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Background: Optical coherence tomography (OCT) enables high-resolution imaging of ocular structures in health and disease. Choroid thickness (CT) is a key vascular retinal parameter that can be assessed by OCT and might be relevant in the evaluation of the vascular component of cognitive decline. We aimed to investigate CT changes in a large cohort of individuals cognitive unimpaired (CU), with mild cognitive impairment due to Alzheimer's (MCI-AD), mild cognitive impairment due to cerebrovascular disease (MCI-Va), Alzheimer's disease dementia (ADD), and vascular dementia (VaD). Methods: Clinical, demographical, ophthalmological and OCT data from the Neuro-ophthalmological Research at Fundació ACE (NORFACE) project were analyzed. CT was assessed in the macula across nine Early Treatment Diabetic Retinopathy Study (ETDRS) quadrants, average thickness, total volume, and subfoveal choroidal thickness. Differences of CT among the five diagnostic groups were assessed in a multivariate regression model, adjusting for demographic and cardiovascular risk factors and OCT image quality. A comparison between manual and automatic CT measurements in a subset of participants was also performed. Results: The study cohort comprised 1,280 participants: 301 CU, 196 MCI-AD, 112 MCI-Va, 578 ADD, and 93 VaD. CT was significantly increased in individuals with cognitive impairment compared to those CU, particularly in the VaD and MCI-Va groups and in the peripheral ETDRS regions. No significant differences were found in inner superior, center and subfoveal choroidal thickness. The interaction of sex and diagnosis had no effect in differentiating CT. Mini-Mental State Examination (MMSE) scores were not correlated to CT. Manual and automated CT measurements showed good reliability. Discussion: Our findings indicated that peripheral choroidal thickening, especially in patients with cerebrovascular disease, may serve as a potential choroidal biomarker for cognitive decline and suggest different pathogenic pathways in AD and VaD. Further research is required to explore CT as a reliable ocular biomarker for cognitive impairment. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aimed to determine whether there is a significant change in eyeball curvature in eyes with retinitis pigmentosa (RP). Methods: The medical records of 35 eyes of 18 patients with RP and age- and axial-length-matched controls were reviewed. The curvature of the posterior pole was determined by approximating a second-order polynomial equation based on the optical coherence tomography (OCT) images. Associations among eyeball curvature, refractive error, and axial length were investigated. Results: The average age of patients with RP was 65.1 ± 13.8 years, and the average axial length of the eye was 23.90 mm. The curvature of the posterior eyeball was steeper in eyes with RP (p = 0.020), and the choroid was thinner in eyes with RP (p < 0.01). The curvature of eyes with RP significantly correlated with refractive error (p = 0.006, r = −0.46) and axial length (p = 0.004, r = −0.48). Conclusions: The significant correlation between eyeball curvature and axial length suggests that myopia affects eyeball shape even in eyes with RP. However, the curvature remained steep in the eyes with RP after matching for age and axial length. A thinner choroid was observed in eyes with RP and may play a role in the steeper posterior eyeball. [ABSTRACT FROM AUTHOR]

Background: To investigate corneal higher-order aberrations (HOAs) and choroidal characteristics in myopic individuals and explore the association between HOAs and choroidal parameters. Methods: Myopic participants were categorized into three groups based on axial lengths (ALs). We compared corneal HOAs, including spherical (Z40), comatic (Z3− 1 and Z31), and trefoil (Z3− 3 and Z33) aberrations, as well as choroidal vascularity index (CVI) and choroidal thickness (CT). Linear regression analysis was used to assess the relationships among corneal HOAs, CVI, CT, spherical equivalent, and AL. Results: Groups 1, 2, and 3 included 105, 98, and 118 eyes, respectively. Group 3 exhibited lower spherical HOA root mean square and Z40 values than group 1(p < 0.05). Group 1 showed lower Z31 levels than other groups (p < 0.001). Groups 1 and 2 had higher mean, central, and I2 vertical CVIs than group 3 (p < 0.05). Group 1 had a larger vertical S1 CVI than group 3 (p < 0.05). Group 3 had smaller horizontal CVI values in all regions except N2 (p < 0.05). Both the mean and CT in all regions decreased as AL increased (p < 0.001). The comatic (Z31) and trefoil (Z33) components were predictors of mean horizontal CVI, and the comatic (Z31) component was correlated with both mean vertical and horizontal CT. Conclusion: Longer AL myopic patients exhibited lower absolute values of spherical aberration and horizontal coma. Alterations in choroid in myopic patients correlated with corneal HOAs. Our results suggest a potential connection between the optical quality and ocular perfusion in myopia. [ABSTRACT FROM AUTHOR]

Introduction: To establish a high myopia model in C57BL/6J mice with monocular form deprivation myopia (FDM) and investigate its ocular structure pathological trajectory. Methods: Healthy 3-week-old C57BL/6J mice were divided into an FDM group (n = 36) and a control group (n = 24). The left eyes of the FDM group were patched, while the right eyes served as controls. Biometric parameters and fundus morphology were assessed at baseline and after 4, 8, and 12 weeks of form deprivation. Results: Significant differences were observed in the deprived eyes, including longer axial length, higher refractive power, deeper vitreous chambers, thinner retina, choroid, and sclera, and smaller scleral fibers' diameters under a transmission electron microscope. Retinal vascular area proportion in covered eyes decreased significantly (P < 0.05), with a decline rate of 11% from weeks 4 to 8 and a faster decline of 19% from weeks 8 to 12, while this proportion increased significantly in control eyes. Discussion: This study successfully induced a high myopia model in mice with long-term form deprivation. The axial length grew dramatically in FDM in the first 8 weeks, while the pathological progress of the fundus accelerated from weeks 8 to 12. [ABSTRACT FROM AUTHOR]

Purpose: Keratoconus (KCN) is characterized by corneal thinning and bulging, leading to vision impairment. Assessing choroidal thickness (CT) in pediatric KCN (pKCN) patients can provide insights for better understanding and managing the disease. CT may serve as a potential indicator of disease activity in KCN patients. This study aims to evaluate CT and retinal thickness (RT) in different stages of pKCN patients and compare the findings with an age-matched control group. Methods and patients: This cross-sectional study included patients under 18 years old who met specific criteria. CT and RT was measured in all subjects using an optical coherence tomography device (Spectralis OCT, version 6.0, Heidelberg Engineering, Germany) with enhanced depth imaging mode, without pupil dilation. Mean CT and RT in pKCN was compared with healthy subjects and assessed among different disease grades using the ABCD grading method. Results: The study included 125 eyes (66 patients) in the pKCN group and 42 control eyes (21 individuals). Grade 2 KCN showed the highest prevalence at 26.4% (N = 33), while grades 3 and 1 had prevalence rates of 24% (N = 30). CT in all specified areas (all P-values < 0.001), as well as RT in the subfoveal area (P-value < 0.001) and 1500 μm nasal to the fovea (P-value = 0.025), were significantly greater in the pKCN group compared to controls. Furthermore, CT and RT differed significantly among the pKCN grades (P-values < 0.001). Conclusion: CT was found to be elevated in pKCN patients, similar to adult KCN cases. CT could potentially serve as a clinical marker for disease activity in pKCN; however, further studies are needed. [ABSTRACT FROM AUTHOR]

The protective effects of time spent outdoors emphasize the major role of daylight in myopia. Based on the pathophysiology of myopia, the impact of blue light stimulation on the signaling cascade, from melanopsin at the blind spot to clinically relevant biomarkers for myopia, was investigated. Parameters and site of light stimulation are mainly defined by the photopigment melanopsin, that is sensitive to blue light with a peak wavelength of 480 nm and localized on the intrinsically photosensitive retinal ganglion cells (ipRGC) whose axons converge to the optic disc, corresponding to the physiological blind spot. Blue light at the blind spot (BluSpot) stimulation provides the opportunity to activate the vast majority of ipRGC and avoids additional involvement of rods and cones which may exert incalculable effects on the signaling cascade. Experimental studies have applied anatomical, histochemical, electrophysiological, imaging, and psychophysical methods to unravel the mode of action of BluSpot stimulation. Results indicate activation of melanopsin, improvement of contrast sensitivity, gain in electrical retinal activity, and increase of choroidal thickness following BluSpot stimulation. Short-term changes of clinically relevant biomarkers lead to the hypothesis that BluSpot stimulation may exert antimyopic effects with long-term application. [ABSTRACT FROM AUTHOR]

