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Purpose To investigate the correlation between choroidal biomarkers using enhanced depth imaging optical coherence tomography (EDI-OCT) and indocyanine green angiography (ICGA) scoring for monitoring the activity of Vogt–Koyanagi–Harada (VKH). Methods Patients who were not in the acute phase of VKH were recruited. Simultaneous EDI-OCT and ICGA were captured in seven patients only at baseline, in six patients at the 3-month follow-up, and in two patients at both the 6- and 9-month follow-ups. Subfoveal choroidal thickness (SFCT), subfoveal choroidal area (SFCA), and choroidal vascular index (CVI) were measured on EDI-OCT using FIJI software and a denoising system. ICGA scoring was performed. Results Fifteen subjects with the median of 4-month follow-up were recruited. Forty-eight pairs of EDI-OCT and ICGA were investigated. In univariate analysis, ICGA scores were positively associated with SFCT, and SFCA, but negatively with CVI. The strength of correlation between ICGA scores and SFCT was strong (correlation coefficient: 0.91). In multivariate analysis, only SFCT remained significant (B: 2.4, 95% confidence interval: 1.9–3.0; P < 0.001). Conclusions SFCT can be an acceptable representative of the subclinical inflammatory activity of VKH. As an alternative to ICGA, SFCT functions better than SFCA and CVI.

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.

AIM: To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal crosslinking. METHODS: This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal crosslinking. The choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d, 1, and 3mo. Choroidal thickness in the four cardinal quadrants and the fovea were evaluated. The choroidal vascularity index was also calculated. RESULTS: There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d, 1mo (P>0.05). There was a significant increase in the 3mo (P=0.034) and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d (P=0.014), there was no statistically significant change in vertical axes and other visits in horizontal sections (P>0.05). CONCLUSION: This study sheds light on choroidal changes in postoperative corneal crosslinking for keratoconus. While it suggests the procedure's relative safety for submacular choroid, more extensive research is necessary to confirm these findings and their clinical significance.

In recent years, ophthalmology, as one of the medical fields highly dependent on auxiliary imaging, has been at the forefront of the application of deep learning algorithm. The morphological changes of the choroid are closely related to the occurrence, development, treatment and prognosis of fundus diseases. The rapid development of optical coherence tomography has greatly promoted the accurate analysis of choroidal morphology and structure. Choroidal segmentation and related analysis are crucial for determining the pathogenesis and treatment strategies of eye diseases. However, currently, choroidal mainly relies on tedious, time-consuming, and low-reproducibility manual segmentation. To overcome these difficulties, deep learning methods for choroidal segmentation have been developed in recent years, greatly improving the accuracy and efficiency of choroidal segmentation. The purpose of this paper is to review the features of choroidal thickness in different eye diseases, explore the latest applications and advantages of deep learning models in measuring choroidal thickness, and focus on the challenges faced by deep learning models.

This prospective study aimed to evaluate the impact of Visian Implantable Collamer Lens (ICL) V4c implantation on retinal and choroidal morphology in patients with high myopia. A total of 97 eyes from 52 high myopic patients who underwent ICL V4c implantation were followed up for 12 months. Preoperative and postoperative evaluations included comprehensive ophthalmic assessments and enhanced depth imaging optical coherence tomography (EDI-OCT) to analyze changes in central retinal thickness (CRT), retinal volume (CRV), choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), and choroidal vascular index (CVI). Repeated measures mixed-effects models were used for comparing pre- and postoperative measurement variables and exploring relationships among age, axial length (AL), spherical equivalent refraction (SER), and postoperative retinal and choroidal changes, with statistical significance set at p < 0.05. Follow-up assessments were conducted at various time points, with participation rates ranging from 21% to 98%. Baseline characteristics showed a median age of 26.7 years, −10.14 diopters of SER, and an AL of 27.44 mm. Throughout the 12-month follow-up, CRT and 3.0 mm CRV consistently increased compared to the baseline, with statistically significant rises observed at postoperative day 1, week 1, and month 12. Most ChT measurements, including subfoveal ChT, declined over the 12 months, except at postoperative 6 months. Horizontal and vertical TCA and LA values significantly increased throughout the follow-up, except for month 6. After surgery, both horizontal and vertical CVI parameters exhibited an increase compared to the baseline, with some changes reaching statistical significance. Correlation analysis performed by repeated measures mixed-effects models showed that no relationship was found between age, AL, and SER and changes in postoperative retinal parameters and CVI parameters. However, postoperative changes in ChT and choroidal area parameters showed a negative correlation with AL and a positive correlation with SER. Our research demonstrated that ICL V4c implantation resulted in noteworthy alterations in retinal and choroidal morphology over a 1-year follow-up period. Moreover, in patients with high myopia, individuals with longer AL and higher degrees of myopia exhibited more pronounced postoperative changes in the choroid and retina. Further studies with extended follow-up durations are necessary to comprehensively understand the long-term effects of ICL implantation on retinal and choroidal morphology and function. [ABSTRACT FROM AUTHOR]

AIM: To investigate the changes in peripapillary choroidal thickness(pCT)within 1a of the first episode of acute primary angle closure glaucoma(APACG).METHODS: A prospective cohort study. A total of 31 patients with APACG who admitted to the ophthalmology department of Shijiazhuang People's Hospital from October 2015 to September 2019 were selected, with 31 eyes in attack group, 31 fellow eyes in preclinical group and 30 cases(30 eyes)in control group. pCT of the three groups was measured respectively at the attack period, 1wk, 1, 3, 6mo and 1a after surgery.RESULTS: The pCT of the attack group was thicker than that in the attack period when at 1wk after surgery, and continued to become thinner within the following 1a(P

The literature review presents the results of optical coherence tomography and optical coherence tomography — angiography used for Graves’ orbitopathy. The data on the thickness of the inner layers of the retina, microcirculation in the peripapillary and macular regions, parameters of the choroid, lamina cribrosa and extraocular muscles were analyzed as possible diagnostic criteria of the condition.

AIM: To characterize spectral-domain optical coherence tomography (SD-OCT) features of chorioretinal folds in orbital mass imaged using enhanced depth imaging (EDI). METHODS: Prospective observational case-control study was conducted in 20 eyes of 20 patients, the uninvolved eye served as a control. All the patients underwent clinical fundus photography, computed tomography, EDI SD-OCT imaging before and after surgery. Two patients with cavernous hemangiomas underwent intratumoral injection of bleomycin A5; the remaining patients underwent tumor excision. Patients were followed 1 to 14mo following surgery (average follow up, 5.8mo). RESULTS: Visual acuity prior to surgery ranged from 20/20 to 20/200. Following surgery, 5 patients' visual acuity remained unchanged while the remaining 15 patients had a mean letter improvement of 10 (range 4 to 26 letters). Photoreceptor inner/outer segment defects were found in 10 of 15 patients prior to surgery. Following surgical excision, photoreceptor inner/outer segment defects fully resolved in 8 of these 10 patients. CONCLUSION: Persistence of photoreceptor inner/outer segment defects caused by compression of the globe by an orbital mass can be associated with reduced visual prognosis. Our findings suggest that photoreceptor inner/outer segment defects on EDI SD-OCT could be an indicator for immediate surgical excision of an orbital mass causing choroidal compression.

