculopathy. Eighty-one participants had myopic maculopathy (45 diffuse chorioretinal atrophy, 31 patchy chorioretinal atrophy, and 5 macular atrophy). Individuals in the lowest quartile of choroidal thickness had a significantly greater OR for the presence of myopic maculopathy than those in the highest quartile of choroidal thickness (OR: 4.78 [95% CI: 1.78-16.72]) after adjusting for confounders, including axial length. The sensitivity analysis among the 1176 myopic individuals with axial length of ≥ 24.0 mm also showed that thinner choroidal thickness was significantly associated with prevalent myopic maculopathy. The present study demonstrated the significant inverse association between choroidal thickness and the likelihood of myopic maculopathy, suggesting that the measurement of choroidal thickness in addition to axial length would be useful for assessing the risk of myopic maculopathy and elucidating its pathogenesis. Proprietary or commercial disclosure may be found after the references.

Association between Aqueous Humor Cytokines and Structural Characteristics Based on Optical Coherence Tomography in Patients with Diabetic Macular Edema.

To investigate the relationship between aqueous humor cytokines and structural characteristics based on optical coherence tomography (OCT) in patients with diabetic macular edema (DME). Forty eyes of 28 patients with DME diagnosed in the Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou were included. All patients collected aqueous humor during anti-VEGF treatment, and the IL-6, IL-8, IL-10, VEGF, VCAM-1, ICAM-1, TGF-β1, FGF, and MCP-1 concentrations were detected. OCT examination was performed before anti-VEGF treatment and 1 month after anti-VEGF operation. Central macular thickness (CMT), macular volume (MV), choroidal thickness (CT), and the number of hyperreflective foci (HRF) were obtained for analysis. Each eye was determined whether there is subretinal effusion (SRD), cystoid macular edema (CME), and diffuse retinal thickening (DRT). The levels of IL-6 and FGF in DME patients with SRD were significantly higher than those without SRD (all P < 0.05). The level of VEGF in DME patients with CME was significantly higher than that in DME patients without CME (P = 0.005); IL-6, TGF-β1, and MCP-1 were significantly higher in DME patients with DRT than that without DRT (all P < 0.05). There was no significant correlation between aqueous humor cytokines and retinal thickness and retinal volume. However, the thinner the CT, the higher the level of aqueous humor cytokines IL-6 (r = -0.313, P = 0.049) and FGF (r = -0.361, P = 0.022). A multivariate linear regression analysis showed that IL-6 was significantly correlated with CT (P = 0.002) and SRD (P = 0.017), FGF was also significantly correlated with CT (P = 0.002) and SRD (P = 0.005), and TGF-β1 was correlated with triglycerides (P = 0.030) and HRF (P = 0.021). DME patients with significant macular cystoid edema changes may be related to high VEGF concentrations and thin CT; meanwhile, the presence of SRD or a high number of HRF on OCT macular scans in DME patients may indicate high levels of intraocular inflammatory factors. Thus, OCT morphology characteristics to some extent reflect intraocular inflammatory factors and VEGF levels and may guide treatment alternatives.

Clinical features associated with the atrophy of fellow eyes in patients with unilateral type 3 macular neovascularization.

We sought to investigate the clinical features of eyes with unilateral type 3 macular neovascularization (MNV) according to the degenerative features of fellow eyes. We retrospectively reviewed 55 patients with unilateral type 3 MNV and identified degenerative features including geographic atrophy (GA) in fellow eyes using multimodal imaging. Then, the clinical features of eyes with type 3 MNV at baseline and during follow-up with anti-vascular endothelial growth factor treatment and an as-needed regimen were compared according to the degenerative features of fellow eyes. Eighteen patients (32.7%) had GA in fellow eyes; initial disease manifestations of type 3 MNV eyes including stage, best-corrected visual acuity, and choroidal thickness (CT) did not vary between groups (all P > 0.05). During follow-up, a rate of complete fluid resolution after three monthly loading injections was not associated with GA in fellow eyes (P = 0.703), while a lower rate of early recurrence within 3months after loading treatment was associated with thinner CT in type 3 MNV eyes and GA over one disc area in fellow eyes (P = 0.025 and P = 0.021). Degenerative features of fellow eyes in patients with unilateral type 3 MNV may be associated with the clinical characteristics of affected eyes.

