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PurposeMethodsResultsConclusionTo evaluate the effects of rheumatoid arthritis (RA) on choroidal vascularity index (CVI) and subfoveal choroidal thickness (SFCT).The study included 56 eyes of 56 rheumatoid arthritis patients and 65 eyes of 65 age- and sex-matched healthy normal participants. CVIs of all participants were measured by transferring enhanced depth imaging optical coherence tomography (EDI-OCT) images to the image J program that is software used for image binarization and compared between the 2 groups. SFCT, central macular thickness (CMT) and optic disc parameters of all participants were measured with spectral domain OCT and compared.The mean CVI values of the RA and control groups were 65.9 ± 1.52 and 68.56 ± 1.62, respectively, and were significantly lower in the RA group (p = 0.001). Mean SFCT values of the RA and control groups were 290.11 ± 15.18 and 332.88 ± 11.04, respectively, and SFCT was significantly lower in the RA group (p = 0.001). RA patients have thin SFCT and low CVI. There was no significant difference between the two groups in terms of CMT and optic disc parameters.RA patients have lower CVI and thinner SFCT than healthy participants. [ABSTRACT FROM AUTHOR]

Abstract Background Although choroidal thickening was reported as a sign of active inflammation in ocular sarcoidosis, there has been no research on the choroidal changes in non-ocular sarcoidosis (defined as systemic sarcoidosis without overt clinical signs of ocular involvement). Therefore, this study aimed to investigate choroidal structural changes in patients with non-ocular sarcoidosis. Methods This retrospective case–control study was conducted at Asan Medical Center, a tertiary referral center. We evaluated 30 eyes with non-ocular sarcoidosis and their age- and spherical equivalent-matched healthy control eyes. The subfoveal choroidal thickness, area ratio (Sattler layer-choriocapillaris complex [SLCC] area to Haller layer [HL] area), and choroidal vascularity index (CVI, luminal area to choroidal area) were analyzed using enhanced depth imaging in optical coherence tomography. Systemic and ocular factors associated with the choroidal thickness were investigated. Results Compared with the healthy control group, the non-ocular sarcoidosis group had significantly thicker subfoveal choroid (total and all sublayers [SLCC and HL]) and lower area ratio. There were no significant differences in the CVIs at all sublayers between groups. In the non-ocular sarcoidosis group, eyes under oral steroid treatment had thinner choroid than eyes under observation. In the control group, eyes with older age and more myopic spherical equivalent had thinner choroidal thickness. Conclusion Total and all sublayers of the subfoveal choroid were significantly thicker without significant vascularity changes in non-ocular sarcoidosis eyes than in healthy control eyes. The degree of choroidal thickening was disproportionally greater at HL than at SLCC. These characteristic choroidal changes may be the subclinical manifestations in non-ocular sarcoidosis.

Purpose: To study the optic nerve head characteristics on optical coherence tomography (OCT) in patients with papilledema and correlate them with intracranial pressure (ICP). Methods: A retrospective hospital-based study of 46 eyes of 23 patients with bilateral optic disc edema secondary to increased ICP. The clinical profile and the OCT features in terms of retinal nerve fiber layer thickness (RNFL), ganglion cell inner plexiform layer (GCIPL) thickness, and enhanced depth imaging (EDI) B scan images of the optic nerve head were studied and correlated with the ICP. Results: Papilledema was secondary to idiopathic intracranial hypertension (IIH) (n = 20), obstructive hydrocephalus (n = 2), and communicating hydrocephalus (n = 1). The mean ICP in 20 IIH patients was 347 mmH2O. The ICP and RNFL thickness in all four quadrants were found to be weakly positively correlated: superior RNFL r (38) = 0.17, P = 0.30, and nasal RNFL r (38) = 0.30, P = 0.05, inferior RNFL r (38) = 0.29, P = 0.07, and temporal RNFL, r (38) = -0.001, P = 0.99. The GCIPL layer thickness and the ICP were weakly negatively correlated in all sectors: superior (38) = -0.23, P = 0.16, superonasal, r (38) = -0.07, P = 0.67, inferonasal r (38) = -0.08, P = 0.64, inferior r (38) = -0.21, P = 0.19, inferotemporal r (38) = -0.23, P = 0.17, superotemporal, r (38) -0.21, P = 0.20. Descriptive features on the B scan, such as peripapillary hyperreflective ovoid mass-like structures and microcystic spaces, were observed most commonly with an ICP of 251-350 mmH2O, and the hyperreflective dots in the RNFL layer and Bruch's membrane inward denting were observed more commonly with an ICP of 351-450 mmH2O. Conclusion: The RNFL thickness in all four quadrants had a weak positive correlation, and the GCIPL layer had a weak negative correlation with the ICP. The EDI descriptive features on OCT may vary with ICP. [ABSTRACT FROM AUTHOR]

Background: Although choroidal thickening was reported as a sign of active inflammation in ocular sarcoidosis, there has been no research on the choroidal changes in non-ocular sarcoidosis (defined as systemic sarcoidosis without overt clinical signs of ocular involvement). Therefore, this study aimed to investigate choroidal structural changes in patients with non-ocular sarcoidosis. Methods: This retrospective case–control study was conducted at Asan Medical Center, a tertiary referral center. We evaluated 30 eyes with non-ocular sarcoidosis and their age- and spherical equivalent-matched healthy control eyes. The subfoveal choroidal thickness, area ratio (Sattler layer-choriocapillaris complex [SLCC] area to Haller layer [HL] area), and choroidal vascularity index (CVI, luminal area to choroidal area) were analyzed using enhanced depth imaging in optical coherence tomography. Systemic and ocular factors associated with the choroidal thickness were investigated. Results: Compared with the healthy control group, the non-ocular sarcoidosis group had significantly thicker subfoveal choroid (total and all sublayers [SLCC and HL]) and lower area ratio. There were no significant differences in the CVIs at all sublayers between groups. In the non-ocular sarcoidosis group, eyes under oral steroid treatment had thinner choroid than eyes under observation. In the control group, eyes with older age and more myopic spherical equivalent had thinner choroidal thickness. Conclusion: Total and all sublayers of the subfoveal choroid were significantly thicker without significant vascularity changes in non-ocular sarcoidosis eyes than in healthy control eyes. The degree of choroidal thickening was disproportionally greater at HL than at SLCC. These characteristic choroidal changes may be the subclinical manifestations in non-ocular sarcoidosis. [ABSTRACT FROM AUTHOR]

Purpose: To investigate that the changes of lamina cribrosa (LC) thickness and depth after latanoprost therapy in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. Methods: In this single-center prospective cross-sectional study, 35 eyes from 35 patients with POAG or OHT (study group) and 26 age- and gender- matched healthy individuals (control group) were included. All participants were examined by spectral domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode for LC thickness and depth measurements at the first visit before latanoprost therapy and at visits after 1 (second visit) and 3 (third visit) months of latanoprost therapy. Results: The mean LC thickness in both horizontal and vertical scans of the study group were thinner than the control group (p < 0.001, for both). During latanoprost therapy in the study group, the LC thickness values in horizontal scans significantly differed over the three visits, gradually increased (p < 0.05). There was significantly decrease in LC depth in horizontal scans between the first and third visits, and the second and third visits (p = 0.003 and p = 0.008, respectively). The gradual decrease in LC depth in vertical scans was observed at all visits, but the statistically significant difference was between the first and third visits only (p = 0.048). Conclusion: POAG/OHT patients showed more LC thinning compared with healthy individuals. The significant increase in LC thickness and the significant decrease in LC depth were detected after IOP reduction therapy with latanoprost in ocular hypertensive/ glaucomatous eyes.