Purpose: To quantify the structural changes in choroidal vessels and to observe choroid microstructural changes in different age and sex groups in a healthy Chinese population. Methods: Enhanced depth imaging optical coherence tomography (EDI-OCT) was employed to analyze the luminal area, stromal area, total choroidal area, subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), large choroidal vessel layer (LCVL), choriocapillaris–medium choroidal vessel layer, and LCVL/SFCT of the choroid in the subfoveal macular area within 1500 μm of the macula. We analyzed the age- and sex-related changes in the subfoveal choroidal structure. Results: A total of 1566 eyes from 1566 healthy individuals were included. The mean age of the participants was 43.62 ± 23.29 years, the mean SFCT of healthy individuals was 269.30 ± 66.43 μm, LCVL/SFCT percentage was 77.21 ± 5.84%, and the mean macular CVI was 68.39 ± 3.15%. CVI was maximum in the 0–10 years group, decreasing with age, and the lowest values occurred in the >80 years group; LCVL/SFCT was the lowest in the 0–10 years group, increasing with age and reaching a maximum in the >80 years group. CVI showed a significant negative correlation with age, and LCVL/SFCT showed a significant positive correlation with age. There was no statistically significant difference between males and females. Interrater and intrarater reliability was less variable with CVI than with SFCT. Conclusions: The choroidal vascular area and CVI decreased with age in the healthy Chinese population, of which the age-related decrease in vascular components maybe dominated by the decrease in choriocapillaris and medium choroidal vessels. Sex had no effect on CVI. The CVI of healthy populations showed better consistency and reproducibility when compared with SFCT. [ABSTRACT FROM AUTHOR]

Purpose: To assess choroidal structural changes in diabetic patients in association with disease duration, HbA1c level, and presence of retinopathy. Methods: This retrospective cross-sectional study included treatment-naive patients with non-proliferative DR (NPDR) (group 1), diabetic patients without DR (group 2), and healthy subjects (group 3). Patients were also grouped according to the duration of diabetes: long-term group (> 15 years, n = 32) and short-term group (˂ 15 years, n = 28). The choroidal thickness was measured at three points; subfoveal, 1500 μm nasal, and 1500 μm temporal to the fovea. The choroidal area, stromal area, luminal area (LA), and choroidal vascularity index (CVI) were quantified using ImageJ. Partial correlation analysis and one-way analysis of covariance test were performed for statistical analysis. Results: The study included 30 eyes of 30 treatment-naive patients with NPDR (group 1), 30 eyes of 30 diabetic patients without DR (group 2), and 30 eyes of 30 healthy persons (group 3). The mean subfoveal, nasal, and temporal choroidal thicknesses were decreased in group 1 in comparison with controls (p < 0.001, p = 0.035, and p = 0.005, respectively). The mean LA in group 1 and group 2 were both significantly lower compared to group 3 (group 1 vs. group 3, p = 0.004; group 2 vs. group 3, p = 0.020). CVI was significantly lower in group 1 and group 2 than in controls (group 1 vs. group 3, p = 0.019; group 2 vs. group 3, p = 0.025). CVI was significantly lower in the long-duration group than in the short-duration group (p < 0.001). A moderate negative correlation was found between the duration of diabetes and CVI (r = − 0.467, p < 0.001). A moderate negative correlation was found between HbA1c level and luminal area and CVI (r = − 0.466, p < 0.001, and r = − 0.425, p < 0.001, respectively). Conclusion: Choroidal structure and CVI are altered even in the absence of clinically confirmed retinopathy and these alterations are related to the duration of diabetes. [ABSTRACT FROM AUTHOR]

This prospective study aimed to evaluate the impact of Visian Implantable Collamer Lens (ICL) V4c implantation on retinal and choroidal morphology in patients with high myopia. A total of 97 eyes from 52 high myopic patients who underwent ICL V4c implantation were followed up for 12 months. Preoperative and postoperative evaluations included comprehensive ophthalmic assessments and enhanced depth imaging optical coherence tomography (EDI-OCT) to analyze changes in central retinal thickness (CRT), retinal volume (CRV), choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), and choroidal vascular index (CVI). Repeated measures mixed-effects models were used for comparing pre- and postoperative measurement variables and exploring relationships among age, axial length (AL), spherical equivalent refraction (SER), and postoperative retinal and choroidal changes, with statistical significance set at p < 0.05. Follow-up assessments were conducted at various time points, with participation rates ranging from 21% to 98%. Baseline characteristics showed a median age of 26.7 years, −10.14 diopters of SER, and an AL of 27.44 mm. Throughout the 12-month follow-up, CRT and 3.0 mm CRV consistently increased compared to the baseline, with statistically significant rises observed at postoperative day 1, week 1, and month 12. Most ChT measurements, including subfoveal ChT, declined over the 12 months, except at postoperative 6 months. Horizontal and vertical TCA and LA values significantly increased throughout the follow-up, except for month 6. After surgery, both horizontal and vertical CVI parameters exhibited an increase compared to the baseline, with some changes reaching statistical significance. Correlation analysis performed by repeated measures mixed-effects models showed that no relationship was found between age, AL, and SER and changes in postoperative retinal parameters and CVI parameters. However, postoperative changes in ChT and choroidal area parameters showed a negative correlation with AL and a positive correlation with SER. Our research demonstrated that ICL V4c implantation resulted in noteworthy alterations in retinal and choroidal morphology over a 1-year follow-up period. Moreover, in patients with high myopia, individuals with longer AL and higher degrees of myopia exhibited more pronounced postoperative changes in the choroid and retina. Further studies with extended follow-up durations are necessary to comprehensively understand the long-term effects of ICL implantation on retinal and choroidal morphology and function.

Purpose: To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age-matched healthy subjects. Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length-matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single-line horizontal-raster enhanced depth imaging – optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann–Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant. Results: The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from −8.5D to +10.5D in the OA group and from −8.0D to +10.0D in the control group. The mean axial length between the two groups (P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 μm; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 μm; P < 0.001) was significantly thinner in the OA group. Conclusion: Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism.

Choroidal cavitations may be rarely observed in choroidal nevi. Enhanced depth imaging optical coherence tomography is a useful tool for the detection and follow-up of these lesions. Purpose: To describe a case of choroidal nevus with intralesional cavitations detected with enhanced depth imaging optical coherence tomography and to show its changes during an 8-year follow-up. Methods: A case report. Results: A 55-year-old male patient was found to have a pigmented lesion at the posterior pole of his right eye, just temporal to the fovea. A complete multiimaging examination was obtained and showed a lesion of about 4 mm of diameter with a small amount of subretinal fluid and chronic changes in the retina overlying the lesion. Based on clinical examination, a diagnosis of choroidal nevus was made, but interestingly the enhanced depth imaging optical coherence tomography revealed the presence of intralesional cavitations. Close follow-up with no intervention was planned, and over 8 years of observation, the lesion remained stable in size, with a gradual increase of the central necrosis. Conclusion: Benign pigmented choroidal lesions can show internal cavitations likely secondary to internal necrosis. This feature does not represent a sign of malignancy of the lesion. Enhanced depth imaging optical coherence tomography is a feasible imaging tool for the visualization of the internal cavitations and to follow their evolution over time. [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 Praxis of Otorhinolaryngology / Kulak Burun Boğaz Uygulamaları is the property of Official Journal of ENT-HNS Society of Istanbul 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 study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age-matched healthy subjects.Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length-matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single-line horizontal-raster enhanced depth imaging - optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann-Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant.Results: The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from -8.5D to +10.5D in the OA group and from -8.0D to +10.0D in the control group. The mean axial length between the two groups (P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 μm; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 μm; P < 0.001) was significantly thinner in the OA group.Conclusion: Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism. [ABSTRACT FROM AUTHOR]