Choroidal Caverns in Stargardt Disease.

PurposeTo report choroidal caverns in patients affected by recessive Stargardt disease (STGD1) and to investigate its clinical features.MethodsRetrospective analysis of STGD1 patients recruited at the Regional Reference Center for Hereditary Retinal Degenerations at the Eye Clinic in Florence from 2012 to 2017. Patients included in the study underwent a complete ophthalmic examination including best-corrected visual acuity, color fundus photography, fundus autofluorescence, optical coherence tomography (OCT) and OCT angiography.ResultsEighty-six patients (172 eyes) were included in the study. Twenty-three eyes (13.3%) of 21 patients presented choroidal caverns. The total number of detected choroidal caverns was 63. Choroidal caverns were only present in patients with stage III and IV STGD. Interestingly, patients with choroidal caverns presented larger macular atrophy (20.53 ± 16.9 mm2 vs. 18.11 ± 20.39 mm2), worse visual acuity (1.03 ± 0.29 vs. 0.83 ± 0.26), and a thinner choroidal thickness (245.9 ± 88.7 vs. 266.0 ± 110.5 µm).ConclusionsChoroidal caverns are present only in the advanced stage of STGD1, and a possible degenerative origin of the finding has been hypothesized.

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 affection in patients with rheumatoid arthritis and its relation to disease activity

ObjectiveThe aim was to evaluate choroidal thickness (CT) in patients with rheumatoid arthritis (RA) and detect the relation between disease activity and joint damage in patients with RA.BackgroundRA is a systemic inflammatory disease associated with various extra-articular organ manifestations including ocular manifestations.Patients and methodsWe included 100 eyes of 50 patients with RA and 100 eyes of 50 controls without RA in the study. Subfoveal CT was measured using enhanced-depth imaging optic coherence tomography. Disease activity score 28 (DAS-28) and Larsen score were calculated for each patient with RA and compared with measurements of CT.ResultsSubfoveal CT was statistically thinner in patients with RA than controls. The mean subfoveal CT for the RA group was 291.12 ± 36.48, whereas that for controls was 305.35 ± 24.08, with a P value of 0.024. Additionally, upon evaluating whether the DAS-28 score correlated with CT, there was a statistically significant correlation between them (P < 0.001). When patients with RA were grouped as having either active RA or RA in remission, subfoveal CT values were statistically significantly lower in the active group. We found a statistically significant correlation between the Larsen score of the patients with RA and the CT measurements (P < 0.001). Patients with thinner CT have more joint damage and higher Larsen scores.ConclusionSubfoveal CT was significantly thinner in patients with RA than in healthy controls, with a statistically significant correlation of CT measurements with both DAS-28 and Larsen scores.

The relationship of ocular parameters with clinical parameters and disease-related quality of life in patients with systemic sclerosis: A cross-sectional study.

To evaluate choroidal thickness (CT), corneal parameters, and scleral thickness (ST) in patients with systemic sclerosis (SSc) and to determine their relationship with disease-related quality of life (QoL). The study included 38 patients with SSc and 40 healthy controls. A detailed ocular examination was performed on all participants. Corneal parameters such as K1, K2, Km, corneal volume (CV), central corneal thickness (CCT), and ST at a distance of 1000, 2000, and 3000μm from the scleral spur were measured. CT was measured at five points, including the subfoveal area and the temporal and nasal points at radii of 750.0 and 1500.0μm. The scleroderma health assessment questionnaire (SHAQ) was administered to SSc patients to investigate the disease-related QoL. Individuals with SSc had thicker ST at all distances from the scleral spur (P=0.008, P=0.001, P=0.002, respectively). All corneal parameters were significantly lower in the SSc group than in the control group (P<0.05). Moreover, SSc patients had significantly lower median CT at N750.0, N1500.0, T750.0, and T1500.0 points and thinner subfoveal CT than healthy controls (P<0.05). There was a weak-moderate negative correlation between ST and the components of the SHAQ scale and SHAQ-global. Despite not having ocular involvement, SSc patients had thicker ST but thinner CT and corneal parameters than healthy controls. This may indicate subclinical inflammation in patients with SSc. Only ST was affected by organ involvement and QoL among the ocular parameters.