Purpose: To study the optic nerve head characteristics on optical coherence tomography (OCT) in patients with papilledema and correlate them with intracranial pressure (ICP). Methods: A retrospective hospital-based study of 46 eyes of 23 patients with bilateral optic disc edema secondary to increased ICP. The clinical profile and the OCT features in terms of retinal nerve fiber layer thickness (RNFL), ganglion cell inner plexiform layer (GCIPL) thickness, and enhanced depth imaging (EDI) B scan images of the optic nerve head were studied and correlated with the ICP. Results: Papilledema was secondary to idiopathic intracranial hypertension (IIH) (n = 20), obstructive hydrocephalus (n = 2), and communicating hydrocephalus (n = 1). The mean ICP in 20 IIH patients was 347 mmH2O. The ICP and RNFL thickness in all four quadrants were found to be weakly positively correlated: superior RNFL r (38) = 0.17, P = 0.30, and nasal RNFL r (38) = 0.30, P = 0.05, inferior RNFL r (38) = 0.29, P = 0.07, and temporal RNFL, r (38) = −0.001, P = 0.99. The GCIPL layer thickness and the ICP were weakly negatively correlated in all sectors: superior (38) = −0.23, P = 0.16, superonasal, r (38) = −0.07, P = 0.67, inferonasal r (38) = −0.08, P = 0.64, inferior r (38) = −0.21, P = 0.19, inferotemporal r (38) = −0.23, P = 0.17, superotemporal, r (38) −0.21, P = 0.20. Descriptive features on the B scan, such as peripapillary hyperreflective ovoid mass-like structures and microcystic spaces, were observed most commonly with an ICP of 251–350 mmH2O, and the hyperreflective dots in the RNFL layer and Bruch’s membrane inward denting were observed more commonly with an ICP of 351–450 mmH2O. Conclusion: The RNFL thickness in all four quadrants had a weak positive correlation, and the GCIPL layer had a weak negative correlation with the ICP. The EDI descriptive features on OCT may vary with ICP.

BACKGROUND: The aim of this study was to determine whether anterior scleral thickness (AST) varies significantly between patients with central serous chorioretinopathy (CSCR) versus normal individuals. To validate scleral thickness measurements by ultrasound biomicroscopy (UBM) vis a vis anterior segment optical coherence tomography (ASOCT). METHODS: This case–control study analyzed 50 eyes of 50 patients with CSCR (cases) and compared it with that of 50 eyes of 50 age- and gender-matched controls. In cases, AST was measured at 1 mm and 2 mm temporal to the temporal scleral spur by ASOCT and UBM. In controls, AST was measured only by ASOCT. In all participants, posterior choroidal thickness (CT) was measured subfoveally, 1 mm nasal and 1 mm temporal to fovea by enhanced depth imaging optical coherence tomography. RESULTS: The mean AST, as measured by ASOCT among cases and controls was 703.86 μm and 667.54 μm, respectively (P = 0.006). The mean AST by ASOCT and UBM in cases were 703.86 μm and 657.42 μm, respectively (P = 0.001). AST measurement by ASOCT and UBM showed a positive and statistically significant correlation (r = 0.431, P = 0.000). The mean CT among cases and controls was 443.56 μm and 373.88 μm, respectively (P = 0.000). We found a weak positive correlation (r = 0.11) in cases and weaker positive correlation in controls, between CT and AST measured by ASOCT. CONCLUSIONS: Our findings suggest that AST varies significantly between patients with CSCR versus normal individuals. We found poor agreement of AST when measured by ASOCT and UBM.

The choroid is the main part of the uvea, the vascular layer of the eye that lies between the retina and the sclera. The high vascular component of the choroid makes this structure susceptible to inflammation in multisystemic diseases, as well as the most common site of metastasis in the eye. Therefore, the choroid is involved in many pathological conditions, from uveitis to intraocular tumors. Differentiating between inflammatory and neoplastic lesions deforming the choroidal profile can sometimes be challenging. In addition, scleral disorders can also deform the choroidal profile. Choroidal imaging includes ophthalmic ultrasonography, indocyanine green angiography, and optical coherence tomography (OCT). Recent advances in choroidal imaging techniques, such as enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source optical coherence tomography (SS-OCT), have facilitated an in-depth analysis of the choroid. The purpose of this review article is to report on and highlight the most common OCT findings to help in the differential diagnosis between inflammatory and neoplastic lesions deforming the choroidal profile. [ABSTRACT FROM AUTHOR]

Purpose: To examine choroidal angiographic features in the posterior pole associated with resolution or persistency of subretinal fluid (SRF) in eyes with central serous chorioretinopathy (CSC). Design: Observational case series. Methods: Twenty-nine patients with treatment-naïve CSC were divided into two groups based on the presence or absence of SRF 3 months after the initial visit (month 3) without any treatment. Using enhanced depth imaging of widefield swept-source optical coherence tomography, the choroidal thickness (CT), vessel density (VD), and vessel diameter index (VDI) in the superotemporal and inferotemporal subfields on the temporal side of the 18-mm circle from the disc were measured at the initial visit. We calculated the vertical difference in CT and other choroidal angiographic parameters and evaluated their association with the SRF condition at 3 months. Results: The SRF-resolved and SRF-persistent groups included 10 and 19 patients, respectively. At the initial visit, sex, age, axial length, symptom duration, the logarithm of the minimum angle of resolution visual acuity, and foveal thickness were not significantly different between the two groups. The SRF status at month 3 was not associated with the vertical difference in CT and choroidal VD (P = .614, .065, respectively). However, the vertical difference in choroidal VDI was positively associated with the future presence of SRF (P = .017). Conclusions: Vertically asymmetric dilation of choroidal vessels in the posterior pole may be a vasculature feature associated with SRF from CSC and may be a good predictor of future SRF status.