This prospective comparative case series aims to compare best-corrected visual acuity (BCVA), retinal microvasculature, and retinal structural changes in patients treated with either ranibizumab or aflibercept for macular edema (ME) secondary to treatment-naïve branch retinal vein occlusion (BRVO) by optical coherence tomography angiography (OCTA). Ten patients were enrolled with macular capillary density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and foveal avascular zone (FAZ) measured in both eyes before and after treatment. Final central retinal thickness and BCVA improved significantly (p < 0.05), and densities of SCP and DCP of BRVO sectors were significantly lower at baseline than fellow eye counterparts and remained persistently lower during treatment, particularly in the aflibercept group (p < 0.05). SCP density, DCP density of both BRVO sectors (p = 0.0001, p < 0.0001), and non-BRVO sectors (p < 0.0001, p < 0.0001) were significantly correlated with final BCVA for diseased eyes. Using multivariate general linear model analysis, and including OCTA parameters only, but not all of the available clinical data, DCP density of BRVO sectors in both eyes was the most predictive factor for final visual outcome (probability p < 0.0001). OCTA offered further qualitative and quantitative evaluation of treatment-naïve BRVO. Judging by OCTA parameters, not only in the diseased eye but also in the fellow eye, DCP density of BRVO sectors was the most predictive factor of final visual outcome. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of the Valsalva manoeuvre (VM) on the choroidal vascularity index (CVI) in healthy volunteers. Methods: This prospective, cross‐sectional study included 60 eyes of 30 healthy volunteers. Enhanced depth imaging‐optical coherence tomography scans of both eyes involving the fovea were taken, and a 1500 μm subfoveal choroidal area was selected for image binarization with open‐access Fiji software. The binarized image was segmented into the stromal area (SA) and luminal area (LA), and CVI was calculated as the ratio (%) of LA to the total choroidal area (TCA). CVI, subfoveal choroidal thickness (SFCT), IOP, systolic and diastolic blood pressure were evaluated at rest and during the VM. Results: During the VM, a mean ± standard deviation increase in LA (0.02 ± 0.05 mm2, p < 0.001) and CVI (1.72 ± 2.83%, p < 0.001) was observed, whereas SA (−0.02 ± 0.05 mm2, p < 0.001) decreased. There was no significant change in TCA (0.00 ± 0.03 mm2, p = 0.55) or SFCT (1.05 ± 10.92 μm, p = 0.46). There was a moderate positive correlation between the spherical equivalent refractive error (SE) and SFCT both at rest and during VM (r58 = 0.49, p < 0.0005 and r58 = 0.49, p < 0.0005, respectively). However, there was no significant correlation between SE and CVI either at rest or during VM (p = 0.11 and 0.06, respectively). In a multiple linear regression analysis, CVI was only associated with SFCT; however, SFCT was also associated with SE, both at rest and during VM (p < 0.001). Conclusion: Valsalva manoeuvre increases CVI by choroidal vascular dilation as demonstrated by an increase in LA and a decrease in SA. Researchers should be careful about unintentional VM during examinations. [ABSTRACT FROM AUTHOR]

Ece Turan-Vural,1 Unsal Vural2 1Ophthalmology Clinic, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey; 2Cardiovascular Surgery Clinic, Siyami Ersek Training and Research Hospital, Istanbul, TurkeyCorrespondence: Ece Turan-VuralHaydarpasa Egitim ve Arastırma Hastanesi Tibbiye Caddesi, Göz Klinigi No: 40, Uskudar/Istanbul 34668, TurkeyTel +90 505 400 46 28Fax +90 216 337 78 77Email dreceturan76@gmail.comObjective: In this study, it aims to investigate the effect of asymptomatic carotid artery stenosis on peripapillary and subfoveal choroid thickness using enhanced depth imaging optical coherence tomography.Patients and Methods: While investigating for coronary artery disease, 76 patients with asymptomatic carotid artery stenosis and 35 patients with normal carotid artery (total = 111) were evaluated. Patients according to the degree of stenosis were divided into four categories as non-stenosis (n = 35), mild (n = 26), moderate (n = 27) and severe stenosis (n = 23). Subfoveal and peripapillary choroid thickness, ocular perfusion and intraocular pressures of all patients were measured using a Fourier-domain optical coherence tomography after general ophthalmological examination. In addition, hypertension, hyperlipidemia, and whether there is a relationship between smoking status and choroid thickness was compared.Results: As the degree of carotid artery stenosis increased, subfoveal and peripapillary choroidal thickness decreased significantly. However, no changes were detected in ocular perfusion and intraocular pressure values (p=0.935, p=0.519). Decrease in peripapillary and subfoveal choroid thickness values was found to be particularly between the group with severe stenosis and the group with control and mild stenosis (p = 0.003, p = 0.001). In addition, as the degree of carotid stenosis increased in patients with hypertension and smoking, peripapillary choroid thickness was found to be thinner (p=0.003).Conclusion: We believe that the possibility of carotid artery stenosis should be considered in cases with decreased choroid thickness. In addition, we think that even if it is asymptomatic, in cases with severe carotid stenosis, in the presence of choroidal thinning, a chance of surgical intervention should be given to the stenosis.Keywords: carotid artery stenosis, subfoveal choroid thickness, peripapillary choroid thickness, enhanced depth imaging optical coherence tomography

INTRODUCTION[|]To evaluate the relationships between macular choroidal thickness (mCT) and ocular parameters, such as optic nerve head (ONH) and multifocal electroretinogram (mf-ERG) parameters, in cases with primary open-angle glaucoma (POAG).[¤]METHODS[|]This controlled and prospective clinical trial included 49 patients with POAG diagnosed for the fırst time and 47 healthy participants. Macular CTs, ONH and mf-ERG parameters were measured, and the examination findings were recorded at baseline and follow-ups.[¤]RESULTS[|]In the POAG group, the mean mCT was 254.92+-37.65 μm at baseline, and it was 235.6+-38.48 μm at 3-month and was 237.55+-37.27 μm at 6-month. In the glaucoma group, there was a significant decrease in the first three months despite the treatment, but no significant change was observed in the next three months. In the healthy group, the mean mCTs were 287.78+-26.77 μm, 285.48+-25.58 μm and 285.02+-27.44 μm at baseline, at 3-month and at 6-month, respectively. No significant change was observed in the control group throughout the process. However, the mean mCT values in the glaucoma group were significantly thinner in all controls compared to the healthy group (p

Aim: To investigate changes in choroidal thickness and vascularity in keratoconus patients treated with corneal crosslinking., Methods: This study evaluated 28 eyes of 22 patients with keratoconus who underwent corneal crosslinking. The choroidal thicknesses were evaluated on enhanced depth imaging optical coherence tomography at the preoperative and postoperative 3d, 1, and 3mo. Choroidal thickness in the four cardinal quadrants and the fovea were evaluated. The choroidal vascularity index was also calculated., Results: There was no significant difference in central choroidal thickness between the preoperative and postoperative 3d, 1mo ( P >0.05). There was a significant increase in the 3mo ( P =0.034) and a significant decrease in the horizontal choroidal vascularity index on the postoperative 3d ( P =0.014), there was no statistically significant change in vertical axes and other visits in horizontal sections ( P >0.05)., Conclusion: This study sheds light on choroidal changes in postoperative corneal crosslinking for keratoconus. While it suggests the procedure's relative safety for submacular choroid, more extensive research is necessary to confirm these findings and their clinical significance., Competing Interests: Conflicts of Interest: Doganay S, None; Kiristioglu MO, None; Doganay D, None; Kacmaz E, None., (International Journal of Ophthalmology Press.)