Reduced photoreceptor outer segment layer thickness and association with vision in amblyopic children and adolescents with unilateral high myopia

Purpose To quantitatively compare reflectivity and other morphological changes of the photoreceptors of normal eyes with amblyopic eyes using the longitudinal reflectance profile (LRP) on swept-source optical coherence tomography (SS-OCT) images in children and adolescents with unilateral high myopia. The relationships between OCT parameters and visual acuity were investigated. Method Twenty-six amblyopes with unilateral high myopia and 34 age-, axial length- and spherical equivalent-matched normal controls were recruited. All participants underwent SS-OCT and detailed ophthalmic investigations. The reflectivity of the outer retinal and photoreceptor outer segment layer thickness were quantified by LRP using ImageJ software. All parameters were measured at three selected regions: at the fovea, 1 mm nasal to the fovea and 1 mm temporal to the fovea. Differences between the groups were evaluated. Results The mean choroidal thickness was thinner in amblyopic eyes compared with controls (165.19±59.02 μm vs 214.97±66.41 μm at the fovea; 128.77±57.06 μm vs 161.54±57.37 μm at 1 mm nasal to the fovea; 188.13±59.51 μm vs 219.87±61.78 μm at 1 mm temporal to the fovea, P<0.05). The amblyopic eyes had higher reflectivity of the ellipsoid zone at 1 mm nasal to the fovea only (85.41±25.78 vs 70.76±18.69, P=0.02). The mean length of the photoreceptor outer segment (OS) layer was significantly greater in the control eyes than in the amblyopic eyes at all three regions (20.19±1.89 vs 18.70±2.23 at the fovea, P=0.006; 16.06±1.47 vs 15.07±1.30 at 1 mm nasal to the fovea, P=0.008; 15.81±1.58 vs 14.56±1.87 at 1 mm temporal to the fovea, P=0.006). The shortened OS length was associated with poorer visual acuity. Conclusion The results of this study revealed that the amblyopes with unilateral high myopia had thinner choroidal thickness and shortened OS thickness compared to normal controls. The findings indicate that abnormal anatomic changes in the amblyopic children and adolescents with unilateral high myopia were not only due to high myopia but more likely due to a combination of high myopia and amblyopia.

The Effect of Obstructive Sleep Apnea Treatment and Severity on Choroidal Thickness in Patients With Central Serous Chorioretinopathy.

This work aimed to analyze the association of obstructive sleep apnea (OSA) with choroidal thickness (CT) in patients with central serous chorioretinopathy (CSC). We identified patients in the Stanford Research Repository with a diagnosis of CSC and OSA. Age- and sex-matched controls with either CSC or OSA only were also identified. CT was measured at 5 points (subfoveal, and 1500 and 3000 µm nasal and temporal) by 2 graders. In addition to OSA treatment and severity, we also investigated the association of Oxygen Desaturation Index and nocturnal oxygen saturation nadir with subfoveal CT (SFCT). A total of 57 patients and 72 eyes met the study inclusion criteria. The mean SFCT was significantly different across the 3 groups: OSA-only was the thinnest, followed by CSC with OSA, and CSC-only was the thickest (194.2 μm, 295.1 μm, and 357.8 μm, respectively, P < .001). SFCT was thicker in CSC with OSA compared with those with only OSA (P < .05). OSA treatment status and OSA severity did not show a significant difference in SFCT in multivariable modeling. Nocturnal oxygen saturation nadir was positively associated with SFCT, but this did not reach significance.. SFCT is significantly different in patients with OSA alone, CSC with OSA, and CSC alone. While OSA treatment status did not demonstrate a significant difference in SFCT in this study, future studies should evaluate patients for OSA in patients known to have CSC and atypically thin CT to further investigate the novel metrics leveraged in this study.

