PURPOSE\nTo measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age.\n\n\nDESIGN\nRetrospective, observational case series.\n\n\nMETHODS\nEDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age.\n\n\nRESULTS\nThe mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life.\n\n\nCONCLUSIONS\nChoroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.

Enhanced Depth Imaging Optical Coherence Tomography of the Choroid in Normal Eyes

PURPOSE
To measure macular choroidal thickness (CT) in highly myopic eyes using enhanced depth imaging optical coherence tomography (OCT).


DESIGN
Retrospective, observational case series.


METHODS
Enhanced depth imaging OCT images were obtained in highly myopic eyes (> or =6 diopters [D]). Images of CT were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. CT was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 1000-mum intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate CT at each location and to correlate CT with age and refractive error.


RESULTS
The mean age of the 31 patients (55 eyes) was 59.7 years (+/- 17.6 years; range, 24 to 90 years), and the mean refractive error was -11.9 D (+/- 3.7 D). The mean subfoveal CT was 93.2 microm (+/- 62.5 microm) and was correlated negatively with age (P = .006), refractive error (P < .001), and history of choroidal neovascularization (P = .013). Regression analysis suggested that subfoveal CT decreased by 12.7 mum for each decade of life and by 8.7 microm for each D of myopia.


CONCLUSIONS
The choroid in highly myopic eyes is very thin and undergoes further thinning with increasing age and degree of myopia. Abnormalities of the choroid may play a role in the pathogenesis of myopic degeneration.

Enhanced Depth Imaging Optical Coherence Tomography of Choroid in Highly Myopic Eyes

International Standing Committee on Human Cytogenetic Nomenclature

Choroidal thickness and ocular growth in childhood.

Traumatic cataract is a main cause of visual impairment in pediatric populations and is preventable. Awareness of the causes and consequences of pediatric eye trauma play roles in health education and prevention of blindness. We conducted a retrospective chart review based on 5-year clinical data of pediatric traumatic cataract cases treated at the Eye and Ear, Nose and Throat Hospital of Fudan University, Shanghai, China. Clinical features including demographic data, injury mechanism, and causative agents were analyzed. A total of 321 eyes of 321 children (male, 74.1%) were included. Penetrating injury accounted for 76.6% of all injuries; 65% of children with such injuries underwent their first surgery on the day of injury. The average age at injury was 6.3 ± 3.7 years, while the peak age was from two to eight years. The main causes of ocular injury were sharp metal objects, toys, and wooden sticks. The causative agent changed with increasing age; however, scissors were the leading cause within almost all age groups. Cataract surgery significantly improved visual acuity in children with traumatic cataract. These findings add information regarding the characterization of pediatric traumatic cataract in China and can help guide safety education and preventative measures.

/pdf/traumatic-cataract-in-children-in-eastern-china-shanghai-56z68qa90l.pdf

Traumatic Cataract in Children in Eastern China: Shanghai Pediatric Cataract Study

PurposeTo describe and identify ocular and wound characteristics, and prognostic factors associated with final visual acuity (VA) in patients with scleral rupture due to blunt ocular trauma.MethodsThe medical records of 61 patients with globe rupture due to blunt ocular trauma who underwent primary repair were reviewed retrospectively. The data recorded included demographic characteristics, initial and final VA, ocular signs, wound characteristics, and surgeries. Initial VA, ocular signs, wound characteristics, and surgeries were analyzed to determine the association with the final VA.ResultsForty three women and 18 men with a mean age of 43.6±23.5 years were included in the study. The locations of scleral wounds were mostly in the superonasal quadrant (41.0%) and zone 2 (75.4%). In eyes with hyphema (P=0.009), vitreous hemorrhage (P=0.001), and retinal detachment (P=0.004), final VA was statistically worse than eyes without these signs. A moderate positive correlation was found between the initial and final VA (P<0.001). Final VA was statistically worse in eyes with horizontal midline wounds than in eyes with vertical midline wounds (P=0.002). A moderate negative correlation was found between scleral wound length and final VA (P<0.001). Patients who underwent cataract surgery had statistically better final VA (P=0.002).ConclusionsScleral rupture was detected mostly in females, superonasal quadrant and zone 2. Poor final VA was significantly associated with poor initial VA, longer wound length, horizontal midline wound, presence of hyphema, vitreous hemorrhage and retinal detachment at presentation, and cataract surgery not performed during follow-up period. Scleral ruptures have different demographic, ocular and wound characteristics than other open globe injuries.