Background: Atropine is an effective medicine for myopia prevention and control. This meta-analysis was conducted to investigate the effects of atropine on choroidal thickness (ChT) in children with myopia. Methods: Between its inception and 1 June 2023, Medline, Embase, and Web of Science were all searched, and only English literature was included. The choroidal thickness was the primary study outcome. Axial length, standardized equivalent refraction were examined as secondary outcomes. STATA 12.0 was used for data extraction and analysis. Results: A total of 307 eyes were involved in this study to evaluate the effect of atropine on ChT, axial length (AL) and standardized equivalent refraction (SER) in myopic children. Choroidal thickening was significantly higher in the atropine group than in the control group at 1 month (WMD, 6.87 mm, 95% CI, 0.04 to 13.10, P = 0.049), whereas it was significantly higher in the atropine group than in the control group at months 6 (WMD, 10.37 mm, 95% CI, −3.21 to 23.95, P = 0.135), 12 (WMD, 15.10 mm, 95% CI, −5.08 to 35.27, P = 0.143) and at final follow-up (WMD, 11.52 mm, 95% CI, −3.26 to 26.31, P = 0.127), the differences were not statistically significant. At months 1 (WMD, −0.03 mm, 95% CI, −0.04 to −0.01, P = 0.003), 6 (WMD, −0.07 mm, 95% CI, −0.01 to −0.03, P = 0.000), 12 (WMD, −0.13mm, 95% CI, −0.15 to −0.11, P = 0.843), and at final follow-up (WMD, −0.08 mm, 95% CI, −0.16 to −0.01, P = 0.127), atropine treatment was able to delay the axial elongation. At 1-month follow-up, there was no significant difference in the effect of atropine on SER in myopic children compared with the control group (WMD, 0.01D, 95% CI, −0.07 to 26.31, P = 0.127), whereas it was able to control the progression of refractive status at final follow-up (WMD, 11.52 mm, 95% CI, −3.26 to 26.31, P = 0.127). Conclusion: Limited evidence suggests that 0.01% atropine causes choroidal thickening in myopic children at 1 month of treatment. In the short term, choroidal thickness may be a predictor of the effectiveness of atropine in controlling myopia in children. 0.01% atropine is effective in controlling myopic progression in terms of SER and AL. Systematic Review Registration: http://www.crd.york.ac.uk/prospero, identifier, CRD42022381195. [ABSTRACT FROM AUTHOR]

Purpose: Given the potential role of light and its wavelength on ocular growth, this study investigated the effect of short‐term exposure to red, cyan and blue light on ocular biometry in humans. Methods: Forty‐four young adults and 20 children, comprising emmetropes and myopes, underwent 2‐h sessions of cyan (507 nm), red (638 nm) and broadband white light on three separate days via light‐emitting glasses. Additionally, young adults were exposed to blue light (454 nm) on an additional day. Axial length (AL) and choroidal thickness (CT) were measured in the right eye before the light exposure (0 min), after 60 and 120 min of exposure and 30 min after light offset using an optical biometer and optical coherence tomographer, respectively. Results: Compared to broadband light, exposure to red light resulted in a significant increase in AL (mean difference between white and red light at 120 min, +0.007 mm [0.002]), but no significant change in CT, while cyan light caused a significant AL reduction (−0.010 mm [0.003]) and choroidal thickening (+0.008 mm [0.002]) in young adults (p < 0.05). Blue light caused a significant decrease of −0.007 mm (0.002) in young adult eyes at 60 min (p < 0.05). In children, cyan light led to a significant reduction in AL (−0.016 mm [0.004]) and strong sustained choroidal thickening (+0.014 mm [0.004]) compared to broadband light at 120 min (p < 0.05). The effects of cyan light on AL and CT were found to be stronger in myopic young adults and emmetropic children. The opposing effects of red and cyan light on ocular biometry were similar between the two age groups (p > 0.05). Conclusions: Exposure to cyan light resulted in AL reduction and choroidal thickening in both young adults and children. Further research is needed to determine the application of these results in developing interventions for myopia control. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion To test the prognostic role of anterior scleral substantia propria (ASSP) thickness in predicting the 3‐month response after half‐dose photodynamic therapy (PDT) in central serous chorioretinopathy (CSCR) and to assess its clinical relevance of ASSP in different CSCR phenotypes.A prospective, exploratory, multi‐centre cohort study conducted at IRCCS San Martino Hospital (Genoa, Italy) and Jules‐Gonin Eye Hospital (Lausanne, Switzerland). Demographic and clinical data, and optical coherence tomography (OCT) were collected at baseline and 3 months after PDT. Based on OCT images, we categorized CSCR phenotypes and collected clinically relevant imaging metrics. ASSP thickness was obtained from four different measurements using anterior segment (AS) OCT. Multivariable regression models were performed to evaluate the distribution of ASSP thicknesses among different CSCR phenotypes and to test the prognostic role of ASSP thickness in discriminating between PDT responders (complete subretinal fluid reabsorption) and partial responders.The study cohort comprised 109 Caucasian patients (82 males, 75.2%) with a total of 142 eyes: 84 eyes simple (59.1%) versus 58 eyes complex (40.9%) CSCR. A linear normal model confirmed a positive association between complex CSCR and higher ASSP thickness (β = 26.1, 95% CL = 12.1/40.1, p < 0.001), with a low prevalence of ciliochoroidal effusion loculations in AS‐OCT (1/142 eyes, 0.7%). ASSP thickening was positively linked to the presence of posterior cystoid retinal degeneration (PCRD; p = 0.002), indicating a potential role in the pathogenesis of severe CSCR phenotypes. In the subgroup of treated patients (61 eyes), 63.9% had a complete response after PDT. In these patients a logistic binary model highlighted a significantly higher risk of PDT non‐responsiveness (OR = 9.62, 95% CL = 2.44/37.9, p = 0.001) associated with a 60‐unit increase in ASSP thickness levels. By contrast, other anatomical parameters (i.e., body surface area, age, gender, axial length) showed no remarkable prognostic roles.This research highlighted the association of ASSP thickening with complex CSCR phenotype in Caucasian patients and its role in predicting PDT efficacy. These findings enhance our comprehension of the anatomical risk factors in patients affected with CSCR and potentially guide a better understanding of non‐responsive cases to PDT treatment. [ABSTRACT FROM AUTHOR]

Background/Objectives: To evaluate the roles of choroidal blood flow (CBF) and choroidal thickness (CT) as predictors of macular edema recurrence in patients with treatment-naive non-ischemic branch retinal vein occlusion (BRVO) after intravitreal ranibizumab (IVR) injection. Methods: Sixteen eyes from sixteen patients with treatment-naive non-ischemic BRVO treated with IVR, once initially and then as needed, were included in the study. CBF and CT in the subfovea, occlusive, and non-occlusive regions were measured via laser speckle flowgraphy and enhanced depth imaging optical coherence tomography over 12 months. Results: Baseline CT was significantly greater in the occlusive region (335 ± 72.1 µm) than in the non-occlusive region (274 ± 36.7 µm, p = 0.028). CT in the occlusive region was reduced significantly after 1 week (p = 0.008), but CBF did not change significantly after IVR throughout the follow-up period (p > 0.05). The occlusive/non-occlusive region CBF ratio at baseline was significantly associated with the number of IVR injections over 12 months (mean 2.63) in patients with BRVO (p = 0.048). Conclusions: Baseline CBF imbalance in eyes with treatment-naive BRVO may indicate the recurrence of macular edema after ranibizumab therapy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the relationship between choroidal thickness (CT) and anterior scleral thickness (AST) in patients with subclinical keratoconus (SKC) and established keratoconus (KC). Methods: This single-center prospective case-control study included 97 eyes of 97 patients: 44 KC eyes, 14 SKC eyes, and 39 age- and axial length (AL)-matched healthy eyes. Using swept-source optical coherence tomography, the AST was manually measured in four directions and the CT was obtained automatically from the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Principal component analysis (PCA) was used to linearly reduce the dimensionality of nine CT inputs to one significant component, CT1. A multivariate model was created to evaluate the association between CT1, AST, and several ocular parameters in SKC and KC patients. Partial correlation was then performed to adjust the confounding factors and to examine the effect of AST on CT1. Results: The PCA showed that CT1 accounts for 86.54% of the total variance in the nine original CTs of the ETDRS grid. The CT1 model was associated with age, AL, and AST in the superior meridian in SKC eyes, whereas in KC eyes, it was correlated with gender, age, AL, and AST in the inferior meridian (p < 0.001). The partial correlation between CT1 and AST in the superior zone was found to be significant, positive, and strong in SKC eyes (r = 0.79, p = 0.019), whereas a significant, positive, and moderate correlation between CT1 and AST at the inferior zone (r = 0.41, p = 0.017) was observed in KC eyes. Conclusions: Choroidal tissue was significantly correlated with the anterior sclera across the vertical meridian. This relationship was observed over the superior sclera in SKC eyes, whereas in established KC, it was over the inferior sclera. These results reveal new insights regarding the interactions between the anterior and posterior structures of the KC eyes and confirm the enigma of the pathophysiology of KC. [ABSTRACT FROM AUTHOR]