BACKGROUND: The aim of this study was to determine whether anterior scleral thickness (AST) varies significantly between patients with central serous chorioretinopathy (CSCR) versus normal individuals. To validate scleral thickness measurements by ultrasound biomicroscopy (UBM) vis a vis anterior segment optical coherence tomography (ASOCT). METHODS: This case-control study analyzed 50 eyes of 50 patients with CSCR (cases) and compared it with that of 50 eyes of 50 age- and gender-matched controls. In cases, AST was measured at 1 mm and 2 mm temporal to the temporal scleral spur by ASOCT and UBM. In controls, AST was measured only by ASOCT. In all participants, posterior choroidal thickness (CT) was measured subfoveally, 1 mm nasal and 1 mm temporal to fovea by enhanced depth imaging optical coherence tomography. RESULTS: The mean AST, as measured by ASOCT among cases and controls was 703.86 jxm and 667.54 pm, respectively (P= 0.006). The mean AST by ASOCT and UBM in cases were 703.86 pm and 657.42 pm, respectively (P= 0.001). AST measurement by ASOCT and UBM showed a positive and statistically significant correlation (r= 0.431, P= 0.000). The mean CT among cases and controls was 443.56 pm and 373.88 pm, respectively (P= 0.000). We found a weak positive correlation (r= 0.11) in cases and weaker positive correlation in controls, between CT and AST measured by ASOCT. CONCLUSIONS: Our findings suggest that AST varies significantly between patients with CSCR versus normal individuals. We found poor agreement of AST when measured by ASOCT and UBM. [ABSTRACT FROM AUTHOR]

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

Background: Choroidal thickness [CT] is associated with many ocular conditions. Different generations of optical coherence tomography [OCT] are important for clinical application.Objective: This study aimed to evaluate the effect of myopia on CT by the use of enhanced depth imaging [EDI] OCT and correlate the measured data with both the axial length [AL] and the refraction.Patients and Methods: A Cross-sectional study included 80 adult patients of both sexes. The patients were divided into 4 groups: [G1, control]: 20 emmetropic subjects. [G2]: 20 myopic patients with refraction up to -6 D. [G3]: 20 myopic patients with refraction >-6 D up to -10 D and [G4]: 20 myopic patients with refraction > -10 D. Spectralis OCT has been utilized in assessing CT in subfoveal region, 500, 1000 and 1500 um temporal and nasal to fovea.Results: A highly statistically significant variation existed among groups considering AL and refraction with G4 having higher values and G2 and G1 having lower values. Regarding CT, the highest value was found in G1 and 2, followed by G3, but the lowest value was found in G4. There was significant positive correlation between refraction in all patients and their AL [p< 0.001], and significant negative correlation appeared between refraction and AL in all patients regarding their all measures of CT [nasal, temporal and subfoveal] [p < 0.001].Conclusion: Myopia with different degrees caused a decrease in CT compared to its thickness of healthy eyes, with marked thinning in advanced myopia.

Deep optic disc drusen (ODD) are located below Bruch's membrane opening (BMO) and may go undetected due to the challenges in imaging them. The purpose of this study is a head-to-head comparison of currently widely used imaging technologies: swept-source optical coherence tomography (SS-OCT; DRI OCT-1 Triton, Topcon) and enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT; Spectralis OCT, Heidelberg Engineering) for the detection of deep ODD and associated imaging features. The eyes included in this study had undergone high-resolution imaging via both EDI SD-OCT and SS-OCT volume scans, which showed at least one deep ODD or a hyperreflective line (HL). Grading was performed by three graders in a masked fashion. The study findings are based on 46 B-scan stacks of 23 eyes including a total of 7981 scans. For scan images with ODD located above or below the level of BMO, no significant difference was found between the two modalities compared in this study. However, for HLs and other features, EDI SD-OCT scan images had better visualization and less artifacts. Although SS-OCT offers deep tissue visualization, it did not appear to offer any advantage in ODD detection over a dense volume scan via EDI SD-OCT with B-scan averaging. [ABSTRACT FROM AUTHOR]

The choroid is the main part of the uvea, the vascular layer of the eye that lies between the retina and the sclera. The high vascular component of the choroid makes this structure susceptible to inflammation in multisystemic diseases, as well as the most common site of metastasis in the eye. Therefore, the choroid is involved in many pathological conditions, from uveitis to intraocular tumors. Differentiating between inflammatory and neoplastic lesions deforming the choroidal profile can sometimes be challenging. In addition, scleral disorders can also deform the choroidal profile. Choroidal imaging includes ophthalmic ultrasonography, indocyanine green angiography, and optical coherence tomography (OCT). Recent advances in choroidal imaging techniques, such as enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source optical coherence tomography (SS-OCT), have facilitated an in-depth analysis of the choroid. The purpose of this review article is to report on and highlight the most common OCT findings to help in the differential diagnosis between inflammatory and neoplastic lesions deforming the choroidal profile.

• The lamina cribrosa is very sensitive to the changes of intraocular pressure. • The duration of increased intraocular pressure is important for determining the presence of ultimate damage to the lamina cribrosa. • The significant increase in lamina cribrosa thickness and the significant decrease in lamina cribrosa depth were detected after intraocular pressure reduction therapy with latanoprost in ocular hypertensive/ glaucomatous eyes. • Spectral domain optical coherence tomography with enhanced depth imaging mode is useful for determining lamina cribrosa changes in glaucomatous eyes. To investigate that the changes of lamina cribrosa (LC) thickness and depth after latanoprost therapy in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. In this single-center prospective cross-sectional study, 35 eyes from 35 patients with POAG or OHT (study group) and 26 age- and gender- matched healthy individuals (control group) were included. All participants were examined by spectral domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode for LC thickness and depth measurements at the first visit before latanoprost therapy and at visits after 1 (second visit) and 3 (third visit) months of latanoprost therapy. The mean LC thickness in both horizontal and vertical scans of the study group were thinner than the control group (p < 0.001, for both). During latanoprost therapy in the study group, the LC thickness values in horizontal scans significantly differed over the three visits, gradually increased (p < 0.05). There was significantly decrease in LC depth in horizontal scans between the first and third visits, and the second and third visits (p = 0.003 and p = 0.008, respectively). The gradual decrease in LC depth in vertical scans was observed at all visits, but the statistically significant difference was between the first and third visits only (p = 0.048). POAG/OHT patients showed more LC thinning compared with healthy individuals. The significant increase in LC thickness and the significant decrease in LC depth were detected after IOP reduction therapy with latanoprost in ocular hypertensive/ glaucomatous eyes. [ABSTRACT FROM AUTHOR]

Obesity is a health-threatening and epidemic medical condition that can affect individuals of different ages and is potentially associated with an increased risk of systemic and ocular disorders. Despite the well-documented adverse effects of obesity on different parts of the body vasculature, less published data are available concerning obesity-related consequences on the ocular vasculature. As the human choroid is a highly vascularized tissue, its morphology and function might be altered in obese individuals. The micro-structural changes within the choroid could also trigger development of subsequent functional abnormalities of the eye. Previous population-based studies have asserted an association between obesity and choroidal thickness; however, they reported conflicting patterns of association between obesity and changes in choroidal thickness. Therefore, to enhance our understanding of the changes in choroidal morphology secondary to obesity, we reviewed studies describing the micro-structural consequences of obesity on the choroidal thickness profile and its underlying physiological and anatomical basis. This review includes all original publications related to the association between choroidal thickness and obesity published until mid-2021 that were indexed in PubMed, Google Scholar, ScienceDirect, or Scopus. [ABSTRACT FROM AUTHOR]