Objectives: This study was performed to assess and analyze the retinal and choroidal thickness in amblyopic eyes using spectral-domain optical coherence tomography and enhanced depth imaging optical coherence tomography. Methods: A total of 67 children with amblyopia and 31 age- and gender-matched healthy non-amblyopic control subjects were enrolled in the study. The 67 amblyopic children were divided into 3 groups: hypermetropic amblyopia (Group 1). microesotropia (Group 2). and myopic anisometropia (Group 3). All of the participants underwent a detailed ophthalmologic examination and orthoptic assessment. The subfoveal choroidal thickness was measured at 500-. 750-. 1000-. and 15000-micron intervals nasally and temporally. Central macular thickness was also measured in the subfoveal. parafoveal inferior. parafoveal superior. parafoveal nasal. and parafoveal temporal superior. inferior. nasal. and temporal quadrants. All of the parameters of the amblyopic eyes. fellow eyes. and control eyes were compared. Results: In all. 34 female and 33 male patients were studied. The mean age was 8.6±2.8 years (range: 5-12 years). Comparison of the choroidal thickness and macular thickness measurements between the amblyopic and non-amblyopic eye of the same patient within each group revealed no statistically significant differences. Comparison of the findings in the amblyopic eyes of Group 1 and Group 3 with the control group revealed that the choroidal thickness measurements were smaller in the amblyopic eyes in all quadrants. however. only the nasal quadrant measurements demonstrated a statistical significance. The subfoveal macular thickness value was also smaller in both groups when compared with the control eyes. Conclusion: Our results indicated that amblyopia. whether anisometropic or microtropic. did not seem to significantly affect choroidal thickness. [ABSTRACT FROM AUTHOR]

INTRODUCTION[|]The aim of this study was to evaluate the macular choroidal thickness (CT) in patients with ocular hypertension (OHT) using spectral domain optical coherence tomography (SD-OCT) and compare the results with healthy individuals.[¤]METHODS[|]Thirty eyes of 30 patients newly diagnosed with OHT and 24 eyes of 24 healthy controls were included in this cross-sectional study. After a detailed ophthalmological examination, macular CT was measured with enhanced depth imaging optical coherence tomography (EDI-OCT) (Cirrus HD-OCT, Carl Zeiss Meditec AG, Jena, Germany) at the fovea and at positions 500 µ, 1000 µ, 1500 µ nasal and temporal to the fovea. The Mann-Whitney U test was used to compare the CT measurements between groups. The correlation between the mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness (RNFL) and CT was evaluated with the Spearman correlation coefficient. Statistical significance was accepted as p

Purpose: The aim of this study was to assess the correlation of hemoglobin A1c (HbA1c) levels with choroidal thickness in patients with type 2 diabetes mellitus (DM) using spectral domain optical coherence tomography (SD-OCT). Methods: In this prospective case series, 180 eyes from 90 patients with type 2 DM were classified into three study groups based on HbA1c values: group 1 included patients with good glycemic control (HbA1c ≤ 7%), group 2 included patients with moderate glycemic control (HbA1c between 7% and 8%), and group 3 included patients with poor glycemic control (HbA1c ≥ 8%). Additionally, 50 eyes from 25 non-diabetic subjects were enrolled to group 4 as a control group. Sub-foveal, nasal, and temporal choroidal thickness were measured and compared. Results: Mean central, nasal, and temporal choroidal thicknesses in diabetic patients (247.80, 238.63, and 239.30 μ m) were significantly less than non-diabetic healthy subjects (277.56, 262.92, and 266.32 μ m). Additionally, mean central, nasal, and temporal choroidal thickness values in group 4 (277.56, 262.92, and 266.32 μ m) were significantly greater than the corresponding values in group 2 (248.34, 237.55, and 236.45 μ m) and group 3 (239.81, 234.62, and 233.94 μ m), but was not significantly different from corresponding values in group 1 (259.46, 246.12, and 251.00 μ m). Conclusion: HbA1c values have a significant correlation with choroidal thickness in diabetic patients, and better glycemic control with HbA1c ≤ 7% may prevent choroidal thinning.

Abstract Background The involvement of choroidal lesions in acute macular neuroretinopathy (AMN) is not yet fully understood. We quantitatively examined sequential changes in the morphology and circulation hemodynamics of the choroid using enhanced depth imaging optical coherence tomography (EDI-OCT) and laser speckle flowgraphy (LSFG) in a patient with AMN. Case presentation A 15-year-old boy was referred to our hospital due to AMN in his right eye alone. The next day AMN developed in his left eye. Three months later, AMN lesions in both eyes spontaneously resolved and the morphology of macular photoreceptors improved. Using EDI-OCT, central choroidal thickness (CCT) was examined for a period of three months, starting from the initial visit. Using LSFG, macular mean blur rate (MBR) was examined for three months, starting 1 week after the initial visit. At the first visit, CCT of the right eye with AMN was 82 μm higher than that of the left eye, which had not yet developed AMN, and decreased by 86 μm after three months. In the left eye, similarly, CCT increased by 16 μm after the AMN onset at 1 week compared with a pre-onset value at the first visit and thereafter decreased by 57 μm at 3 months. Macular MBR increased by 20–55% OD and 51–71% OS during the follow-up until 3 months. Conclusions We found that the choroid at the macula thickened at the onset of AMN and became thin with the regression of disease. Therefore, in concert with MBR data, these results further strengthened our hypothesis that choroidal circulation impairment plays a role in the pathogenesis of AMN.

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Optic neuritis (ON) is common clinical manifestation of MS. Spectral domain optical coherence tomography (SD-OCT) has been used as a useful tool to quantify the neuronal damage in the eyes of MS patients. The study aimed to evaluate the lamina cribrosa thickness (LCT) and lamina cribrosa depth (LCD) in patients with MS and their relationship with Expanded Disability Status Scale (EDSS) score. Fifty-two eyes of 26 relapsing-remitting MS patients and 39 eyes of 39 healthy age- and sex- matched participants were evaluated in this prospective, cross-sectional, observational study. There were two MS subgroups: 38 MS eyes without an ON history (MS−ON), and 14 MS eyes with an ON history (MS+ON). The LCT and LCD were measured with SD-OCT. Of the 26 participants with MS, 14 (53.8%) were female and the mean (SD) age was 35.1 (6.2) years; of the 39 healthy controls, 26 (66.7%) were female and the mean (SD) age was 36.7 (8.2) years (P=0.19 for sex and P=0.27 for age). The mean LCT was not significantly different between MS patients and healthy controls (272.66 ± 33.52 μm and 272.58 ± 35.97 μm, respectively, P=0.992). The mean LCD was 325.15 ± 67.07 μm for the MS+ON group, 409.71 ± 93.18 μm for the MS−ON group, and 427.64 ± 91.65 μm for the healthy control group. The LCD was significantly decreased in MS+ON group compared to MS−ON group (P=0.011) and healthy controls (P=0.002). EDSS score was negatively correlated with LCD in MS patients (r= -0.313, P=0.025). This study revealed decreased LCD in MS eyes particularly with optic neuritis, and its relationship with increased disease severity. Additional longitudinal studies are needed to confirm the use of LCD as an imaging biomarker in patients with MS. [Med-Science 2018; 7(4.000): 867-72]