To identify genetic influences on subfoveal choroidal thickness of older adults using a genome-wide association study (GWAS). We recruited 300 participants from the population-based Korean Longitudinal Study on Health and Aging (KLoSHA) and Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) cohort studies and 500 participants from the Bundang age-related macular degeneration (AMD) cohort study dataset. We conducted a GWAS on older adult populations in the KLoSHA and KLOSCAD cohorts. Single nucleotide polymorphisms (SNPs) associated with choroidal thickness were identified with P values < 1.0 × 10−4 in both the right and left eyes, followed by validation using the Bundang AMD cohort dataset. This association was further confirmed by a functional in vitro study using human umbilical vein endothelial cells (HUVECs). The ages of the cohort participants in the discovery and validation datasets were 73.5 ± 3.3 and 71.3 ± 7.9 years, respectively. In the discovery dataset, three SNPs (rs1916762, rs7587019, and rs13320098) were significantly associated with choroidal thickness in both eyes. This association was confirmed for rs1916762 (genotypes GG, GA, and AA) and rs7587019 (genotypes GG, GA, and AA), but not for rs13320098. The mean choroidal thickness decreased by 56.7 μm (AA, 73.8%) and 31.1 μm (GA, 85.6%) compared with that of the GG genotype of rs1916762, and by 55.4 μm (AA, 74.2%) and 28.2 μm (GA, 86.7%) compared with that of the GG genotype of rs7587019. The SNPs rs1916762 and rs7587019 were located close to the FAM124B gene near its cis-regulatory region. Moreover, FAM124B was highly expressed in vascular endothelial cells. In vitro HUVEC experiments showed that the inhibition of FAM124B was associated with decreased vascular endothelial proliferation, suggesting a potential mechanism of choroidal thinning. FAM124B was identified as a susceptibility gene affecting subfoveal choroidal thickness in older adults. This gene may be involved in mechanisms underlying retinal diseases associated with altered choroidal thickness, such as age-related macular degeneration. [ABSTRACT FROM AUTHOR]

Background: We aimed to compare choroidal thickness (ChT) and retinal nerve fiber layer (RNFL) thickness in the affected and contralateral eyes of patients with Posner-Schlossman Syndrome (PSS) during acute, remission, and intermittent phases. Methods: This prospective observational study included 18 patients(36 eyes) diagnosed with PSS. These patients underwent a comprehensive ophthalmologic evaluation including slit lamp examination, visual acuity testing, intraocular pressure (IOP) measurement, and funduscopic examination, and assessment of RNFL thickness, macular thickness, and macular ChT. Patient data collected included gender, age, number of keratic precipitates (KPs), and number of episodes. Optical coherence tomography (OCT) was used to measure RNFL thickness, macular thickness, and macular ChT in both eyes during the acute, remission, and intermittent phases. The affected eye was compared with the unaffected eye at each phase. Results: In affected eyes, macular ChT was lower in the acute phase compared to the remission phase at N1500, N1000, N500, and subfoveal locations (allp < 0.05).The central macular recess ChT was also significantly thinner in the acute phase compared to the intermittent and remission phases. Age significantly correlated with ChT in the central recess (p =.024). Macular thickness was thinner during the acute phase in the affected eye (p =.048). The RNFL in the affected eye was thinner in the intermittent phase than in the acute phase at the inferior-temporal (p =.011) and global sectors (p =.044). During the acute phase, RNFL in the affected eye was thinner at the superior-nasal (p =.049), inferior-temporal (p =.003), and global (p =.041) sectors compared to the unaffected eye. In the intermittent phase, the affected eye's RNFL was thinner at the superior-nasal, inferior-temporal, inferior-nasal, and global sectors compared to the unaffected eye (allp < 0.05), while no difference was observed in both eyes at the nasal, superior-temporal, and temporal sectors. The number of episodes and age were significantly associated with RNFL thickness (p <.05). Conclusion: This study demonstrated that in eyes affected by PSS, RNFL, macular ChT, and macular thickness thinned during the acute phase. The number of episodes and age are significant factors in the development of PSS. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusions To evaluate ocular refractive development, choroidal thickness (ChT) and changes in choroidal blood flow in form‐deprived myopia (FDM) Guinea pigs treated with repeated low‐level red‐light (RLRL) therapy.Twenty‐eight 3‐week‐old male tricolour Guinea pigs were randomised into three groups: normal controls (NC, n = 10), form‐deprived (FD, n = 10) and red light treated with form‐deprivation (RLFD, n = 8). Interocular refraction and axial length (AL) changes were monitored. Optical coherence tomography angiography (OCTA) measured choroidal thickness, vessel area density, vessel skeleton density and blood flow signal intensity (flux) in the choriocapillaris and medium–large vessel layers. The experimental intervention lasted 3 weeks.At week 3, the FD group had higher myopia and longer axial length than the NC group (all p < 0.001). The RLFD group had higher hyperopia and shorter axial length than the FD group (all p < 0.001). At week 1, the NC group had a thicker choroidal thickness than the FD group (p < 0.05). At weeks 2 and 3, the RLFD group had a thicker choroidal thickness than the FD group (p = 0.002, p < 0.001, respectively). Additionally, the NC group had higher vessel area density, vessel skeleton density and flux in the choriocapillaris layer than the FD group at the three follow‐up time points (all p < 0.05). At week 3, the vessel skeleton density and flux were higher in the RLFD group than in the FD group (all p < 0.05). Correlation analysis results showed that weekly changes in refraction and choroidal thickness were negatively correlated with changes in axial length (all p < 0.05). Choroidal thickness changes were positively correlated with alterations in the vessel area density, vessel skeleton density and flux in the choriocapillaris layer, as well as vessel skeleton density and flux changes in the medium–large vessel layers (all p < 0.05).Repeated low‐level red‐light (RLRL) therapy retards FDM progression in Guinea pigs, potentially through increased choroidal blood flow in the choriocapillaris layer. [ABSTRACT FROM AUTHOR]

Caffeine, commonly found in coffee and tea, affects various aspects of eye health as it blocks adenosine receptors, impacting tear production, intraocular pressure, macular perfusion, and choroidal thickness. However, its connection with eye conditions like glaucoma and cataracts remains uncertain due to conflicting research findings. Some studies suggest potential benefits for cataracts, while others warn against frequent caffeine intake in glaucoma and surgical scenarios due to possible increases in intraocular pressure. Conflicting evidence also exists regarding its effects on dry eye, macular degeneration, myopia/hyperopia, diabetic retinopathy, retinopathy of prematurity, and central serous retinopathy. Caffeine does not seem to be a risk factor for dry eye, although studies have shown that caffeine may offer protection against wet age-related macular degeneration, and the metabolite 7-methylxanthine could be a more promising treatment for myopia. Moreover, caffeine can potentially cause tremors and might hinder surgical performance, especially in less experienced surgeons. Recommendations from experts vary, highlighting the need for further research to fully understand how caffeine affects the eye. Individuals genetically predisposed to glaucoma should be cautious due to the possibility of clinically significant elevations in intraocular pressure with caffeine consumption. For delicate procedures like microsurgery, where tremors can be detrimental, caution should be exercised with caffeine. This review underscores the importance of additional studies to provide clearer insights and prudent recommendations regarding caffeine's impact on eye health. [ABSTRACT FROM AUTHOR]