To describe the optical coherence tomography (OCT) findings of toxoplasmic retinochoroiditis at different stages of activity. Observational case series. A total of 32 eyes of 31 patients were included; 43 sets of OCT were reviewed. A total of 14 lesions were classified as active, 13 as partially active, and 16 as inactive. All active lesions demonstrated increased retinal thickness and reflectivity with blurring of details of retinal layers. Choroidal granuloma was detected in eight (61.5%) and serous retinal detachment in nine (64%). In partially active lesions, sustained thickening and/or attachment of posterior hyaloid face with fine epiretinal membrane was the hallmark. Scarified lesions showed decreased retinal and choroidal thickness starting from the periphery. Characteristic signs for decreased activity of a lesion seen in majority of both partially active and inactive lesions were RPE changes and retina-RPE approximation. We called this unique feature 'hourglass configuration'. Features in OCT are helpful to specify and monitor the activity of toxoplasmic retinochoroiditis. [ABSTRACT FROM AUTHOR]

Copyright of Türkiye Klinikleri Journal of Ophthalmology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of MN Opthalmology / MN Oftalmoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of MN Opthalmology / MN Oftalmoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 14-year-old male presented with blurring of vision, headache, and bilateral serous macular detachment (SMD) with thick choroid without any significant leak on fluorescein angiogram. As the imaging was inconclusive, we advised him thorough systemic evaluation. His platelet count was significantly reduced with a higher percentage of blast cells on peripheral smear. The diagnosis of B-cell acute lymphoblastic leukemia was confirmed by an oncologist on flow cytometry and was immediately started on chemotherapy. After a month, SMD resolved completely with the restoration of visual acuity. This case highlights the role of early diagnosis and urgent treatment before systemic manifestations reducing disease mortality.

PurposeThe effect of an oral trans-resveratrol-based supplement (Longevinex®) on choroidal thickness, measured using optical coherence tomography (OCT) enhanced depth imaging, was investigated in a prospective study.Materials and methods34 young, healthy participants were randomly divided into two age- and gender-matched groups. They were then assigned in a randomized fashion to treat with either a trans-resveratrol-based group (Longevinex®, Las Vegas) or placebo. All participants underwent ocular imaging with spectral domain (SD)-OCT (Spectralis; Heidelberg Engineering, Heidelberg) at the baseline and then again 1 h following treatment. The choroidal thickness was measured in a masked fashion at the fovea and at four additional points, located at 500 μm and 1000 μm nasal to the fovea and 500 μm and 1000 μm temporal to the fovea.ResultsIn the resveratrol group, the foveal choroidal thickness at the baseline was 267.73 ± 84.19 μm (mean ± SD); it increased to 284.57 ± 92.39 μm 1 h after drug treatment (p = 0.033). The mean choroidal thickness was also significantly increased at each of the four extrafoveal points (all p < 0.05). In the control group, the mean baseline choroidal thickness at the fovea was 269.73 ± 71.40 μm (mean ± SD) and it was 268.43 ± 70.15 μm (mean ± SD) 1 h after the placebo was administered (p = 0.183); there were also no significant differences in choroidal thickness at the four additional points (all p > 0.05) Conclusion: A significant increase in choroidal thickness following oral administration of a trans-resveratrol-based supplement was observed. There was no change in choroidal thickness in the placebo-treated control group. We speculate that the increased choroidal thickness is the result of choroidal vessel vasodilation.

Recent advances have made it possible to image the suprachoroidal space, and the understanding of its clinical applications is currently being greatly expanded. This opinion piece covers the advances in imaging techniques that enable the demonstration of the suprachoroidal space, and its implication in various retinal pathologies. It also reviews its potential uses as a route for drug delivery for the treatment of retinal diseases, and its use in innovative surgical techniques. Current research is leading the way for the suprachoroidal space to be an aspect of retinal disease diagnosis, monitoring, medical treatment, and surgical manipulation.

Introduction: The aim of the study was to evaluate functional and structural abnormalities in patients with acute central serous chorioretinopathy (CSC) with multifocal electroretinography (mfERG) and enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: This prospective observational study included 57 patients with unilateral CSC. Both eyes underwent mfERG and EDI-OCT. Peak amplitudes and implicit times of the first kernel responses were analyzed and compared with those of 25 age-matched normal controls. Correlational analyses were performed between the mfERG results and EDI-OCT parameters. Results: Compared with the normal controls, the amplitude and implicit time on mfERG were significantly impaired in the area with serous retinal detachment (SRD) and the area beyond the SRD. Eyes with a greater reduction in SRD had a less impaired mfERG response in fellow eyes than those whose retinal detachments were not spontaneously decreased by >90% after 3 months. Correlational analysis revealed that the subfoveal choroidal thickness was negatively correlated with the mfERG parameters. Conclusions: The findings of this study indicate diffuse functional impairment in acute CSC involving both eyes and areas beyond the SRD. The retinal response of the unaffected eye was associated with regression of SRD. Functional retinal abnormality was found to correlate with pathological changes in the choroid. [ABSTRACT FROM AUTHOR]

Copyright of MN Opthalmology / MN Oftalmoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract To provide information on the effects of phosphodiesterase type 5 (PDE5) inhibitors on choroidal vessels and central serous chorioretinopathy (CSC) and possible implications for development of exudative age-related macular degeneration (AMD). Two independent investigators conducted a qualitative review of PubMed to identify studies on the choroidal effect of PDE5 inhibitors in June 2019. The search used key words that included PDE5 inhibitors, sildenafil, tadalafil, vardenafil, choroid, choroidal flow, choroidal vessels, choroidal thickness, CSC, AMD or a combination. Only studies which assessed choroidal findings were included. Many ocular diseases are related to changes in choroidal thickness and perfusion. Patients with AMD, who have decreased choroidal perfusion, may manifest more severely diminished choroidal ability to deliver oxygen and other metabolites to the retina, leading to growth of neovascular tissue. As a result of this engorgement of the choroidal vasculature, some patients may have leakage across the retinal pigment epithelium (RPE) and accumulation of subretinal fluid, resulting in CSC. Transient visual symptoms, i.e., changes in color perception and increased light sensitivity, are well-known adverse effects, but there have been rare reports of vision-threatening ocular complications in users of PDE5 inhibitors, such as nonarteritic anterior ischemic optic neuropathy and cilioretinal artery occlusion. The choroid is a vascular tissue analogous in many respects to the corpus cavernosum, and PDE5 inhibitors may increase the choroidal thickness and perfusion. While it is intuitively obvious that thickness of the choroid alone does not guarantee better choriocapillaris oxygenation, it is a reasonable step towards ameliorating ischemia. These drugs have numerous physiologic effects on the choroid related to blood flow, such as clinical consequences in CSC and AMD.