Choroidal thickness changes in children with chronic heart failure due to dilated cardiomyopathy

PurposeTo evaluate choroidal thickness (CTh) in children with chronic heart failure (CHF) secondary to dilated cardiomyopathy (DCM) using spectral domain optical coherence tomography (SD-OCT) and to compare their values to those of healthy children.MethodsSixty eyes of thirty children (mean age 9.9 ± 3.57 years) with chronic heart failure (left ventricular ejection fraction, LVEF ≤ 55%) due to DCM lasting for over 6 months were prospectively enrolled. The control group consisted of 30 age- (mean age 10.16 ± 3.42 years) and sex-matched healthy children. All participants underwent transthoracic echocardiography with LVEF measured using the Simpson method and had the blood serum level of N-terminal-pro-brain natriuretic peptide marker (NT-proBNP) determined. All children underwent SD-OCT and had subfoveal choroidal thickness (SFCTh) and CTh measured at 1500 µm (μm) nasally, temporally, superiorly and inferiorly from the fovea in both eyes by two investigators.ResultsCTh at all locations was statistically significantly lower in children with DCM compared to the control group. Mean CTh in the group with CHF compared to the control group were (304.03 vs. 369.72 μm, p < 0.05) at the subfoveal location, (245.87 vs. 284 μm, p < 0.05) 1500 μm nasally from the fovea, (291.5 vs. 355.95 μm, p < 0.05) 1500 μm temporally from the fovea, (303.98 vs. 357.58 μm, p < 0.05) 1500 μm superiorly from the fovea and (290.92 vs. 344.96 μm, p < 0.05) 1500 μm inferiorly from the fovea. The average difference CTh between the study groups ranged from 38.13 to 65.69 μm at individual locations. In both groups, CTh was the thickest at subfoveal location (304.03 vs. 369.72 μm, p < 0.05) and the thinnest was 1500 μm nasally from the fovea (262.37 vs. 336.87 μm, p < 0.05). There was no correlation between CTh and age, gender, biometry and refractive error. No correlation was found between CTh and LVEF and NT-proBNP.ConclusionPatients with CHF due to DCM had a thinner CTh at all measured locations. The results of our research indicate that CHF affects CTh and this parameter may be very helpful in monitoring the clinical course of the disease in children with DCM.

Decreased choroidal and scleral thicknesses in highly myopic eyes with posterior staphyloma

In this cross-sectional study, we investigated choroidal thickness (CT) and scleral thickness (ST) in highly myopic eyes and their associations with ocular factors. Patients underwent widefield swept-source optical coherence tomography (OCT) to measure the CT and ST at the subfovea and 3000 μm superior, inferior, temporal, and nasal to the fovea and macular curvature. A total of 237 eyes (154 patients) were included. At all five measurement points, thinner CTs and STs were associated with longer axial lengths (r = − 0.548 to − 0.357, all P < 0.001) and greater macular curvatures (r = − 0.542 to − 0.305, all P < 0.001). The CT and ST were significantly thinner in eyes with posterior staphyloma than in those without at all measurement points (all P ≤ 0.006) but did not differ between eyes with the wide macular and narrow macular type of staphyloma. Eyes with myopic maculopathy of category ≥ 3 according to the International Meta-Analysis for Pathologic Myopia classification had significantly thinner CTs and STs than those with category ≤ 2 (all P ≤ 0.005). In highly myopic eyes, a decrease in the CT and ST was more pronounced in eyes with more structural changes, such as longer axial length, steeper macular curvature, and the presence of posterior staphyloma.

Choroidal thickness profile and clinical outcomes in eyes with polypoidal choroidal vasculopathy.

To investigate the relationship between choroidal thickness (CT) profile and clinical outcomes after anti-vascular endothelial growth factor (VEGF) treatment in polypoidal choroidal vasculopathy (PCV). Medical records of patients diagnosed with PCV who received anti-VEGF treatment over 12months were reviewed. Subfoveal CT (SFCT) and peripapillary CT (PCT) were measured on swept-source optical coherence tomography images. Patients were divided into various groups based on choroidal profiles including SFCT, nasal PCT (nPCT) and ratio of SFCT to nPCT (SFCT/nPCT). Clinical outcomes were compared between the thin and thick CT groups. A total of 65 patients with PCV patients were included. After ant-VEGF treatment, SFCT was significantly decreased after anti-VEGF treatment (P = 0.001), but nasal PCT (nPCT) was not. Clinical outcomes were not different between the thin and thick SFCT groups. Total number of injections during the 12months was significantly fewer in the thin nPCT group (3.4 ± 1.3) than in the thick nPCT group (4.5 ± 1.8) (P = 0.020). Complete resolution after loading injections was more frequently observed in the high SFCT/nPCT ratio (> 1.9) group (87.9%) than in the low SFCT/nPCT ratio (≤ 1.90) group (59.4%) (P = 0.009). The ratio of SFCT/nPCT showed the best predictive ability for poor responders (area under curve = 0.771). These results suggest that baseline nPCT and SFCT/nPCT ratio could be a good biomarker that reflects clinical outcomes after anti-VEGF treatment in PCV.