Purpose: To assess the choroidal status of Systemic Lupus Erythematosus (SLE) patients using Optical Coherence Tomography (OCT) and OCT-Angiography. Methods: SLE patients with disease duration < 10 years, no disease activity and no ocular involvement were recruited and cross-sectionally evaluated. A demographically similar cohort of healthy subjects was used for comparison. The main outcome is choroidal vascularity index (CVI). As secondary outcomes, choriocapillaris parameters and choroidal thickness (CT) were evaluated. Results: Forty eyes of 40 subjects (20 SLE patients and 20 healthy subjects) were studied with a mean ± SD age of 36.7 ± 9.9 years. In the SLE group, the mean ± SD duration of disease was 7.35 ± 2.21 years. Increased CVI was found in the SLE group (p = 0.022). Considering the choriocapillaris, SLE patients presented a lower number (p = 0.037) and a smaller total area (p = 0.041) of signal voids. No differences between groups were found in CT. For SLE patients, CT at subfoveal, temporal and inferior locations presented a negative moderate correlation with disease duration. A strong correlation between choriocapillaris parameters and age was demonstrated for both groups. Conclusions: This study provides evidence of subclinical choroidal changes in adult SLE patients with inactive disease and no overt ocular manifestation. Increased CVI and fewer and smaller flow voids in choriocapillaris with normal CT suggest increased choroidal vascularity in SLE. [ABSTRACT FROM AUTHOR]

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

Introduction: The aim of this study was to explore the relationship between choroidal biomarkers and the response to anti-VEGF in PCV eyes. Methods: We conducted a hospital-based retrospective study. We included 54 patients diagnosed with PCV who had received standard 3 monthly anti-VEGF monotherapy and had finished regular follow-ups. Choroidal thickness (CT), three-dimensional choroidal vascularity index (CVI), and the vascular density of choriocapillaris (CCVD) were measured utilizing swept-source optical coherence tomography angiography (SS-OCTA). Effective and poor responders were classified based on the changes in morphologic features. Multivariate linear regression models were performed for the outcomes to determine independent prognostic factors. Receiver operating characteristic (ROC) curves were used to compare the predictive ability of CT and CVI as biomarkers between effective and poor responders. Results: A higher CVI at baseline was the only factor that correlated with the poor response after 3 monthly injections of anti-VEGF (p = 0.038). The greater change of central macular thickness (CMT) was significantly correlated with increased CMT (p = 0.030), decreased CT (p = 0.042), and decreased CVI (p = 0.038) at baseline. Using ROC curves, we found that the CVI value demonstrated superior predictive ability compared to the CT value, with AUC of 0.842 and the best cut-off value of 0.445. Conclusion: A higher three-dimensional CVI using SS-OCTA is a promising biomarker to predict the poor anatomical response to anti-VEGF treatment in PCV patients. [ABSTRACT FROM AUTHOR]

Purpose: To describe the epidemiological and clinical features and course of patients with posterior scleritis (PS). Methods: This retrospective, cross-sectional consecutive case series analyzed the medical records of 16 patients diagnosed with PS. Results: Female gender and unilateral involvement were dominant. Blurred vision (84.21%) and ocular pain (78.95%) were the most common presenting complaints. Serous retinal detachment was the most common ocular finding (84.21%), followed by optic disc swelling (42.11%). Increased scleral thickness was observed in all patients, although a T-sign was detected 8 of 19 eyes (42.1%). Recurrence occured in 5 of 19 eyes in mean 30.2 ± 34.7 months. Central macular thickness, choroidal thickness, and retinal nerve fiber layer thickness were reduced with treatment at final examination significantly (p =.005,.002, and.002, respectively). Conclusions: PS should be considered in patients presenting with unilateral ocular pain and decreased vision. Not only USG findings but also OCT findings are very useful in the follow-up of treatment response. [ABSTRACT FROM AUTHOR]

Abstract Background Optical coherence tomography (OCT) enables high-resolution imaging of ocular structures in health and disease. Choroid thickness (CT) is a key vascular retinal parameter that can be assessed by OCT and might be relevant in the evaluation of the vascular component of cognitive decline. We aimed to investigate CT changes in a large cohort of individuals cognitive unimpaired (CU), with mild cognitive impairment due to Alzheimer's (MCI-AD), mild cognitive impairment due to cerebrovascular disease (MCI-Va), Alzheimer’s disease dementia (ADD), and vascular dementia (VaD). Methods Clinical, demographical, ophthalmological and OCT data from the Neuro-ophthalmological Research at Fundació ACE (NORFACE) project were analyzed. CT was assessed in the macula across nine Early Treatment Diabetic Retinopathy Study (ETDRS) quadrants, average thickness, total volume, and subfoveal choroidal thickness. Differences of CT among the five diagnostic groups were assessed in a multivariate regression model, adjusting for demographic and cardiovascular risk factors and OCT image quality. A comparison between manual and automatic CT measurements in a subset of participants was also performed. Results The study cohort comprised 1,280 participants: 301 CU, 196 MCI-AD, 112 MCI-Va, 578 ADD, and 93 VaD. CT was significantly increased in individuals with cognitive impairment compared to those CU, particularly in the VaD and MCI-Va groups and in the peripheral ETDRS regions. No significant differences were found in inner superior, center and subfoveal choroidal thickness. The interaction of sex and diagnosis had no effect in differentiating CT. Mini-Mental State Examination (MMSE) scores were not correlated to CT. Manual and automated CT measurements showed good reliability. Discussion Our findings indicated that peripheral choroidal thickening, especially in patients with cerebrovascular disease, may serve as a potential choroidal biomarker for cognitive decline and suggest different pathogenic pathways in AD and VaD. Further research is required to explore CT as a reliable ocular biomarker for cognitive impairment.

Abstract Background To investigate corneal higher-order aberrations (HOAs) and choroidal characteristics in myopic individuals and explore the association between HOAs and choroidal parameters. Methods Myopic participants were categorized into three groups based on axial lengths (ALs). We compared corneal HOAs, including spherical (Z4 0), comatic (Z3 − 1 and Z3 1), and trefoil (Z3 − 3 and Z3 3) aberrations, as well as choroidal vascularity index (CVI) and choroidal thickness (CT). Linear regression analysis was used to assess the relationships among corneal HOAs, CVI, CT, spherical equivalent, and AL. Results Groups 1, 2, and 3 included 105, 98, and 118 eyes, respectively. Group 3 exhibited lower spherical HOA root mean square and Z4 0 values than group 1(p

Abstract Purpose Keratoconus (KCN) is characterized by corneal thinning and bulging, leading to vision impairment. Assessing choroidal thickness (CT) in pediatric KCN ( pKCN) patients can provide insights for better understanding and managing the disease. CT may serve as a potential indicator of disease activity in KCN patients. This study aims to evaluate CT and retinal thickness (RT) in different stages of pKCN patients and compare the findings with an age-matched control group. Methods and patients This cross-sectional study included patients under 18 years old who met specific criteria. CT and RT was measured in all subjects using an optical coherence tomography device (Spectralis OCT, version 6.0, Heidelberg Engineering, Germany) with enhanced depth imaging mode, without pupil dilation. Mean CT and RT in pKCN was compared with healthy subjects and assessed among different disease grades using the ABCD grading method. Results The study included 125 eyes (66 patients) in the pKCN group and 42 control eyes (21 individuals). Grade 2 KCN showed the highest prevalence at 26.4% (N = 33), while grades 3 and 1 had prevalence rates of 24% (N = 30). CT in all specified areas (all P-values

Abstract The protective effects of time spent outdoors emphasize the major role of daylight in myopia. Based on the pathophysiology of myopia, the impact of blue light stimulation on the signaling cascade, from melanopsin at the blind spot to clinically relevant biomarkers for myopia, was investigated. Parameters and site of light stimulation are mainly defined by the photopigment melanopsin, that is sensitive to blue light with a peak wavelength of 480 nm and localized on the intrinsically photosensitive retinal ganglion cells (ipRGC) whose axons converge to the optic disc, corresponding to the physiological blind spot. Blue light at the blind spot (BluSpot) stimulation provides the opportunity to activate the vast majority of ipRGC and avoids additional involvement of rods and cones which may exert incalculable effects on the signaling cascade. Experimental studies have applied anatomical, histochemical, electrophysiological, imaging, and psychophysical methods to unravel the mode of action of BluSpot stimulation. Results indicate activation of melanopsin, improvement of contrast sensitivity, gain in electrical retinal activity, and increase of choroidal thickness following BluSpot stimulation. Short-term changes of clinically relevant biomarkers lead to the hypothesis that BluSpot stimulation may exert antimyopic effects with long-term application.