Background: Choroidal metastasis represents the most common malignant intraocular tumours. Objectives: The objective of this study is to detect the structural and vascular features of choroidal metastasis by multimodal imaging. Methods: Sixteen eyes of 16 patients with choroidal metastasis were enrolled in this prospective study. The multimodal imaging was performed in all patients: fluorescein angiography, indocyanine green angiography, enhanced depth imaging optical coherence tomography (EDI-OCT), OCT angiography (OCTA), and ultrasonography. Results: The choroidal metastasis was located in the macula region in 9 eyes (57%) and in the extramacular region in 7 eyes (43%). EDI-OCT showed a mean thickness of 950 ± 246 µm, a smooth anterior tumour surface in 5 eyes (31%), and a lumpy bumpy appearance in 11 eyes (69%). The most frequent EDI-OCT features were represented by choriocapillaris thinning (100%), shaggy photoreceptors (82%), subretinal fluid with speckles (69%), subretinal lipofuscin pigment (6%), absence of drusen (100%), optical shadowing (94%), low-internal optical reflectivity (75%), and retinal pigment epithelium alterations (43%). OCTA revealed an absence of intratumoral vascular network in all cases. Conclusions: The multimodal imaging contributed to greater insights into the anatomical and vascular features of choroidal metastasis. It allows for the collection of useful information to establish an appropriate diagnosis and follow-up. [ABSTRACT FROM AUTHOR]

This prospective comparative case series aims to compare best-corrected visual acuity (BCVA), retinal microvasculature, and retinal structural changes in patients treated with either ranibizumab or aflibercept for macular edema (ME) secondary to treatment-naïve branch retinal vein occlusion (BRVO) by optical coherence tomography angiography (OCTA). Ten patients were enrolled with macular capillary density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and foveal avascular zone (FAZ) measured in both eyes before and after treatment. Final central retinal thickness and BCVA improved significantly (p < 0.05), and densities of SCP and DCP of BRVO sectors were significantly lower at baseline than fellow eye counterparts and remained persistently lower during treatment, particularly in the aflibercept group (p < 0.05). SCP density, DCP density of both BRVO sectors (p = 0.0001, p < 0.0001), and non-BRVO sectors (p < 0.0001, p < 0.0001) were significantly correlated with final BCVA for diseased eyes. Using multivariate general linear model analysis, and including OCTA parameters only, but not all of the available clinical data, DCP density of BRVO sectors in both eyes was the most predictive factor for final visual outcome (probability p < 0.0001). OCTA offered further qualitative and quantitative evaluation of treatment-naïve BRVO. Judging by OCTA parameters, not only in the diseased eye but also in the fellow eye, DCP density of BRVO sectors was the most predictive factor of final visual outcome.

Purpose: To evaluate the relationship between coronary artery calcification and subfoveal thicknesses of individual chorioretinal layers in subjects with subclinical atherosclerosis by using enhanced-depth imaging optical coherence tomography. Methods: In this retrospective, noninterventional, cross-sectional study, we included 193 eyes from 193 subjects and divided them into three cardiovascular (CV) risk groups based on coronary artery calcification (CAC) scores calculated from cardiac-gated computed tomography: low (CAC = 0; n = 77), intermediate (CAC = 1–300; n = 83), and high (CAC >300; n = 33). Central macula individual retinal layer thicknesses and subfoveal choroidal thickness were measured and compared among groups. Multivariate linear regression was used to evaluate associations of subfoveal choroidal thickness or central retinal thickness with CAC scores. Results: Average subfoveal choroidal thickness differed significantly among low, intermediate, and high CV risk groups (all p < 0.05). There were no statistically significant changes in segmented retinal layer thickness of the central macula. Multivariate regression analyses showed that higher CAC scores were significantly negatively associated with subfoveal choroidal thickness (β = –2.169, p < 0.001). Conclusions: Higher CAC scores were significantly associated with subfoveal choroidal thinning in subjects with subclinical atherosclerosis. Prominent reductions in the subfoveal choroidal layer could provide a useful biomarker for predicting CV risk in patients of advanced age with subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]

The choroid is one of the most vascularized tissues in the body, responsible for over 70% of the blood flow in the eye. Choroid status seems to be a decisive factor in the pathogenesis of diseases such as age-related macular degeneration, central serous retinopathy, degenerative myopia, retinal vasculitis and some neoplastic diseases. However, traditional imaging methods, including indocyanine green angiography, ultrasound and optical coherence tomography (OCT), do not allow for the exact visualization of its structure. Until recently, the knowledge about choroid morphology was based mainly on post-mortem examinations. Only the application of novel modifications to the OCT technique, including enhanced depth imaging OCT (EDI-OCT), swept source OCT (SS-OCT) and OCT angiography, enabled its better visualization and examination. The increasing availability of these technologies enables fast, repeatable and non-invasive measurements of choroid thickness in everyday clinical practice. The correlation between new anatomical discoveries and functional results may make it possible to broaden the knowledge about pathogenesis of numerous eye diseases and even define new disease units. [ABSTRACT FROM AUTHOR]

Camila Zanella Benfica,1,2 Teresinha Zanella,3 Lucas Brandolt Farias,1,2 Maria Lúcia Rocha Oppermann,1,3 Luis Henrique Santos Canani,1,4 Daniel Lavinsky1,2 1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; 2Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 3Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; 4Department of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Purpose: To analyze choroidal thickness (CT) of pregnant women with type 1 diabetes mellitus (DM), type 2 DM and gestational diabetes mellitus (GDM) using spectral-domain optical coherence tomography. Patients and methods: This cross-sectional study included 144 eyes of 72 pregnant women in the third trimester divided into four groups: 27 non-diabetic pregnant women; 15 pregnant women with GDM; 16 with type 2 DM and 14 with type 1 DM. CT was measured using optical coherence tomography at ten different locations. We also analyzed possible confounding factors, such as gestational age, glycosylated hemoglobin, time from DM diagnosis, hypertension and severity of diabetic retinopathy. Results: The comparison between the four groups showed a thinner choroid in patients with type 1 DM in all locations, with statistical significance in subfoveal and temporal measurements. When comparing only patients with type 1 and type 2 DM, adjusting for confounding factors, the choroid of patients with type 1 DM remained thinner at all macular points, also with statistical significance in subfoveal and temporal measurements. Conclusion: Pregnant women with type 1 DM had significantly thinner CT measurements on subfoveal and temporal locations. No differences were found in CT between the control group and pregnant women with GDM and type 2 DM. Keywords: choroid, enhanced depth imaging optical coherence tomography, pregnancy, gestational diabetes mellitus, diabetes mellitus

Abstract Background High myopia, a cause of serious visual impairment, is a significant global public health concern. We investigate longitudinal changes in macular choroidal thickness (CT) during pregnancy and 6-months postpartum in women with high myopia (HM). Methods A prospective longitudinal study was conducted in HM-pregnant women during the course of pregnancy (n = 42 eyes, 42 patients) and 6 months postpartum (n = 40 eyes, 40 patients, two cases lost).Macular CT was measured via enhanced-depth imaging (EDI)-optical coherence tomography (OCT) (EDI-OCT). Intraocular pressure (IOP), axial length (AL), refractive error, mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), and body mass index (BMI) were also measured. Results Macular CTs of HM pregnant women (214.3 ± 52.3 μm) had increased significantly during the third trimester of pregnancy compared with postpartum women (192.7 ± 51.9 μm, p = 0.014). No significant differences in AL, refractive error, or MAP were found between pregnant and postpartum groups (p > 0.05 for all parameters).During pregnancy, macular CT was negatively correlated with AL (first trimester: p = 0.010; second trimester: p = 0.013; and third trimester: p = 0.008) and positively correlated with refractive error (first trimester: p = 0.038; second trimester: p = 0.024; and third trimester: p = 0.010). No correlations between macular CT and age, IOP, MOPP, MAP, or BMI were found. Conclusions Our study revealed the presence of a significantly thicker choroid during the third trimester of pregnancy compared with 6-mo postpartum in HM women. Macular CT positively correlated with refractive error and negatively correlated with AL during pregnancy, but did not correlate with gestational age, MOPP, IOP, MAP, or BMI.