Purpose: Technological development of optic coherence tomography has enabled a detailed assessment of the optic nerve and deeper structures and in vivo measurements. The aim of this study was to compare the lamina cribrosa morphology of the optic nerve in idiopathic intracranial hypertension (IIH) and healthy individuals. Methods: The lamina cribrosa morphology of optic nerve in 15 eyes with IIH and 17 eyes of healthy individuals were compared. Four parameters such as Bruch membrane opening (BMO), lamina cribrosa thickness (LCT), prelaminar tissue thickness (PTT), and anterior lamina cribrosa surface depth (ALCSD) were retrospectively evaluated. Results: By enhanced depth imaging-optic coherence tomography (EDI-OCT), PTT and BMO were found to be significantly greater (574,35 ± 169,20 μm and 1787,40 ± 140,87 μm, respectively) in IIH patients than healthy individuals (187,18 ± 132,15 μm and 1632,65 ± 162,58 μm, respectively), whereas ALSCD was found to be significantly less in IIH patients (234,49 ± 49,31 μm) than healthy individuals (425,65 ± 65,23 μm). There was not a statistically significant difference regarding LCT between the IIH patients (238,59 ± 17,31 μm) and healthy individuals (244,96 ± 15,32 μm). Conclusion: Increased intracranial pressure causes morphological changes in lamina cribrosa. Assessment of lamina cribrosa with EDI-OCT is important for diagnosis and follow-up of patients with IIH. EDI-OCT is objective, reproducible, and cost-effective assistive imaging tool in IIH patients.

Purpose: To investigate the retinal microvascular and choroidal thickness changes in eyes with active Behḉet's disease posterior uveitis and post-remission. Patients and methods: A prospective longitudinal observational analytic study where patients with active Behḉet's posterior uveitis (BU) were assessed by optical coherence tomography angiography (OCTA) and enhanced depth imaging OCT during activity and after remission, for retinal microvascular and subfoveal choroidal thickness (SFCT) changes. Results: 26 eyes of 20 patients were included. With remission of active posterior uveitis, capillary density in both layers increased, only being significant in the superficial capillary plexus (SCP) 1.81 ± 3.57% (p = 0.025), while the foveal avascular zone (FAZ) area increased by 0.036 ± 0.069 mm (p = 0.023). Conclusion: OCTA can be used to monitor the activity of Behḉet's posterior uveitis. Comparing the retinal microvascular changes during activity and after remission, the superficial capillary plexus was found to be more indicative of the activity status, while the deep capillary plexus and foveal avascular zone area—being more irreversible—are more useful as prognostic indicators. Subfoveal choroidal thickness, on the other hand, proved to be a consistent indictor of visual function; however, its change doesn't accurately reflect the activity status. [ABSTRACT FROM AUTHOR]

The cardinal diagnostic signs of neurofibromatosis type 1 (NF1) are Lisch nodules of the iris and optic pathway gliomas. Retinal mi-crovascular alterations have been described but with uncertain significance. Choroidal nodules, detectable with near-infrared reflectance (NIR) imaging, are present in most cases and have been proposed as a new diagnostic criterion. Recently, a study reported the presence of unusual dilated choroidal vessels, visible through NIR examination. We report a case of a 65-year-old patient with NF1. Best-corrected visual acuity was 20/20 with a refractive error of +2.75 diopters in both eyes. Anterior segment examination revealed Lisch nodules in both eyes. At NIR imaging the patient presented typical choroidal alterations in both eyes. No retinal vessel anomalies were detected. The patient presented enlarged choroidal vessels in the left eye, first detected by NIR and then analyzed through enhanced depth imaging spectral domain optical coherence tomography (EDI-SDOCT). These vessels extended from the choroidal-scleral junction to the outer border of the retinal pigment epithelium/Bruch's layer. The choriocapillaris layer was absent above the dilated vessels. The presence of enlarged choroidal vessels may be considered as a novel distinctive ophthalmologic aspect of NF1, but further studies are necessary. [ABSTRACT FROM AUTHOR]

Deep optic disc drusen (ODD) are located below Bruch’s membrane opening (BMO) and may go undetected due to the challenges in imaging them. The purpose of this study is a head-to-head comparison of currently widely used imaging technologies: swept-source optical coherence tomography (SS-OCT; DRI OCT-1 Triton, Topcon) and enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT; Spectralis OCT, Heidelberg Engineering) for the detection of deep ODD and associated imaging features. The eyes included in this study had undergone high-resolution imaging via both EDI SD-OCT and SS-OCT volume scans, which showed at least one deep ODD or a hyperreflective line (HL). Grading was performed by three graders in a masked fashion. The study findings are based on 46 B-scan stacks of 23 eyes including a total of 7981 scans. For scan images with ODD located above or below the level of BMO, no significant difference was found between the two modalities compared in this study. However, for HLs and other features, EDI SD-OCT scan images had better visualization and less artifacts. Although SS-OCT offers deep tissue visualization, it did not appear to offer any advantage in ODD detection over a dense volume scan via EDI SD-OCT with B-scan averaging.

Background: Diffuse choroidal hemangioma (DCH) is a benign vascular tumor that is characteristically found in the Sturge–Weber syndrome (SWS). Recent genetic discoveries demonstrate that DCH occurs sporadically from an activating mutation in GNAQ at codon R183. Mutations in GNAQ or GNA11 result in dysregulation of the mitogen-activated protein kinase, which influences gene transcription and results in cellular proliferation. DCH may not always be readily detected on routine ophthalmological examination, consequently diagnosis and multidisciplinary referral are often delayed. Purpose: A literature search was performed through April 2020 without a lower date limit. This review will summarize the pathogenesis, diagnosis and management of DCH. Discussion: Multimodal imaging facilitates early detection of the condition. In particular, enhanced depth imaging spectral domain optical coherence tomography enables non-invasive, high-resolution visualization of the choroid to even detect mild choroidal thickening. Management of symptomatic DCH is generally difficult and results in poor visual outcome, thus, treatment is generally unwarranted, unless the hemangioma complicated by serous retinal detachment. The main treatment method is radiation therapy with external beam radiation therapy, proton beam therapy, plaque brachytherapy, and gamma knife surgery where low doses of radiation entail fewer complications. One method of alternative management is with photodynamic therapy that, although less invasive with a lower rate of complications, is not always feasible or effective in cases with extensive exudative retinal detachment. Conclusions: Multimodal ophthalmological imaging facilitates diagnosis of DCH and lifelong surveillance is essential in patients. [ABSTRACT FROM AUTHOR]

Objective: To study the choroidal vascularity index (CVI) and choroidal thickness changes in primary open-angle glaucoma (POAG) compared to healthy control eyes with the enhanced depth imaging (EDI) modality of an optical coherence tomography (OCT). Methods: In this cross-sectional observational study, the CVI and the subfoveal choroidal thickness were assessed with EDI OCT and compared among 31 POAG cases and 25 healthy controls, which were age- and sex-matched. EDI OCT images were binarized into luminal area (LA) and stromal area. The CVI was defined as proportion of the luminal area to the total circumscribed choroidal area. The correlation between the visual field mean deviation (MD) value and choroidal parameters of the POAG cases were also evaluated. Results: The eyes with POAG had lower mean CVI compared to the control eyes (p<0.00001) while the mean choroidal thickness values were mostly similar (p=0.94). The CVI values of the POAG eyes had significant correlation with the visual field MD values (r=0.51, p=0.01), while choroidal thickness values of the POAG eyes did not demonstrate such an association with the visual field MD values (r=0.14, p=0.51). Conclusion: The lower CVI in POAG eyes compared to healthy controls and its significant correlation with the severity of glaucoma imply the role of choroidal vascularity in POAG pathogenesis. [ABSTRACT FROM AUTHOR]