Abstract Introduction Our aim in this work was to investigate the macular choroidal thickness (ChT) changes in 6–12-year-old Danish children with myopia during 2 years of low-dose atropine treatment and 1-year wash-out vs. placebo in an investigator-initiated, placebo-controlled, double-blind randomized clinical trial. Methods Ninety-seven participants were randomized to either 0.01% for 2 years, 0.1% loading dose for 6 months followed by 0.01% for 18 months, or placebo, then a 1-year wash-out. The primary outcome was ChT in the sub-foveal and inner and outer superior, nasal, inferior, and temporal sectors. The secondary outcome was axial length (AL). Outcomes were measured at baseline and 6, 12, 24, and 36 months. One-way analysis of variance was used to detect baseline ChT differences between AL-stratified groups ( 25 mm). To determine the longitudinal changes in ChT and its effect on AL, all eyes were included in linear mixed modeling with individual eyes nested in the study ID as a random effect. Results Longer eyes had significantly thinner ChT in all choroidal sectors (adj-P

Caffeine, commonly found in coffee and tea, affects various aspects of eye health as it blocks adenosine receptors, impacting tear production, intraocular pressure, macular perfusion, and choroidal thickness. However, its connection with eye conditions like glaucoma and cataracts remains uncertain due to conflicting research findings. Some studies suggest potential benefits for cataracts, while others warn against frequent caffeine intake in glaucoma and surgical scenarios due to possible increases in intraocular pressure. Conflicting evidence also exists regarding its effects on dry eye, macular degeneration, myopia/hyperopia, diabetic retinopathy, retinopathy of prematurity, and central serous retinopathy. Caffeine does not seem to be a risk factor for dry eye, although studies have shown that caffeine may offer protection against wet age-related macular degeneration, and the metabolite 7-methylxanthine could be a more promising treatment for myopia. Moreover, caffeine can potentially cause tremors and might hinder surgical performance, especially in less experienced surgeons. Recommendations from experts vary, highlighting the need for further research to fully understand how caffeine affects the eye. Individuals genetically predisposed to glaucoma should be cautious due to the possibility of clinically significant elevations in intraocular pressure with caffeine consumption. For delicate procedures like microsurgery, where tremors can be detrimental, caution should be exercised with caffeine. This review underscores the importance of additional studies to provide clearer insights and prudent recommendations regarding caffeine’s impact on eye health.

Purpose To evaluate the efficacy of eplerenone in central serous chorioretinopathy (CSCR) patients in a clinical trial design. Methods In this double-blind clinical trial, naive acute. CSCR patients were divided into two groups: treatment with eplerenone 25 mg daily in the 1st week followed by 50 mg for the next 3 weeks and placebo group. Best-corrected visual acuity (BCVA), central macular thickness (CMT), macular volume (MV), and choroidal thickness (CT) were measured before and after 1 month of the intervention using the optical coherence tomography technique. Results Thirty-one CSCR (male: 23, female: 8) and 25 CSCR patients (male: 18, female: 7) with the mean age of 35.65 ± 5.94 and 37.08 ± 6.41 years were recruited and divided randomly into treatment and placebo groups, respectively. BCVA improved significantly in the treatment group (from 0.28 ± 0.26 to 0.11 ± 0.14, P = 0.002) compared with the placebo group (from 0.31 ± 0.26 to 0.21 ± 0.14, P = 0.052). Although CT, CMT, and MV improved significantly in each group, there were no significant differences between the groups. Conclusion In this study, we found favorable short-term clinical effects of eplerenone in acute CSCR patients, showing the pivotal role of mineralocorticoid receptors in the retina.

Artur Ma&lstrok;yszczak,1 Joanna Wiktoria Prze&zacute;dziecka-Do&lstrok;yk,2 Urszula Szyde&lstrok;ko-Pa&sacute;ko,1 Marta Misiuk-Hoj&lstrok;o1 1Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland; 2Ophthalmology Clinical Center SPEKTRUM, Research and Development Center CREO, Wroclaw, Dolnoslaskie, PolandCorrespondence: Artur Ma&lstrok;yszczak, Department and Clinic of Ophthalmology, Wroclaw Medical University, Borowska 213, Wroc&lstrok;aw, Dolnoslaskie, 50-556, Poland, Tel +71 736 43 00, Email arturm100@gmail.comPurpose: The purpose of this study was to evaluate retinal and choroidal vascularization parameters in patients with type 2 diabetes mellitus (DM), without diabetic retinopathy (DR), and to compare them to healthy controls.Patients and methods: Seventy-four eyes from 74 patients (40 eyes in the DM group and 34 eyes in the control group) were included in the study. Optical coherence tomography angiography RTVue XR Avanti was used to obtain 3× 3mm scans of the macula. The choroidal vascularity index (CVI), superficial and deep capillary plexus vascular densities (SCP and DCP, respectively), and choroidal thickness (CT) were measured.Results: In the diabetic group, SCP was lower in the superior and nasal segments (48.68 vs 50.62, p=0.02; 45.50 vs 48.82, p=0.02, respectively). The DCP did not differ between the groups. CVI was significantly lower in the study group in all measured segments, including central and parafoveal (31.73 vs 48.86 and 50.32 vs 59.58, p< 0.001, respectively). CT was larger in the study group only at the center of the macula (281.89μm vs 268.37μm p< 0.001) and in the inferior segment (337.47μm vs 329.40μm, p< 0.001). In the multivariate regression, clinical and vascularization parameters affecting CVI and CT were analyzed after adjusting for age and sex. Decreased central CVI was associated with the presence of DM, lower central SCP, and bigger foveal avascular zone area (b=− 0.68, b=0.47, b=− 0.21). Parafoveal CVI was also negatively affected by DM (b= − 0.46) and positively by parafoveal SCP (b= 0.44). Increased central CT was found to be positively associated with higher central SCP (b=0.48) and male sex (b=0.20).Conclusion: The results of our study confirmed a reduction of SCP and CVI in diabetic patients without DR. DM and SCP are age and sex independent parameters affecting CVI. Central CT is affected by SCP and sex, rather than the presence of diabetes.Keywords: choroidal vascularity index, choroidal thickness, OCTA, diabetes

Abstract Background We aimed to compare choroidal thickness (ChT) and retinal nerve fiber layer (RNFL) thickness in the affected and contralateral eyes of patients with Posner-Schlossman Syndrome (PSS) during acute, remission, and intermittent phases. Methods This prospective observational study included 18 patients(36 eyes) diagnosed with PSS. These patients underwent a comprehensive ophthalmologic evaluation including slit lamp examination, visual acuity testing, intraocular pressure (IOP) measurement, and funduscopic examination, and assessment of RNFL thickness, macular thickness, and macular ChT. Patient data collected included gender, age, number of keratic precipitates (KPs), and number of episodes. Optical coherence tomography (OCT) was used to measure RNFL thickness, macular thickness, and macular ChT in both eyes during the acute, remission, and intermittent phases. The affected eye was compared with the unaffected eye at each phase. Results In affected eyes, macular ChT was lower in the acute phase compared to the remission phase at N1500, N1000, N500, and subfoveal locations (allp

Abstract To identify genetic influences on subfoveal choroidal thickness of older adults using a genome-wide association study (GWAS). We recruited 300 participants from the population-based Korean Longitudinal Study on Health and Aging (KLoSHA) and Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) cohort studies and 500 participants from the Bundang age-related macular degeneration (AMD) cohort study dataset. We conducted a GWAS on older adult populations in the KLoSHA and KLOSCAD cohorts. Single nucleotide polymorphisms (SNPs) associated with choroidal thickness were identified with P values