Clinical characteristics and prognostic factors of scleral rupture due to blunt ocular trauma.

Purpose The aim of our study was to examine the effect of hypermetropia and anisometropic, exotropic, and esotropic amblyopia on choroidal thickness. Methods A prospective, cross-sectional, comparative study of 120 children under the age of 16 years was conducted. Choroidal thickness was measured in patients with hypermetropia, anisometropia, esotropia, exotropia, and controls. Results The mean subfoveal choroidal thickness in the control and hypermetropia groups was 323.9±69.0 µm and 348.9±64.5 µm, respectively. Mean choroidal thickness in amblyopic and fellow eyes was 387.4 and 351.9 µm in anisometropic, 353.8 and 338.7 µm in exotropic, 347.5 and 336.5 µm in esotropic, and 389.3 and 359.3 µm in esotropic+anisometropic groups, respectively. Choroid was significantly thicker in amblyopic eyes of anisometropic group compared to fellow (P=0.004) and control (P=0.03) eyes. The difference of choroidal thickness was not significant between both eyes and when compared to control eyes in the other groups. Conclusions Anisometropic amblyopic eyes had thicker choroids compared to controls and fellow eyes. However the choroidal thickness was not significantly different between amblyopic and fellow eyes of esotropic or exotropic patients.

Choroidal Thickness in Strabismus and Amblyopia Cases.

Purpose:To determine the effects of strabismus surgery on choroidal thickness.Methods:This was a prospective randomized study. The measurements of subfoveal and macular choroidal thickness of patie...

The effect of strabismus surgery on choroidal thickness.

Purpose: To report the infrequent complications, including antielevation and adherence syndrome, after a unilateral and bilateral inferior oblique (IO) recession procedure and to discuss the possible causes. Methods: A retrospective chart review was conducted for patients on whom unilateral or bilateral IO weakening surgeries were performed. Results: Forty-three patients were included in the study. In 23 patients unilateral and in 20 patients bilateral IO weakening was performed. All patients underwent IO recession surgery. Mild limitation of elevation developed in two patients and adherence syndrome developed in one patient. All occurred after unilateral IO recession. No duction deficiency was observed in patients after bilateral IO recession. Conclusion: Antielevation and adherence syndrome can develop after unilateral IO recession surgery. Care should be taken not to tighten the neurofibrovascular bundle of the IO muscle during surgery.

Infrequent Complications of Inferior Oblique Recession Surgery

Duane retraction syndrome (DS) is a rare congenital strabismus with genetic heterogeneity. The genetic causes of DS are not always of monogenic origin; various chromosomal copy number variations (CNVs) have also been reported. The objective of our study was to characterize the CNVs, including gains and losses detected by high-resolution chromosomal microarray in patients with DS.
 Twenty patients with DS were investigated using high-resolution chromosomal microarray analysis (CMA) (Affymetrix CytoScan Array 750 K). Conventional cytogenetic analysis was also performed. All samples revealed normal karyotype by cytogenetic analysis. However, in all our patients, multiple CNVs, including gains and losses, were detected using the high-resolution CMA method. Chromosomal loci 1q21.2, 2p11.2–q11.1, 2q21.1–q21.2, 4p16.1, 7p11.2–q11.21, 14q32.33, 17p11.2–q11.1 and 20p11.1–q11.21 were the most frequently affected regions. This study emphasized that CNVs in several chromosomal regions are known to be involved in DS. We also underscore the genetic heterogeneity of DS. Our suggestion is that genes located in the most frequently affected regions should be focused on in the following candidate gene studies.

Chromosomal microarray analysis of patients with Duane retraction syndrome

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