Copyright of MN Opthalmology / MN Oftalmoloji is the property of Medical Network and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parash Gyawali, Ranju Kharel Sitaula, Anish Kharal, Asmita Bhusal, Manisha Paudel, Sagun Narayan Joshi BP Koirala Lions Centre for Ophthalmic Studies, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, NepalCorrespondence: Parash GyawaliBP Koirala Lions Centre for Ophthalmic Studies, Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, NepalTel +97 798 4006 9980Email parash.gyawali619@gmail.comPurpose: This study was conducted primarily to measure sub-foveal choroidal thickness (SFCT) in healthy Nepalese population. Also, the correlation of SFCT with age, inter-eye difference of SFCT, inter-gender variation and inter-ethnic variation of SFCT was observed.Materials and methods: A cross-sectional, hospital based study in 162 participants (324 eyes) of six ethnic groups (Brahmin, Chhetri, Newar, Tamang, Muslim, and Gurung) was conducted. The mean age of participants was 37.37 ± 15.02 years. All the participants underwent SFCT measurement using Spectral Domain Optical Coherence Tomography (Spectralis HRA+OCT, Heidelberg Engineering, Germany) with the help of in-built caliber. Age, inter-gender, inter-eye and inter-ethnic differences in SFCT were recorded and analyzed.Results: The average SFCT of right eye (RE) and left eye (LE) was 307.98 ± 74.64 μm and 312.63 ± 76.90 μm respectively, with average SFCT of 310.31 ± 75.70 μm for both eyes. SFCT of only the RE was selected for further calculation due to insignificant inter-eye difference of SFCT (p = 0.128). There was a significant negative correlation of SFCT with age (r = −0.705, p = 0.01). A regression analysis showed thinning of SFCT by 3.50 ± 0.278 μm per year. In another context, SFCT of male and female was 305.49 ± 79.72 μm and 313.55 ± 70.76 μm respectively. However, there was no significant inter-gender difference (p = 0.51). Similarly, inter-ethnic variations of SFCT was also statistically non -significant (p = 0.74).Conclusion: SFCT was negatively correlated with the age of participants, implying a decrease in choroidal thickness (CT) with an increase in age. Age can be considered as an important factor in the measurement of SFCT. Gender and ethnic groups did not have a significant role in the measurement and comparison of SFCT.Keywords: sub-foveal choroidal thickness, enhanced depth imaging, optical coherence tomography, OCT, spectral domain, SD

Arnaldo Dias-Santos,1–3 Joana Tavares Ferreira,1–3 Sofia Pinheiro,4 João Paulo Cunha,1,3 Marta Alves,5 Ana Luísa Papoila,3,5–6 Maria Francisca Moraes-Fontes,3,7–8 Rui Proença9,101Department of Ophthalmology, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 2Department of Ophthalmology, Hospital CUF Descobertas, Lisbon, Portugal; 3NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; 4Autoimmune Disease Unit, Unidade de Doenças Auto-imunes/serviço Medicina 3, Hospital de Santo António Dos Capuchos, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 5Epidemiology and Statistics Unit, Research Center, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 6CEAUL (Center of Statistics and Applications), Lisbon University, Lisbon, Portugal; 7Autoimmune Disease Unit, Unidade de Doenças Auto-imunes/serviço de Medicina 7.2, Hospital Curry Cabral, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal; 8Instituto Gulbenkian de Ciência, Oeiras, Portugal; 9Department of Ophthalmology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; 10Faculty of Medicine, University of Coimbra, Coimbra, PortugalCorrespondence: Arnaldo Dias-SantosServiço de Oftalmologia, Hospital de Santo António dos Capuchos, Alameda de Santo António dos Capuchos, Lisboa 1169-050, PortugalTel +351 21313 6492Email arnaldomiguelsantos@gmail.comPurpose: To compare choroidal thickness (CT) between patients with systemic lupus erythematosus (SLE) without ophthalmologic manifestations and a control group. To study the effects in CT of disease duration, activity index, medication and systemic comorbidities.Methods: Cross-sectional study where spectral-domain optical coherence tomography with enhanced depth imaging was used to measure CT in 13 locations, subfoveally and at 500-μm intervals along a horizontal and a vertical section from the fovea. Linear regression models were used.Results: Sixty-eight SLE patients and fifty healthy controls were enrolled. CT multivariable analysis revealed lower values in SLE patients (12.93–26.73 μm thinner) in all locations, except the inferior quadrants (6.48–10.44 μm thicker); however, none of these results reached statistical significance. Contrary to the control group, the normal topographic variation in CT between macular quadrants and from the center to the periphery was not observed in the SLE group. Multivariable analysis in the SLE group alone revealed a significant negative association with anticoagulants (50.10–56.09 μm thinner) and lupus nephritis (40.79–58.63 μm thinner). Contrary to controls, the CT of SLE patients did not respond to changes in mean arterial pressure.Conclusion: CT in SLE appears to be thinner, particularly in the subset of patients with nephritis and taking anticoagulants, suggesting more advanced systemic vascular disease. Choroidal responses to hemodynamic changes may also be altered in SLE.Keywords: choroidal thickness, enhanced depth imaging, spectral domain optical coherence tomography, systemic lupus erythematosus

Copyright of Türkiye Klinikleri Journal of Ophthalmology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To evaluate choroidal structural changes in patients with multiple evanescent white dot syndrome (MEWDS) during the acute and recovery stages.Methods: Enhanced-depth imaging optical coherence tomography (EDI-OCT) scans of 16 patients with unilateral MEWDS were acquired during the acute and recovery stages in both eyes. Images were binarized with the ImageJ software to measure subfoveal choroidal thickness (CT), total choroid area, luminal area and choroidal vascularity index (CVI).Results: In the acute stage, subfoveal CT, total choroidal area and CVI were significantly higher in eyes with MEWDS compared to fellow eyes (371.2 ± 101.8 vs 317.1 ± 90.3 µm, p = .001; 2.826 ± 0.686 vs 2.524 ± 0.674 mm2, p = .014; 69.49 ± 3.51 vs 68.27 ± 3.41%, p = .044, respectively). In the recovery stage, subfoveal CT, total choroidal area and CVI in eyes with MEWDS significantly decreased to respectively 333.4 ± 90.5 µm, p = .007, 2.592 ± 0.570 p = .002, and 67.31 ± 2.74%, p = .014.Conclusions: Choroidal thickness and vascularity are significantly increased during the acute stage of MEWDS. [ABSTRACT FROM AUTHOR]