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the world and anti-vascular endothelial growth factor (VEGF) injections have been the standard of care for the wet/neovascular variant since 2004. Currently, there are conflicting reports regarding its effect on the choroid, which supplies outer retina with oxygen and other nutrients. We synthesize available information of anti-VEGF on choroidal thickness (CT) in treatment-naïve typical neovascular AMD patients during the initial 12-week loading phase. We found 43 studies involving 1901 eyes from 1878 patients were included. Meta-analysis of 35 studies reporting CT at baseline and after 12 weeks suggested a significant decrease in CT with anti-VEGF treatment. A greater mean change with aflibercept compared to ranibizumab was found in subgroup analyses of sub-foveal CT in types 1 and 2 macular neovascularization. The long-term consequences of reduced CT in neovascular AMD remain unclear and require further targeted studies. [ABSTRACT FROM AUTHOR]

Introduction: Our aim in this work was to investigate the macular choroidal thickness (ChT) changes in 6–12-year-old Danish children with myopia during 2 years of low-dose atropine treatment and 1-year wash-out vs. placebo in an investigator-initiated, placebo-controlled, double-blind randomized clinical trial. Methods: Ninety-seven participants were randomized to either 0.01% for 2 years, 0.1% loading dose for 6 months followed by 0.01% for 18 months, or placebo, then a 1-year wash-out. The primary outcome was ChT in the sub-foveal and inner and outer superior, nasal, inferior, and temporal sectors. The secondary outcome was axial length (AL). Outcomes were measured at baseline and 6, 12, 24, and 36 months. One-way analysis of variance was used to detect baseline ChT differences between AL-stratified groups (< 24 mm, 24–25 mm, or > 25 mm). To determine the longitudinal changes in ChT and its effect on AL, all eyes were included in linear mixed modeling with individual eyes nested in the study ID as a random effect. Results: Longer eyes had significantly thinner ChT in all choroidal sectors (adj-P < 0.01) at baseline. There was no statistically significant change in any ChT sector after 3 years in the placebo group. Sub-foveal and nasal ChT in the 0.1% loading dose and 0.01% group were not significantly different from placebo after 2-year treatment. In the placebo group, a 1-mm increase in AL was significantly associated with a 47-µm thinner nasal ChT after 3 years (95% confidence interval (CI): – 55; – 38, adj-P < 0.001). A 10-µm thicker nasal choroid at baseline was associated with 0.13 mm (95% CI: 0.009; 0.017, adj-P < 0.001) less 3-year axial elongation. Conclusions: The ChT in Danish children with myopia remained stable over the 3-year follow-up. A thinner choroid at myopia onset might predispose to increased axial elongation. Treatment with 0.01% atropine did not change the ChT. We speculate that low-dose atropine does not primarily reduce myopia progression via a choroidal mechanism. Trial Registration: ClinicalTrials.gov identifier, NCT03911271. [ABSTRACT FROM AUTHOR]

Aim: To compare the Subfoveal Choroidal Thickness (SFCT) measured by Enhanced Depth Imaging (EDI) technique of Spectral Domain Optical Coherence Tomography (SD-OCT) in healthy pregnant and preeclamptic women. Methods: Our study was cross-sectional hospital-based study in which healthy pregnant women and women having preeclampsia were selected from Obstetrics and Gynecology department and enrolled in it. The guidelines of the American College of Obstetricians and Gynecologists were used to diagnose the cases of preeclampsia. The study included 100 women (200 eyes) which were grouped into 50 healthy pregnant women (group 1), i.e., n = 100 eyes and 50 preeclamptic women (group 2), i.e., n = 100 eyes. SFCT was measured using the EDI technique of SD-OCT and data were entered in a Microsoft Excel sheet. Statistical analysis was done using Epi Info. Software version 7.2.1.0 (Atlanta, Georgia, US) and the results of both the groups were compared. Results: The mean SFCT in both the eyes of the healthy pregnant group and the preeclamptic group was 318.12 ± 37.12 µm and 209.04 ± 26.73 µm, respectively, with a P-value 0.001 showing a statistically significant difference between both the groups. Conclusion: The SFCT is significantly decreased in preeclamptic pregnant women than in healthy pregnant women.

Abstract Background Considering that changes in the choroidal thickness are closely related to ocular growth, we studied the choroidal thickness (CT) and the blood flow features in children with unilateral myopic anisometropia (UMA) as well as investigating the relationship between choroidal changes and myopia. Methods Subjective refractive, axial length (AL), and biometric parameters were measured in 98 UMA children (age: 8–15 years). CT and choroidal blood-flow features, including the choroidal vessel volume (CVV), choroidal vascularity index (CVI), and choriocapillaris perfusion area (CCPA), were measured through swept-source optical coherence tomography angiography. The macular region was categorized into four concentric circles of diameters 0–1 mm (central fovea), 1–3 mm (parafovea), 3–6 mm (perifovea), and 6–9 mm (extended), and further categorized into superior (S), inferior (I), temporal (T), and nasal (N) quadrants. Results The aforementioned four regions of myopic eyes displayed significantly lower CT, CVV, and CVI than those of non-myopic eyes. CCPA changes differed across different regions of both the eyes (parts of N and T quadrants). There was an inverse association between CT and the interocular AL difference (central and other regions S, T quadrant). No correlation was noted between CVV and CVI with interocular AL difference. CT and CVV were positively correlated in the 0–6-mm macular region of myopic eyes (Spearman correlation coefficient = 0.763, P

Abstract High myopia can lead to pathologic myopia and visual impairment, whereas its causes are unclear. We retrospectively researched high myopia cases from patient records to investigate the association between axial elongation and myopic maculopathy. Sixty-four eyes were examined in patients who visited the department between July 2017 and June 2018, had an axial length of 26 mm or more, underwent fundus photography, and had their axial length measured twice or more. The average axial length was 28.29 ± 1.69 mm (mean ± standard deviation). The average age was 58.3 ± 14.4 years old. Myopic maculopathy was categorized as mild (grades 0 and 1) and severe (grades 2, 3, and 4). The severe group had longer axial lengths than the mild group (P

Abstract This study aims to develop a method to quantify choroidal vessels in normal eyes using wide-field optical coherence tomography (OCT) en-face images. The study included participants with normal eyes in whom wide-angle OCT images were acquired to generate planarized choroidal en-face and thickness map images. The images were segmented into central, midperipheral, and peripheral areas, and the midperipheral and peripheral areas were further segmented into supratemporal, infratemporal, supranasal, and infranasal sectors. The mean planarized choroidal-vessel density (p-CVD), planarized choroidal-vessel size (p-CVS), and choroidal thickness (CT) were calculated in each sector. Sex differences were analyzed using the Mann–Whitney U test. The study included 162 participants comprising 84 female (mean age, 43.5 years; axial length, 24.0 mm) and 78 male (mean age, 44.4 years; axial length, 24.2 mm) participants with no significant differences in demographics (P ≥ 0.107). Men had a higher mean p-CVD in all regions (P

Abstract Background To investigate the subfoveal retinal and choroidal thickness in patients with unilateral Fuchs Uveitis Syndrome (FUS). Methods This comparative contralateral study was performed in affected eyes with FUS versus fellow eyes. For each eye parameters such as subfoveal choroidal thickness (SCT), subfoveal choriocapillary thickness (SCCT), central macular thickness (CMT), and central macular volume (CMV) were measured; then the measured values of affected and fellow unaffected eye were compared. Results Thirty-seven patients (74 eyes) including 19 females (51.4%) with a mean age of 36.9 ± 7.6 years were enrolled. The mean SCT was lower in the affected eyes (344.51 ± 91.67) than in the fellow (375.59 ± 87.33) with adjusting for duration of disease and axial lengths (P

Abstract To evaluate the impact of excimer laser-assisted deep anterior lamellar keratoplasty (Exc-DALK) and excimer laser-assisted penetrating keratoplasty (Exc-PKP) on subfoveal choroidal thickness (SFCT) in eyes with advanced keratoconus. A retrospective comparative clinical study, which compares the outcomes of 24 eyes treated with Exc-DALK (G1) against matched group of 43 eyes treated with Exc-PKP (G2) at both 2 months (T1) and 2 years (T2) postoperatively. Main outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), and SFCT. Preoperatively, there were no significant differences between both groups regarding BCVA, CMT or SFCT (p > 0.05). There were no significant differences between both groups regarding BCVA at both follow-ups (p > 0.05). There were no significant differences between both groups regarding CMT at both follow-ups (p > 0.05). SFCT was higher in G2 than G1 at both follow-ups (p 0.05). In G2, SFCT increased significantly at T1 (p