Abstract Background The impact of pregnancy on the choroid is still under investigation. The aim of this study is to compare choroidal thickness measurements of healthy pregnant women in the third trimester and healthy non-pregnant women using spectral-domain optical coherence tomography (OCT). Methods This cross-sectional study included 122 eyes of 61 women, divided into two groups: 27 healthy pregnant women in the third trimester and 34 age-matched healthy non-pregnant women. Choroidal thickness was measured using Enhanced Depth Imaging OCT at ten different locations: at the fovea and every 500 µm from the fovea up to 2500 µm temporally and up to 2000 µm nasally. Results There were no significant differences in the ten measurements of choroidal thickness comparing both groups. Mean subfoveal choroidal thickness was 304.1 + 9.6 µm in the control group and 318.1 + 15.6 µm in the pregnant women group (p = 0.446). There was also no statistically significant association between gestational age and choroidal thickness measurements in the healthy pregnant women group. Conclusions Our study showed no statistically difference in choroidal thickness between healthy non-pregnant women and healthy pregnant women in the third trimester.

A structurally and functionally intact choroid tissue is vitally important for the retina function. Although central retinal artery is responsible to supply the inner retina, choroidal vein network is responsible for the remaining one-third of the external part. Abnormal choroidal blood flow leads to photoreceptor dysfunction and photoreceptor death in the retina, and the choroid has vital roles in the pathophysiology of many diseases such as central serous chorioretinopathy, age-related macular degeneration, pathologic myopia, Vogt–Koyanagi–Harada disease. Biomarkers of choroidal diseases can be identified in various imaging modalities that visualize the choroid. Indocyanine green angiography enables the visualization of choroid veins under the retinal pigment epithelium and choroidal blood flow. New insights into a precise structural and functional analysis of the choroid have been possible, thanks to recent progress in retinal imaging based on enhanced depth imaging (EDI) and swept-source optical coherence tomography (SS-OCT) technologies. Long-wavelength SS-OCT enables the choroid and the choroid–sclera interface to be imaged at greater depth and to quantify choroidal thickness profiles throughout a volume scan, thus exposing the morphology of intermediate and large choroidal vessels. Finally, OCT angiography allows a dye-free evaluation of the blood flow in the choriocapillaris and in the choroid. We hereby review different imaging findings of choroidal diseases that can be used as biomarkers of activity and response to the treatment.

Purpose: To measure the choroidal thickness by enhanced depth imaging optical coherence tomography (EDI-OCT) in normal eyes. Methods: In a prospective case series, 208 eyes of 104 normal Iranian subjects were enrolled. Complete ophthalmic examination was performed. Inclusion criteria were best corrected visual acuity (BCVA) ≥20/20, ≤ ±1 diopter of refractive error in either spherical or cylindrical components, normal intraocular pressure (IOP) and no systemic or ocular diseases. The choroidal thickness was measured by EDI-OCT subfoveally, and 1500 μm and 3000 μm nasal and temporal to the fovea. Results: Mean age was 34.6 ± 9.8 years (range, 18–57 years). Mean subfoveal choroidal thickness was 363 ± 84 μm. Choroidal thickness was 292 ± 76 and 194 ± 58 μm at 1500 and 3000 μm nasal to the fovea, respectively, and 314 ± 77 and 268 ± 66 μm at 1500 and 3000 μm temporal to the fovea, respectively. There was no statistically significant difference in the choroidal thickness between sexes and laterality of the eyes. Choroidal thickness at fovea (P < 0.001) and at all extrafoveal locations decreased significantly for every 10 years increase in age. Conclusion: In normal Iranian subjects participating in this study, mean choroidal thickness was comparable with other reports.

Objective The aim was to investigate changes in retinal and choroidal thickness (CT) maps in patients with retinitis pigmentosa (RP) in comparison to controls using enhanced depth imaging optical coherence tomography (OCT). Participants and methods A cross-sectional study was done on a consecutive sample of 32 eyes of 22 patients with RP. Control group included 30 eyes of 15 age-matched healthy participants. Full ophthalmological examination was done for every participant. Enhanced depth imaging OCT was performed measuring retinal and CT at the nine early treatment diabetic retinopathy study (ETDRS) subfields. Results The mean central CT was statistically significantly thinner (269.73±48.48 µm) in the patients’ group compared with 291.90±29.33 µm in the control group (P=0.023). On comparing the four choroidal quadrants between the two groups, patients with RP had significantly thinner choroid only in the nasal quadrant (P

We aimed to determine the effect on choroidal thickness of daily 5 mg tadalafil use in patients with erectile dysfunction (ED) and to evaluate agreement between short form of International Index of Erectile Function (IIEF 1–5, 15) scores and choroidal thickness during follow‐up. Enhanced depth imaging spectral domain–optical coherence tomography (EDI‐OCT) was used to measure full choroidal thickness in the subfoveal area, choroidal thickness (CT) and small‐choroidal‐vessel‐layer (SCVL) thickness. Thirty of the 45 patients included complete their follow‐ups and exhibited medication continuity. Patients were divided into two groups, five (16.7%) with ED at any level at third‐month follow‐up, and 25 (83.3%) with no ED, and subgroup analysis was then performed. Median changes in SCVL thickness at first‐ and sixth‐month follow‐ups were 20.5 µm versus 9.0 μm (p =.001) and 23.5 µm versus 12.5 µm (p =.005) in patients without and with ED respectively. The SCVL thickness increased by 20 μm compared with the baseline level, indicating an improvement in the patient's complaints of erectile dysfunction. The level of increase in SCVL thickness can be a useful and objective guide to clinicians if they cannot be present when the IIEF questionnaire is administered. [ABSTRACT FROM AUTHOR]

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

Purpose: To evaluate retinal and choroidal changes in patients with internal carotid artery stenosis who had undergone carotid artery stenting or endarterectomy. Methods: The study included 43 patients with internal carotid artery (ICA) stenosis that required stenting or endarterectomy and 40 healthy controls. Patients were divided into two groups according to the degree of stenosis evaluated by magnetic resonance angiography. Group 1 consisted of patients having ICA stenosis of 50 to 70%, and Group 2 has more than 70%. Enhanced depth imaging optical coherence tomography (EDI-OCT) was used to measure the retinal thickness (RT) and choroidal thickness (CT) in all subjects before surgery and at 1, 3, and 6 months after surgery. Results: Subfoveal and parafoveal CT were significantly lower in patients with ICA stenosis than the control group (p <.05, respectively). Patients with 50-70% stenosis had a significant increase in the CT at 1, 3, and 6 months after ICA stenting or endarterectomy (p <.05). Patients with >%70 stenosis did not have a significant increase in the CT at any time after ICA stenting or endarterectomy. Retinal thickness was not statistically different between the patients with ICA stenosis and the control subjects, and RT showed no significant change in patients with ICA stenosis before and after the surgery. Conclusion: Choroidal thickness was significantly thinner in patients with internal carotid artery stenosis. ICA stenting provided a recovery in the choroidal thickness in patients with moderate to advanced stenosis. [ABSTRACT FROM AUTHOR]