Fovea-Sparing versus Standard Internal Limiting Membrane Peeling for Myopic Traction Maculopathy: A Study of 102 Consecutive Cases

To investigate the long-term outcomes of pars plana vitrectomy (PPV) with fovea-sparing internal limiting membrane (ILM) peeling (FSIP) and standard ILM peeling for myopic traction maculopathy (MTM). Retrospective case series. A total of 102 eyes of 96 consecutive patients who underwent primary PPV for MTM and were followed up for at least 12 months. We compared the outcomes of eyes that underwent vitrectomy with FSIP from October 2012 to March 2017 with those of eyes that underwent vitrectomy with standard ILM peeling from June 2008 to September2012. Best-corrected visual acuity (BCVA) at 12 months and the final follow-up visit after surgery, time to MTM resolution, and postoperative complications such as macular hole (MH) formation. There were 26 and 76 eyes in the FSIP and standard ILM peeling groups, respectively. In both groups, the mean visual acuity (VA) at the 12-month follow-up was significantly improved relative to the mean preoperative VA (P < 0.001 for both groups). The preoperative and postoperative BCVA (logarithm of the minimum angle of resolution) showed no significant between-group differences (preoperative: 0.60±0.35 in the FSIP group and 0.61±0.39 in the standard ILM peeling group, P= 0.935; postoperative BCVA: 0.32 ± 0.43 in the FSIP group and 0.37 ± 0.38 in the standard ILM peeling group, P= 0.281). The mean time to the resolution of foveal retinal detachment and schisis was also comparable between groups (8.9 ± 4.8 months in the FSIP group and 6.9 ± 4.6 months in the standard ILM peeling group, P= 0.084). None of the eyes in the FSIP group and 6 eyes (8%) in the standard ILM peeling group developed postoperative MH. Consequently, the BCVA at 12 months deteriorated by 3 or more lines for 4 eyes (5%) in the standard ILM peeling group; this deterioration was not observed for any eye in the FSIP group. Risk factors for postoperative MH formation were worse preoperative visual acuity (P = 0.035) and thinner choroidal thickness (P = 0.025). The visual and anatomic improvements after vitrectomy with FSIP may be comparable to those after vitrectomy with standard ILM peeling, with FSIP showing the ability to prevent postoperative MH formation and a consequent impairment in vision.

Evaluation of choroidal changes in adolescent idiopathic scoliosis using enhanced depth imaging optical coherence tomography

BackgroundWe aimed to evaluate the choroidal thickness (CT) in patients with adolescent idiopathic scoliosis (AIS) using enhanced depth imaging optical coherence tomography (EDI‐OCT).MethodsIn this cross‐sectional, observational comparative study, 56 eyes of 56 patients with AIS and 56 eyes of 56 age‐ and sex‐matched healthy subjects were included. All participants underwent complete ophthalmologic examination and CT measurements at the fovea and at 750 μm intervals from the fovea to 1,500 μm in the nasal and temporal site obtained by spectral domain EDI‐OCT.ResultsThe mean subfoveal CT was lower in the AIS patients (285.2 ± 24.4 μm) than that of the controls (313.2 ± 28.8 μm; p < 0.001). The difference was also significant at all extrafoveal measurement points (p < 0.001 for all). There were negative correlations of CTs at subfoveal and extrafoveal locations with the Cobb's angle in the AIS patients (for subfoveal location: r = −0.71 and p < 0.001; and for extrafoveal locations: r = −0.66 and p < 0.001 at 750 μm in the nasal side; r = −0.64 and p < 0.001 at 1,500 μm in the nasal side; r = −0.71 and p < 0.001 at 750 μm in the temporal side; and r = −0.69 and p < 0.001 at 1,500 μm in the temporal side).ConclusionThis preliminary study showed that AIS patients have thinner CT compared to that of healthy subjects. The lower CT was correlated with the increased angle of scoliosis.