Abstract This study aimed to investigate the effect of orbital wall decompression surgery and reduction of proptosis on the choroidal vascularity index (CVI) and subfoveal choroidal thickness (SFCT) in patients with thyroid eye disease (TED). Fifty-one eyes from 38 patients with controlled TED and proptosis were enrolled in this study. The majority of the patients (50.9%) had a clinical activity score (CAS) of zero, and none had a CAS greater than 2. The patients underwent a complete baseline ophthalmologic examination, and their choroidal profile alterations were monitored using enhanced depth imaging optical coherence tomography (EDI-OCT) before and during the three months after surgery. Changes in SFCT, luminance area (LA), total choroidal area (TCA), and the choroidal vascularity index (CVI) were measured as the ratio of LA to TCA in EDI-OCT images. The participants had an average age of 46.47 years, and 22 were female (57.9%). The SFCT of the patients exhibited a significant reduction over the follow-up period, decreasing from 388 ± 103 to 355 ± 95 µm in the first month (p

Abstract Background To compare the ocular features of highly myopic eyes with posterior staphyloma of wide macular type according to its morphological complexity. Methods In this cross-sectional study, wide macular posterior staphyloma (WMPS) was classified into the primary (Curtin type I) and the compound (Curtin types VI to X) forms based on the configuration within the staphyloma. The grades of myopic maculopathy and the thicknesses of choroid and sclera were compared between the primary and compound forms of WMPS. Results A total of 154 eyes (103 patients) with primary WMPS and 65 eyes (49 patients) with compound WMPS were included. Eyes with compound WMPS had worse visual acuity (P = 0.001) and greater axial length (P

Abstract Background Myopia affects 1.4 billion individuals worldwide. Notably, there is increasing evidence that choroidal thickness plays an important role in myopia and risk of developing myopia-related conditions. With the advancements in artificial intelligence (AI), choroidal thickness segmentation can now be automated, offering inherent advantages such as better repeatability, reduced grader variability, and less reliance for manpower. Hence, we aimed to evaluate the agreement between AI-automated and manual segmented measurements of subfoveal choroidal thickness (SFCT) using two swept-source optical coherence tomography (OCT) systems. Methods Subjects aged ≥ 16 years, with myopia of ≥ 0.50 diopters in both eyes, were recruited from the Prospective Myopia Cohort Study in Singapore (PROMYSE). OCT scans were acquired using Triton DRI-OCT and PLEX Elite 9000. OCT images were segmented both automatically with an established SA-Net architecture and manually using a standard technique with adjudication by two independent graders. SFCT was subsequently determined based on the segmentation. The Bland–Altman plot and intraclass correlation coefficient (ICC) were used to evaluate the agreement. Results A total of 229 subjects (456 eyes) with mean [± standard deviation (SD)] age of 34.1 (10.4) years were included. The overall SFCT (mean ± SD) based on manual segmentation was 216.9 ± 82.7 µm with Triton DRI-OCT and 239.3 ± 84.3 µm with PLEX Elite 9000. ICC values demonstrated excellent agreement between AI-automated and manual segmented SFCT measurements (PLEX Elite 9000: ICC = 0.937, 95% CI: 0.922 to 0.949, P

AIM: To observe the imaging characteristics of the affected eyes of patients with central serous chorioretinopathy(CSC)of different ages and their asymptomatic fellow eyes.METHODS: Retrospective study. A total of 76 cases(88 eyes)of CSC patients diagnosed in the ophthalmology department of our hospital from April to September, 2023 and 35 cases(35 eyes of asymptomatic fellow eyes of patients with unilateral CSC)were selected for the study. According to age, they were divided into young and middle-aged groups(50 years old). The imaging features of the affected eyes of CSC patients of different ages and their asymptomatic fellow eyes were observed.RESULTS: The subfoveal choroidal thickness(SFCT)of CSC eyes in the young and middle-aged patients(487.30±83.33 μm)was significantly greater than that of the middle-aged group(414.17±96.02 μm, P

AbstractPurposeMethodsResultsConclusionsTo reveal changes in choroidal thickness, retinal vessel density, and serum HIF-1α and TNF-α levels in obstructive sleep apnea syndrome (OSAS) and their correlation.This prospective case-control study included 118 patients divided into mild-to-moderate OSAS (n = 40), severe OSAS (n = 39), and a control group (n = 39). Choroidal thickness was evaluated with OCT, vessel density with OCTA, AHI index with polysomnography, and serum HIF-1α and TNF-α levels were analyzed using the enzyme-linked immunosorbent assay.The serum HIF-1α values of the participants in the mild-moderate OSAS and severe OSAS groups were [893.25(406.7–2068) and 1027(453–2527), respectively], and were both significantly higher than the control group [(521.5(231.6–2741))] (p < 0.001). Serum TNF-α levels did not differ significantly between the groups (p = 0.051).). Subfoveal choroidal thickness (SFCT) values of the severe OSAS groups were significantly lower than the control group (p < 0.05). The superficial and deep capillary plexus vascular density (SVD and DVD) values of the severe OSAS group were lower than the control group (p < 0.05). Serum HIF-1α and TNF-α levels of all participants were negatively correlated with both their SVD values (p < 0.05, r: –0.220 and p < 0.05, r: –0.252, respectively) and their DVD values (p < 0.001, r: –0.324 and p = 0.001, r: –0.299, respectively).Increased serum levels of inflammatory mediators (HIF-1α ve TNF-α) in OSAS cause a decrease in SFCT, SVD, and DVD, which is an indication of systemic vascular damage. Further research on developing treatment strategies to modulate TNF-α ve HIF-1α may help recede vascular morbidity in OSAS patients. [ABSTRACT FROM AUTHOR]

Background: Considering that changes in the choroidal thickness are closely related to ocular growth, we studied the choroidal thickness (CT) and the blood flow features in children with unilateral myopic anisometropia (UMA) as well as investigating the relationship between choroidal changes and myopia. Methods: Subjective refractive, axial length (AL), and biometric parameters were measured in 98 UMA children (age: 8–15 years). CT and choroidal blood-flow features, including the choroidal vessel volume (CVV), choroidal vascularity index (CVI), and choriocapillaris perfusion area (CCPA), were measured through swept-source optical coherence tomography angiography. The macular region was categorized into four concentric circles of diameters 0–1 mm (central fovea), 1–3 mm (parafovea), 3–6 mm (perifovea), and 6–9 mm (extended), and further categorized into superior (S), inferior (I), temporal (T), and nasal (N) quadrants. Results: The aforementioned four regions of myopic eyes displayed significantly lower CT, CVV, and CVI than those of non-myopic eyes. CCPA changes differed across different regions of both the eyes (parts of N and T quadrants). There was an inverse association between CT and the interocular AL difference (central and other regions S, T quadrant). No correlation was noted between CVV and CVI with interocular AL difference. CT and CVV were positively correlated in the 0–6-mm macular region of myopic eyes (Spearman correlation coefficient = 0.763, P < 0.001). Conclusions: In UMA children, CCT and blood flow may be related to myopia progression. A robust correlation between CT and CVV in the 0–6-mm macular region and reduced CT and diminished blood flow indicated an association with myopia. [ABSTRACT FROM AUTHOR]

This study aims to develop a method to quantify choroidal vessels in normal eyes using wide-field optical coherence tomography (OCT) en-face images. The study included participants with normal eyes in whom wide-angle OCT images were acquired to generate planarized choroidal en-face and thickness map images. The images were segmented into central, midperipheral, and peripheral areas, and the midperipheral and peripheral areas were further segmented into supratemporal, infratemporal, supranasal, and infranasal sectors. The mean planarized choroidal-vessel density (p-CVD), planarized choroidal-vessel size (p-CVS), and choroidal thickness (CT) were calculated in each sector. Sex differences were analyzed using the Mann–Whitney U test. The study included 162 participants comprising 84 female (mean age, 43.5 years; axial length, 24.0 mm) and 78 male (mean age, 44.4 years; axial length, 24.2 mm) participants with no significant differences in demographics (P ≥ 0.107). Men had a higher mean p-CVD in all regions (P < 0.001). The mean p-CVS was greater in men in all regions except for the supratemporal sector (P < 0.001). No significant differences in sex in the mean CT were observed in all regions (P ≥ 0.106). The p-CVD and p-CVS in normal eyes differ between sexes. This finding may contribute to the understanding of the pathophysiology of choroidal diseases. [ABSTRACT FROM AUTHOR]