AIM: To assess peripapillary retinal nerve fiber layer (RNFL) and choroidal thickness obtained with enhanced depth imaging (EDI) mode compared with those obtained without EDI mode using Heidelberg Spectralis optical coherence tomography (OCT). METHODS: Fifty eyes of 25 normal healthy subjects and 32 eyes of 20 patients with different eye diseases were included in the study. All subjects underwent 3.4 mm diameter peripapillary circular OCT scan centered on the optic disc using both the conventional and the EDI OCT protocols. The visualization of RNFL and choroidoscleral junction was assessed using an ordinal scoring scale. The paired t-test, intraclass correlation coefficient (ICC), 95% limits of agreement (LoA), and Bland and Altman plots were used to test the agreement of measurements. RESULTS: The visibility score of RNFL obtained with and without EDI was of no significant difference (P=0.532), the visualization of choroidoscleral junction was better using EDI protocol than conventional protocol (P

AIM: To observe the choroidal thickness in nonarteritic anterior ischemic optic neuropathy(NAION)measured by enhanced depth imaging optical coherence tomography(EDI-OCT)and evaluate its clinical significance. METHODS: Totally 30 patients diagnosed with NAION were studied and 60 individuals with normal fundus were set as control. Choroidal thickness was measured by EDI-OCT. Choroidal thickness of the affected eye and contralateral eye in patient group and right eye of the control group were evaluated and recorded. RESULTS: Differences in age, gender and refractive status between NAION group and control were not significant(P>0.05). Choroidal thickness near fovea and optic disc in affected eye and contralateral eye in patient group was thinner compared to these of control group(PP>0.05). CONCLUSION: In NAION patients, choroidal thickness of affected eyes and unaffected contralateral eyes were significantly thinner compared to these of control group. Diminish of the observed choroidal thickness in this study might be explained by small vessels occlusion in posterior ciliary artery, which would affect the blood supply of the choroid.

Purpose: This study aimed to assess the course of changes in choroidal morphology after immersion of the foot in warm water at 40°C using enhanced depth imaging optical coherence tomography (EDI-OCT)., Methods: Forty-three right eyes of 43 healthy participants were included. Changes in choroidal morphology were determined using EDI-OCT to evaluate subfoveal choroidal thickness (SCT). Systolic, diastolic, and mean blood pressures (SBP, DBP, and MBP, respectively) were also measured to determine systemic circulatory dynamics at baseline, immediately after immersion (0 min), and 10, 20, and 30 min after immersion., Results: Immediately after immersion, SBP, DBP, and MBP were significantly declined versus baseline. In contrast, the SCT was significantly increased after warm water immersion. However, all these parameters did not change significantly compared to the baseline within 30 min., Conclusion: In the normal eye, parasympathetic nerve activity induced by warming stimuli increases choroidal morphology in response to a decrease in systemic circulatory activity, which normalizes within 30 min. The findings of this study may provide basic data for the prevention and treatment of various choroidal diseases in which sympathetic hyperactivity is involved in the pathogenesis., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2024, Toh et al.)

Purpose: To determine whether water drinking test (WDT) alters choroidal structure using binarization of enhanced depth imaging optical coherence tomographic (EDI-OCT) images. Methods: We performed a prospective study of 57 eyes of 57 normal subjects. The intraocular pressure (IOP), EDI-OCT images, and laser speckle flowgraphic images were recorded at baseline, and at 15, 30, 45, and 120 min after the WDT. The EDI-OCT images were converted to binary images using ImageJ software, and we examined luminal area, interstitial area, whole choroidal area, the ratio of luminal area to whole choroidal area (L/W ratio), subfoveal choroidal thickness (SCT), and central retinal thickness (CRT). Results: The luminal area, L/W ratio, whole choroidal area, and IOP were significantly increased 30 min after water drinking; levels returned to the baseline at 120 min. No significant changes were found in the CRT and interstitial area. The fluctuations in the SCT after water intake were significantly correlated with those in the L/W ratio and luminal area but not with those of the interstitial area. The choroidal blood flow velocity was significantly decreased at 30 min. Fluctuations in the luminal area, L/W ratio, and whole choroidal area were significantly correlated with IOP fluctuations. Conclusions: The changes in the SCT after water drinking were mainly due to the changes in the choroidal vascular space. Dilatations of the choroidal vessels after water drinking may lead to choroidal thickening and subsequent IOP elevation. These findings should be considered in the evaluation of choroidal structure in patients with retinal disease. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of full-dose, half-dose, and half-dose-half-fluence photodynamic therapy (PDT) in central serous chorioretinopathy (CSC). Methods: This retrospective study enrolled patients with CSC who received full-dose (verteporfin 6 mg/m2), half-dose (verteporfin 3 mg/m2), and half-dose-half-fluence (verteporfin 3 mg/m2 and light energy reduced to 25 J/cm2) PDT. We measured visual acuity, subfoveal choroidal thickness (SFCT), subretinal fluid (SRF) thickness, and choroidal vascularity index (CVI) before and 3 months after PDT. Results: Forty-three eyes (42 patients) were analyzed. Full-dose and half-dose groups showed improved vision (P = 0.023, 0.004, respectively), but half-dose-half-power group was not significantly improved (P = 0.254). SFCT in all three groups were significantly decreased (P = 0.005, 0.004, 0.002, respectively). SRF thicknesses in full-dose and half-dose groups showed significant decreases (P = 0.005, < 0.001, respectively). Half-dose-half-fluence group demonstrated the decrease but it was not statistically significant (P = 0.084). CVI were decreased in full-dose and half-dose groups (all P = 0.005). However, in the half-dose-half-fluence group, CVI was increased (P = 0.003). Conclusion: Full-dose and half-dose PDT were both effective in CSC treatment. Half-dose PDT can be considered to reduce complications. The effect of half-dose-half-fluence PDT was less clear than the other two protocols. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationships between macular choroidal thickness (mCT) and ocular parameters, such as optic nerve head (ONH) and multifocal electroretinogram (mf-ERG) parameters, in cases with primary open-angle glaucoma (POAG). Methods: This controlled and prospective clinical trial included 49 patients with POAG diagnosed for the fırst time and 47 healthy participants. Macular CTs, ONH and mf-ERG parameters were measured, and the examination findings were recorded at baseline and follow-ups. Results: In the POAG group, the mean mCT was 254.92±37.65 µm at baseline, and it was 235.6±38.48 µm at 3-month and was 237.55±37.27 µm at 6-month. In the glaucoma group, there was a significant decrease in the first three months despite the treatment, but no significant change was observed in the next three months. In the healthy group, the mean mCTs were 287.78±26.77 µm, 285.48±25.58 µm and 285.02±27.44 µm at baseline, at 3-month and at 6-month, respectively. No significant change was observed in the control group throughout the process. However, the mean mCT values in the glaucoma group were significantly thinner in all controls compared to the healthy group (p<0.05). Furthermore, significant correlations were found between CT and some ONH, as well as mf-ERG parameters. Conclusion: The choroid can play an important role in the pathogenesis of glaucoma. Significant correlations in parameters support this relationship. We have observed that the glaucomatous effect initiated first in the inferior quadrant of ONH. [ABSTRACT FROM AUTHOR]