To assess differences in healthy eyes in volume (CV) and choroidal thicknesses (CT) across all macular Early Treatment Diabetic Retinopathy Study (ETDRS) areas measured by swept source (SS)-OCT and spectral domain (SD)-OCT with enhanced depth imaging (EDI). One hundred and fifty healthy eyes were studied in patients aged between 21–68 years. All of these patients underwent an ophthalmic examination that included axial length (AL), a fast macula protocol with EDI by Spectralis SD-OCT, and a 3D macular cube by DRI-Triton SS-OCT. CT and CV values were measured after a manual segmentation with SD-OCT and automatically with SS-OCT. The values obtained by SD-OCT were statistically higher than the values obtained by SS-OCT in all ETDRS areas. To determine the differences that were related to total CV or AL, the eyes were divided depending on their total CV and AL values into two groups. There were persistent differences between the two devices that were not related to the total CV. In subjects with a higher AL, these differences were not present in either the total CV or the subfoveal CT. In longer eyes, the differences diminished, and there were no statistical differences between the devices in the subfoveal area, temporal quadrants, inferior inner ring, or CV. The choroidal values obtained with the SD-OCT are statistically higher than those measured by SS-OCT. Both techniques are able to clearly visualize the choroidoscleral interface and provide different values that are highly correlated. These differences are smaller in eyes with a longer AL and are not related to the total CV. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the change in subfoveal choroidal thickness (SFCT) in eyes that underwent pars plana vitrectomy (PPV) for idiopathic macular hole (IMH). Material and Methods: Eyes with unilateral IMH diagnosis and no other retinal pathology (Group 1) were included in this prospective and controlled study. The control group (Group 2) was formed with the healthy fellow eyes of the patients. PPV operation, inverted internal limiting membrane (ILM) fl ap technique and intraocular sulfur hexafl uoride (SF6) gas implantation were applied to eyes with IMH. SFCT was measured by optical coherence tomography with the enhanced depth imaging method in all eyes during the 6-month follow-up period at the fi rst, second, third and sixth months. Results: Sixty-four eyes of 32 patients were included in the study. The mean age of the patients was 67.3 years. The success rate in closing the macular hole was 93.75%. In the preoperative period, the mean SFCT in Group 1 (211.8 µm) was statistically significantly thinner than Group 2 (245.0 µm) (p <0.012), and this difference became more pronounced after PPV in the 6-month postoperative follow-up period (p <0.000) Conclusion: Choroidal thickness in eyes with IMH may be thinner than in healthy fellow eyes, and this thinness may deepen after macular surgery and gas endotamponade application. [ABSTRACT FROM AUTHOR]

Background: We compared with and without enhanced depth imaging mode (EDI) in semi-automated quantification of retinal and choroidal biomarkers in optical coherence tomography (OCT) in patients with diabetic retinopathy (DR) or retinal vein occlusion (RVO) complicated by macular edema. We chose to study three OCT biomarkers: the numbers of hyperreflective foci (HF), the ellipsoid zone reflectivity ratio (EZR) and the choroidal vascularity index (CVI), all known to be correlated with visual acuity changes or treatment outcomes. Methods: In a single examination, one eye of each patient (n = 60; diabetic retinopathy: n = 27, retinal vein occlusion: n = 33) underwent macular 870 nm spectral domain-OCT (SD-OCT) B-scans without and with EDI mode. Semi-automated quantification of HF, EZR and CVI was applied according to preexisting published protocols. Paired Student’s t-test or Wilcoxon rank-sum test was used to test for differences in subgroups. Intraclass correlation coefficient (ICC) and Bland–Altman plots were applied to describe the agreement between quantification in EDI and conventional OCT mode. The effect of macular edema on semi-automated quantification was evaluated. Results: For the entire cohort, quantification of all three biomarkers was not significantly different in SD-OCT scans with and without EDI mode (p > 0.05). ICC was 0.78, 0.90 and 0.80 for HF, EZR and CVI. The presence of macular edema led to significant differences in the quantification of hyperreflective foci (without EDI: 80.00 ± 33.70, with EDI: 92.08 ± 38.11; mean difference: 12.09, p = 0.03), but not in the quantification of EZR and CVI (p > 0.05). Conclusion: Quantification of EZR and CVI was comparable whether or not EDI mode was used. In conclusion, both retinal and choroidal biomarkers can be quantified from one single 870 nm SD-OCT EDI image.

We aimed to examine the choroidal changes in ocular toxoplasmosis with spectral domain optical coherence tomography using the enhanced depth-imaging mode. The clinical and laboratory data and spectral domain optical coherence tomography images of patients diagnosed with ocular toxoplasmosis and admitted to Dicle University, Department of Ophthalmology were analyzed retrospectively. The demographic properties such as best-corrected visual acuity intraocular pressure, biomicroscopic findings and dilated fundus examination were noted. The patients were categorized into three groups: active ocular toxoplasmosis, inactive ocular toxoplasmosis and healthy control groups. Enhanced depth-imaging coherence tomography images of both lesion area and subfoveal region were obtained in patients with active and inactive ocular toxoplasmosis, whereas only the enhanced depth-imaging coherence tomography images of subfoveal region were obtained in control group to measure choroidal thickness. A total of 54 subjects were evaluated including 20 individuals in the control group, 10 patients in active ocular toxoplasmosis group and 24 patients in inactive ocular toxoplasmosis group. No statistical significance was observed among the groups in terms of age, gender and intraocular pressure. Significant differences were noted in BCVA and SFCT among three groups. The mean ChT of the lesion area was significantly thicker in active ocular toxoplasmosis group than inactive ocular toxoplasmosis group (p=0.001). Monitoring of choroid is possible by EDI technique of spectral domain optical coherence tomography. This method is easily applicable and beneficial in the examining of ocular toxoplasmosis. Best-corrected visual acuity and the choroidal thickness in lesion area may vary according to activity. [Med-Science 2018; 7(3.000): 656-9]

Yuji Yoshikawa,1 Takuhei Shoji,1 Junji Kanno,1 Itaru Kimura,1 Masanori Hangai,2 Kei Shinoda1 1Department of Ophthalmology, Saitama Medical University, Saitama, Japan; 2Hangai Eye Institute, Saitama, Japan Purpose: To evaluate the ability of enhanced-depth imaging (EDI) optical coherence tomography angiography (OCTA) to detect vascular signals inside the glaucomatous optic disc.Patients and methods: Ten glaucomatous eyes of 8 subjects and 11 nonglaucomatous eyes of 7 subjects underwent EDI and conventional OCTA for optic disc analysis. The optic disc vessel density (VD) at maximum scan depth (2 mm) was compared between the 2 methods and between glaucomatous and nonglaucomatous eyes. Regression analysis was used to determine the factors affecting disc VD.Results: The median (25th, 75th percentile) of the visual field mean deviation was –20.5 (–25.1, –13.5) dB in glaucoma. The disc VD measured with the EDI method was significantly greater than that measured with the conventional method in glaucoma and nonglaucoma. The disc VD was also significantly lower in glaucoma than in nonglaucoma. The disc VD and mean deviation were significantly and positively correlated in both methods (conventional: R2=0.27, EDI: R2=0.22).Conclusion: The correlation between disc VD and glaucoma severity was comparable between conventional and EDI measurements. Images obtained with EDI-OCTA have the additional benefit of revealing more vascular signals in deeper layers. The disc VD, as determined by both conventional and EDI-OCTA methods, may be an indicator of glaucoma severity. Keywords: optical coherence tomography angiography, enhanced-depth imaging, vessel density, glaucoma severity, mean deviation