Background: The goal of the study was to analyze variations in central, perifoveal, and peripheral retinal thickness (RT) and choroidal thickness (CT) in patients with diabetic macular edema (DME) measured with ultra-wide-field optical coherence tomography (UWF-OCT). Additionally, correlations between RT and CT in the central, perifoveal, and peripheral sectors and the presence of selected systemic factors were evaluated. Methods: A total of 74 consecutive adult diabetic patients with DME and 75 healthy controls were included. Study participants were divided into three groups: DME patients without panretinal photocoagulation (PRP; 84 eyes), DME patients after PRP (56 eyes), and healthy controls (125 eyes). RT and CT were analyzed in three zones: a central circle of 3 mm diameter (central), a ring contained between a centered 9 mm circle and the central 3 mm circle (perifoveal), and a second, more peripheral ring between centered 18 mm and 9 mm circles (peripheral). Additionally, DME subgroups were analyzed according to the correlation of RT and CT with age, axial length, best corrected visual acuity (BCVA), diabetes duration, insulin therapy duration, body mass index (BMI), glycosylated hemoglobin (HbA1c) values, intravitreal injection (IVI) count, and the advancement of retinopathy assessed by the simplified diabetic retinopathy severity scale (DRSS). Results: The increase in RT in the far peripheral sectors in DME patients was not significant. The increases in central and perifoveal RT and lower values of CT in PRP-naive DME patients were strongly associated with poorer BCVA. Patients with DME after PRP presented with BCVA improvements significantly related to the number of IVIs. The amount of DME and RT in peripheral sectors were both independent of systemic factors such as BMI, duration of diabetes, duration of insulin intake, retinopathy severity, and HbA1c levels. Conclusions: Peripheral retinal sectors in DME patients are less affected in terms of increase in their thickness compared to central ones. Functional and morphological associations of DME with UWF-OCT testing refer to central and perifoveal sectors. [ABSTRACT FROM AUTHOR]

Background: To investigate the subfoveal retinal and choroidal thickness in patients with unilateral Fuchs Uveitis Syndrome (FUS). Methods: This comparative contralateral study was performed in affected eyes with FUS versus fellow eyes. For each eye parameters such as subfoveal choroidal thickness (SCT), subfoveal choriocapillary thickness (SCCT), central macular thickness (CMT), and central macular volume (CMV) were measured; then the measured values of affected and fellow unaffected eye were compared. Results: Thirty-seven patients (74 eyes) including 19 females (51.4%) with a mean age of 36.9 ± 7.6 years were enrolled. The mean SCT was lower in the affected eyes (344.51 ± 91.67) than in the fellow (375.59 ± 87.33) with adjusting for duration of disease and axial lengths (P < 0.001). The mean SCCT, CMT, and CMV were higher in eyes with FUS than in fellow eyes (P < 0.05). Conclusions: The result of our study demonstrated that affected eyes in patients with FUS tend to have thinner SCT and thicker SCCT and CMT compared to uninvolved fellow eyes. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to introduce the coefficient of spatial variance of choroidal thickness to describe the choroidal variation and investigate its associated factors in healthy eyes. Methods: This retrospective cross-sectional study included 1031 eyes from 1031 subjects who received a swept-source optical coherence tomography examination. The mean choroidal thickness in the macular 6 × 6 mm region and 900 subregions of 0.2 × 0.2 mm were computed using the embedded algorithm. Before analysis, potential segmentation and magnification errors were corrected. The coefficient of spatial variance was defined as the standard deviation divided by the mean (multiplied by 100%) of the choroidal thicknesses across 900 grids. Potential factors associated with the coefficient of spatial variance were assessed using multiple linear regression. Results: The mean choroidal thickness of the entire 6 × 6 mm macular region was 204.50 ± 72.88 μm. The mean coefficient of spatial variance was 26.58 ± 8.24%, ranging from 11.00 to 61.58%. Statistical analysis revealed that the means choroidal thickness (β = − 0.08, R2 = 0.42, p < 0.001) and anterior chamber depth (β = − 2.39, R2 = 0.05, p = 0.06) were associated with the coefficient of spatial variance. Conclusion: Our study first incorporated the coefficient of spatial variance to represent the spatial variation of the choroidal thickness and observed that the greater thinning of the choroid is correlated with a more pronounced spatial variation. [ABSTRACT FROM AUTHOR]

To evaluate the impact of excimer laser-assisted deep anterior lamellar keratoplasty (Exc-DALK) and excimer laser-assisted penetrating keratoplasty (Exc-PKP) on subfoveal choroidal thickness (SFCT) in eyes with advanced keratoconus. A retrospective comparative clinical study, which compares the outcomes of 24 eyes treated with Exc-DALK (G1) against matched group of 43 eyes treated with Exc-PKP (G2) at both 2 months (T1) and 2 years (T2) postoperatively. Main outcomes included best-corrected visual acuity (BCVA), central macular thickness (CMT), and SFCT. Preoperatively, there were no significant differences between both groups regarding BCVA, CMT or SFCT (p > 0.05). There were no significant differences between both groups regarding BCVA at both follow-ups (p > 0.05). There were no significant differences between both groups regarding CMT at both follow-ups (p > 0.05). SFCT was higher in G2 than G1 at both follow-ups (p < 0.01). Compared to preoperative SFCT, there were no significant changes in SFCT in G1 at both follow-ups (p > 0.05). In G2, SFCT increased significantly at T1 (p < 0.01) and did not differ significantly at T2 (p = 0.17). SFCT increased significantly after Exc-PKP but not after Exc-DALK, which might indicate that Exc-DALK affects the choroid less and thus could represent a less traumatic approach to ocular tissue than Exc-PKP. [ABSTRACT FROM AUTHOR]

This study aimed to compare the dominant and non-dominant eyes of healthy individuals in terms of CT and CVI values to assess the effect of ocular dominance on choroidal morphology. Three hundred eyes of 150 individuals were included in this study. All patients underwent routine ophthalmological examinations and hole-in-the-card tests to determine the dominant eye. EDI-OCT was used to obtain choroidal images. Choroidal thickness (CT) was measured at three points on the choroid including the subfoveal region (subfoveal choroidal thickness (SFCT)), 1500 μm nasal (NCT) and temporal (TCT) to the fovea. Choroidal vascularity index (CVI), total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured at fovea-centered choroidal area by image binarization via Image J software. While 93(%62) participants were right-eyed, 57(%38) participants were left-eyed. We could not detect any difference in SFCT, NCT, TCT, TCA, LA, SA, and CVI measurements between the dominant and the non-dominant eyes. (p > 0.05 for all). We could not detect any effect of ocular dominance on choroidal structures. These results also support the use of randomized ocular data regardless of which eye is dominant when investigating CVI and CT in scientific research. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this study is to investigate the effects of vitamin D deficiency in choroidal vacular index (CVI) and choroidal thickness (CT) of the subfoveal and peripapillary area. Materials and Methods: All macular and peripapillary images were taken by enhanced depth imaging (EDI) mode of spectral domain optical coherence tomography (SD-OCT). The CT was measured at five different points; at the subfovea and at 500µm intervals away from the optic nerve in the superior, inferior, nasal, and temporal quadrants. Choroid images taken from subfoveal and peripapillary region were divided into luminal and stromal areas determined by image binarization method. CVI was defined as the ratio of LA to total choroid area (TCA). Results: The mean vitamin D levels were 10.58±3.04 ng/mL in Group 1, and 24.92±3.77 ng/mL in Group 2 (p <0.0001). Subfoveal and peripapillary nasal, superior and inferior CT was found to be statistically significantly thinner in Group 1 (p <0.001, all). CVI in subfoveal region, peripapillary nasal and superior quadrants was statistically significantly lower in Group 1 (p=0.001, p=0.012, p=0.011, respectively). There were positive correlations between vitamin D levels and subfoveal CT, nasal, superior, and inferior peripapillary CT (p < 0.001, p = 0.001, p < 0.001, p < 0.001, respectively) and subfoveal CVI, nasal, and superior peripapillary CVI (p = 0.007, p = 0.007, p = 0.003 respectively). Conclusion: In individuals with vitamin D deficiency, both CT and CVI may be negatively affected in the subfoveal, peripapillary nasal and superior quadrants. [ABSTRACT FROM AUTHOR]