Purpose: To compare the choroidal thickness (CT) measured by enhanced depth imaging optical coherence tomography (EDI-OCT) in preeclamptic, healthy pregnant, and healthy nonpregnant women. Methods: Studies that focused on the CT evaluation of pregnant women were retrieved by searching PubMed, Embase, Ovid, Cochrane, and Web of Science. We used Stata 14.0 SE for the meta-analysis and presented the results as the weighted mean difference (WMD) with a corresponding 95% CI. Results: A total of 14 studies with 1,227 participants were included in our meta-analysis. The CT of the healthy pregnancies (μm, WMD = 34.19, 95% CI: 20.63–47.76) was significantly higher than that of the nonpregnancies (Test of WMD = 0: z = 4.94, p = 0.000), but the CT of the preeclampsia (μm, WMD = 54.30, 95% CI: –13.40 to 122.01) was not significantly different from the nonpregnancies (Test of WMD = 0: z = 1.57, p = 0.116). In the preeclampsia versus healthy pregnancy group, 3 studies found that the choroid was thinner with preeclampsia, only one study found the CT increased. Conclusions: This meta-analysis suggested that the CT of the healthy pregnant women was significantly higher than that of the nonpregnant women. The presence of preeclampsia might complicate this situation. Most studies found that the CT decreased in the preeclamptic patients because of the increases in the systemic vasospasm and the blood pressure, which led to no significant difference compared with the nonpregnant women. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the correlation of hemoglobin A1c (HbA1c) levels with choroidal thickness in patients with type 2 diabetes mellitus (DM) using spectral domain optical coherence tomography (SD-OCT). Methods: In this prospective case series, 180 eyes from 90 patients with type 2 DM were classified into three study groups based on HbA1c values: group 1 included patients with good glycemic control (HbA1c ≤ 7%), group 2 included patients with moderate glycemic control (HbA1c between 7% and 8%), and group 3 included patients with poor glycemic control (HbA1c ≥ 8%). Additionally, 50 eyes from 25 non-diabetic subjects were enrolled to group 4 as a control group. Sub-foveal, nasal, and temporal choroidal thickness were measured and compared. Results: Mean central, nasal, and temporal choroidal thicknesses in diabetic patients (247.80, 238.63, and 239.30 µm) were significantly less than non-diabetic healthy subjects (277.56, 262.92, and 266.32 µm). Additionally, mean central, nasal, and temporal choroidal thickness values in group 4 (277.56, 262.92, and 266.32 µm) were significantly greater than the corresponding values in group 2 (248.34, 237.55, and 236.45 µm) and group 3 (239.81, 234.62, and 233.94 µm), but was not significantly different from corresponding values in group 1 (259.46, 246.12, and 251.00 µm). Conclusion: HbA1c values have a significant correlation with choroidal thickness in diabetic patients, and better glycemic control with HbA1c ≤7% may prevent choroidal thinning. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the macular choroidal thickness (CT) in patients with ocular hypertension (OHT) using spectral domain optical coherence tomography (SD-OCT) and compare the results with healthy individuals. Methods: Thirty eyes of 30 patients newly diagnosed with OHT and 24 eyes of 24 healthy controls were included in this cross-sectional study. After a detailed ophthalmological examination, macular CT was measured with enhanced depth imaging optical coherence tomography (EDI-OCT) (Cirrus HD-OCT, Carl Zeiss Meditec AG, Jena, Germany) at the fovea and at positions 500 µ, 1000 µ, 1500 µ nasal and temporal to the fovea. The Mann-Whitney U test was used to compare the CT measurements between groups. The correlation between the mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness (RNFL) and CT was evaluated with the Spearman correlation coefficient. Statistical significance was accepted as p<0.05. Results: The mean CT in the OHT group was significantly thinner than that of the controls at locations 1000 µ (250.13±69.53µ vs 275.92±47.34µ; p=0.02) and 1500µ (236.03±65.44µ vs 265.46±47.56µ; p=0.009) temporal to the fovea. The CT at the other measurement points was also thinner in eyes with OHT, but the difference failed to reach statistical significance. A moderately negative correlation was detected between the mean deviation and CT at locations 1000µ (r=-0.42; p=0.03) and 1500µ (r=-0.44; p=0.02) temporal to the fovea There was a moderate correlation between the average RNFL thickness and CT at locations 500µ (r=0.44; p=0.03), 1000µ (r=0.42; p=0.04) and 1500µ (r=0.56; p=0.005) temporal to the fovea. Conclusion: In the present study, the macular CT was thinner in patients with OHT and this thinning was statistically significant at the temporal macula. A longitudinal, prospective study involving multiple EDI-OCT measurements is required to further understand the relationship. [ABSTRACT FROM AUTHOR]

Background: During pregnancy, various physiological changes occur in almost all organs of the body including the eyes. Increased blood volume and cardiac output results in ocular blood flow increase. Consequently, the choroid is a highly vascular tissue; any local or systemic pathology affecting the vasculature could also affect the choroid. Objective: The aim of the study was to report and evaluate choroidal changes in healthy pregnant women, pregnant women with gestational diabetes mellitus (GDM), and pregnant women with gestational hypertension (GH) and to compare the measured parameters with those of healthy non-pregnant women. Patients and Methods: This prospective comparative study comprised 180 eyes of 90 women divided into 4 groups; Group 1(control): 30 healthy non-pregnant females, Group 2 (Low risk pregnancy): 30 healthy pregnant females ≥ 24 weeks of gestation, Group 3 and 4 (high risk pregnancy): each consisted of 15 pregnant females ≥ 24 weeks of gestation with GDM or GH. All four groups were age-matched. Choroidal thickness (CT) was measured using enhanced depth imaging spectral domain optical coherence tomography at seven different locations. Results: CT increased significantly in healthy pregnant females (third trimester) compared to control group and decreased significantly in high risk pregnant females compared to healthy pregnant and non-pregnant females. Conclusion: Reporting changes in CT during pregnancy may give valuable data to interpret pregnancy-related ocular pathologies. [ABSTRACT FROM AUTHOR]

Purpose: To measure changes in the choroidal vascularity index (CVI) in chronic Vogt-Koyanagi-Harada (VKH) disease during a recurrent anterior uveitis attack.Methods: Forty VKH patients and 40 normal controls were included in this study. Choroidal images were recorded before and during a recurrent anterior uveitis attack, as well as after appropriate treatment. CVI was measured by the binarization technique using ImageJ software (Bethesda, MD).Results: The CVI was 0.75 ± 0.09 in quiescent VKH patients, which was significantly higher compared to healthy controls (0.70 ± 0.05, p ＜ 0.0001). The CVI significantly decreased to 0.72 ± 0.09 when granulomatous anterior uveitis appeared in these patients. However, it returned to 0.75 ± 0.08 after uveitis resolved.Conclusions: A significant decrease of the CVI occurred during recurrent anterior uveitis in chronic VKH. CVI may provide a novel parameter to guide the treatment of VKH disease. [ABSTRACT FROM AUTHOR]