Objectives: To analyze optic nerve head images of pseudoexfoliative glaucoma (PXG) patients and healthy volunteers obtained with enhanced depth imaging spectral domain-optical coherence tomography (SD-OCT). Materials and Methods: Seventy patients with PXG and 68 age- and gender-matched healthy subjects were included in this prospective study. The prelaminar tissue and lamina cribrosa were imaged using spectralis OCT with the enhanced depth imaging technique. PXG disease stage was determined with visual field to evaluate relationships between prelaminar tissue thickness (PTT), lamina cribrosa thickness (LT) and disease severity. Results: There was no significant difference between the PXG group and control group with regard to age, gender, central corneal thickness, or axial length. The mean PTT (93.1±44.5 μm, p0.05), a statistically significant difference was detected between stages for LT (p

AIM: To compare choroidal thickness at the macula in eyes with unilateral idiopathic full-thickness macular holes(FTMH)with that of unaffected fellow eyes, and eyes of normal control patients.METHODS: Cross-sectional study. Thirty patients with unilateral idiopathic FTMH and thirty age, sex, and race-matched controls were recruited. Axial lengths were measured using laser interferometry. Enhanced depth imaging optical coherence tomography images were obtained using Heidelberg spectral-domain optical coherence tomography. Choroidal thickness was measured at the fovea, and at 1 mm and 2 mm nasally, temporally, superiorly and inferiorly from the center of the fovea. Statistical analysis was performed using independent and paired t-tests, chi-square tests, and Pearson correlation tests(PRESULTS: The mean subfoveal choroidal thickness was 201.0±44.0 μm in the FTMH group, 225.3±51.4 μm in the fellow eye group and 262.3±70.3 μm in the control group. The choroid was thinner in FTMH eyes at all locations when compared to control eyes(PPP>0.05). Choroidal thickness was generally highest subfoveally and lowest nasally. Subfoveal choroidal thickness was negatively correlated with age(r=-0.278, P=0.032), and axial length(r=-0.328, P=0.011).CONCLUSION: Choroidal thickness is lower in both eyes of patients with unilateral FTMH compared to healthy control eyes.

Purpose: The aim of this study was to determine whether choroidal thickness (CT) increases at the time of exudative recurrence in diabetic patients with unilateral diabetic macular oedema (DME) treated with intravitreal injections of anti‐VEGF or dexamethasone. Methods: A real‐life, prospective, two‐centre study was conducted over a 9‐month period investigating diabetic patients presenting with unilateral DME treated with anti‐VEGF or dexamethasone intravitreal injections, and CT was measured manually, using the enhanced depth imaging module of the spectral domain optical coherence tomography. Choroidal thickness (CT) was measured in the morning, in both the affected and healthy eye of each patient at two timepoints: when the macula was 'dry' (T0) and at the time of exudative recurrence (T1). Results: A total of 51 patients with unilateral DME were included. Mean CT in the affected eye was significantly thicker at the time of exudative recurrence (210.8 ± 44.1 μm at T0 versus 238.0 ± 49.0 μm at T1, p < 0.001). There was no significant variation in CT in the fellow eye (214.4 ± 52.3 µm at T0 versus 218.9 ± 53.4 µm at T1, p = 0.53). The type of intravitreal injection, the number of injections and the CT at T0 had no influence on the change in CT. Conclusion: This study found that CT increased significantly in the affected eye at the time of recurrence of DME treated with anti‐VEGF or dexamethasone injections. Choroidal thickness (CT) could constitute an interesting new indicator for monitoring patients with DME. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the changes in the choroidal structure in the setting of retinal vein occlusion (RVO). Methods: Changes in the structure of the choroid were studied in sixty-four eyes with unilateral central or branch RVO using optical coherence tomography (OCT) with enhanced depth imaging and OCT-angiography (OCT-A). Choroidal vascularity index (CVI), Haller layer/choroidal thickness (H/C) ratio, and choriocapillaris flow density were used to compare the structural characteristics of the choroid with fellow eyes and the eyes of thirty-four age-, gender-, and systemic co-morbidity–matched controls. Results: Eyes with RVO had a higher H/C ratio but a lower choriocapillaris flow density compared to both fellow and control eyes (p < 0.001). CVI was significantly lower in both eyes of the patients with RVO compared with control eyes (p < 0.05) with a more robust decrease in the eye that had developed RVO (p < 0.001). The H/C ratio (r = 0.303 p < 0.001), CVI (r = − 0.268, p = 0.001), and choriocapillaris flow density (r = − 0.237, p = 0.003) were all correlated with logMAR visual acuity, and other clinical features. Conclusion: Retinal vein occlusions alter the hemodynamic properties of the choroid leading to structural changes. These changes may be secondary to a compensatory mechanism to supply oxygen to hypoxic retina. [ABSTRACT FROM AUTHOR]

To provide information on the effects of phosphodiesterase type 5 (PDE5) inhibitors on choroidal vessels and central serous chorioretinopathy (CSC) and possible implications for development of exudative age-related macular degeneration (AMD). Two independent investigators conducted a qualitative review of PubMed to identify studies on the choroidal effect of PDE5 inhibitors in June 2019. The search used key words that included PDE5 inhibitors, sildenafil, tadalafil, vardenafil, choroid, choroidal flow, choroidal vessels, choroidal thickness, CSC, AMD or a combination. Only studies which assessed choroidal findings were included. Many ocular diseases are related to changes in choroidal thickness and perfusion. Patients with AMD, who have decreased choroidal perfusion, may manifest more severely diminished choroidal ability to deliver oxygen and other metabolites to the retina, leading to growth of neovascular tissue. As a result of this engorgement of the choroidal vasculature, some patients may have leakage across the retinal pigment epithelium (RPE) and accumulation of subretinal fluid, resulting in CSC. Transient visual symptoms, i.e., changes in color perception and increased light sensitivity, are well-known adverse effects, but there have been rare reports of vision-threatening ocular complications in users of PDE5 inhibitors, such as nonarteritic anterior ischemic optic neuropathy and cilioretinal artery occlusion. The choroid is a vascular tissue analogous in many respects to the corpus cavernosum, and PDE5 inhibitors may increase the choroidal thickness and perfusion. While it is intuitively obvious that thickness of the choroid alone does not guarantee better choriocapillaris oxygenation, it is a reasonable step towards ameliorating ischemia. These drugs have numerous physiologic effects on the choroid related to blood flow, such as clinical consequences in CSC and AMD. [ABSTRACT FROM AUTHOR]