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

Purpose To measure peripapillary choroidal thickness (PPCT) and to assess its associations. Methods The population-based cross-sectional Beijing Eye Study 2011 included 3468 participants. Detailed medical and ophthalmic examinations were performed. We measured PPCT by spectral-domain optical coherence tomography (SD-OCT) with a 3.4-mm scan circle centered on the optic nerve head. Results Peripapillary choroidal thickness measurements were available for 3060 (88.2%) study participants with a mean age of 64.4 ± 9.6 years (range, 50-93 years). Mean global PPCT was 134 ± 53 μm (range, 35-348 μm). Peripapillary choroid was thickest in the superior region (155 ± 60 μm), followed by the temporal region (144 ± 75 μm; P 0.05) associated with blood pressure, blood concentration of lipids, intraocular pressure and prevalence of glaucoma, diabetic retinopathy, and retinal vein occlusions. The decrease of PPCT with longer axial length occurred predominantly in the temporal region. Conclusions Peripapillary choroidal thickness is thickest superiorly and thinnest inferiorly. It decreases by 2 μm per year of life and by 5 μm per diopter of myopia. Thinner PPCT is correlated with larger parapapillary α and β zones. The association of thinner PPCT with lower best corrected visual acuity may warrant further study.

Peripapillary Choroidal Thickness in Adult Chinese: The Beijing Eye Study.

PURPOSE This study examined the association between peripapillary choroidal thickness (PCT) with age and race in a group of African descent (AD) and European descent (ED) subjects with normal eyes. METHODS Optic nerve head images from enhanced depth imaging spectral-domain optical coherence tomography of 166 normal eyes from 84 subjects of AD and ED were manually delineated to identify the principal surfaces of Bruch's membrane (BM), Bruch's membrane opening (BMO), and anterior sclera (AS). Peripapillary choroidal thickness was measured between BM and AS at increasing distance away from BMO. The mean PCT was compared between AD and ED subjects and generalized estimating equation (GEE) regression analysis was used to examine the association between race and PCT overall, in each quadrant, and by distance from BMO. Models were adjusted for age, BMO area, and axial length in the regression analysis. RESULTS Overall, the mean PCT increased from 63.9 μm ± 18.1 at 0 to 250 μm to 170.3 μm ± 56.7 at 1500 to 2000 μm from BMO. Individuals of AD had a greater mean PCT than those of ED at all distances from BMO (P < 0.05 at each distance) and in each quadrant (P < 0.05 in each quadrant). Results from multivariate regression indicate that ED subjects had significantly lower PCT compared to AD overall and in all quadrants and distances from BMO. Increasing age was also significantly associated with a lower PCT in both ED and AD participants. CONCLUSIONS Peripapillary choroidal thickness varies with race and age, as individuals of AD have a thicker peripapillary choroid than those of ED. (ClinicalTrials.gov number, NCT00221923.).

Peripapillary Choroidal Thickness Variation With Age and Race in Normal Eyes

Purpose:Numerous studies have detected choroidal thickness abnormalities and changes in open-angle glaucoma (OAG), as measured by enhanced depth imaging optical coherence tomography technologies, but the results have not always been consistent. Therefore, a meta-analysis and systematic review was pe

Choroidal Thickness and Open-Angle Glaucoma: A Meta-Analysis and Systematic Review.

Purpose: To evaluate the characteristics and relationship between peripapillary choroidal thickness (pCT), lamina cribrosa thickness (LCT), and peripapillary outer retinal layer thickness (pORT) as determined using spectral domain optical coherence tomography (SD-OCT) enhanced depth imaging (EDI). Methods: In total, 255 participants were included (87 healthy subjects, 87 glaucoma suspects (GS), and 81 glaucoma cases). The pORT, defined as the thickness between the posterior outer plexiform layer and the retinal pigment epithelium (RPE) interface, and the pCT, between the outer margin of the RPE and the choroidal-scleral interface, were manually measured using EDI scanning of the circumpapillary retinal nerve fiber layer (RNFL). LCT was determined by EDI scanning of the optic nerve head (ONH). Baseline characteristics, including axial length (AXL) and the SD-OCT measurements of the participants, were compared among the three groups. The correlation between putative factors and pCT was determined using univariate and multivariate linear regression analyses. Results: In all three groups, both pORT and pCT were thinnest in the inferior area among the four quadrants. In the healthy group, the mean peripapillary RNFL, pORT, and LCT were significantly greater in comparison with those of the GS and glaucoma groups (p < 0.001, p < 0.038, and p < 0.001, respectively). The pCT demonstrated no significant differences among the three groups (p = 0.083). Only age and AXL were associated with pCT by multivariate analysis. Conclusions: The pCT is substantially thinner in the inferior area of the ONH. In addition, the pCT demonstrates the strongest correlation with age and AXL, but was not associated with glaucoma or LCT.

/pdf/relationship-between-the-lamina-cribrosa-outer-retina-and-4kqtd0qyqh.pdf

Relationship between the Lamina Cribrosa, Outer Retina, and Choroidal Thickness as Assessed Using Spectral Domain Optical Coherence Tomography

Previously published studies have reported a correlation between retinal vein occlusion (RVO) and glaucoma [1-5]. In particular, the population-based Beaver Dam Eye Study found that the optic cup-to-disc ratio was a significant predictor of RVO [4]. The Blue Mountain Study reported that RVO was significantly associated with glaucoma, hypertension, stroke, and angina [5]. More recently, Kim et al. [3] showed that the thickness of the retinal nerve fiber layer (RNFL) was thinner in the fellow eyes of patients with unilateral RVO, especially in the infero- and superotemporal sectors, compared with control eyes.

True glaucomatous changes cannot be easily assessed in RVO-affected eyes because the retinal hemorrhage and edema generated by this disorder affect the states of the optic disc, RNFL, and visual field (VF). In patients with unilateral RVO, the fellow eye can serve as an appropriate surrogate for determining the relationship between glaucoma and RVO [3]. Because glaucoma is mostly a bilateral disease, the observation of structural glaucomatous changes in the fellow eye of patients with unilateral RVO suggests that these 2 disease entities (glaucoma and RVO) may share a common pathogenic mechanism. Additionally, the status of the fellow eye is important in cases of unilateral RVO, because if RVO-induced irreversible damage occurs, then only the fellow eye remains functional for sight. Thus, the possibility of glaucoma developing in the fellow eye of an RVO patient is of clinical importance in patient care.

Although the relationship between glaucoma and RVO is well recognized, not every patient with unilateral RVO shows glaucomatous structural changes in the fellow eye. Some (or many) eyes with unilateral RVO in the fellow eye do not demonstrate glaucomatous optic disc changes, although glaucomatous damage may be indicated in the future as this may be a cross-sectional observational effect. Therefore, we hypothesized that there might be some differences between glaucomatous and non-glaucomatous eyes with unilateral RVO in the fellow eye in terms of the baseline characteristics and RVO types. Hence, the aim of the present study was to compare the baseline characteristics of the patients and the fluorescein angiographic findings in RVO, especially in terms of the occlusion sites of RVO, between glaucomatous and non-glaucomatous eyes (with apparently healthy optic discs) that had unilateral RVO in the fellow eye.

/pdf/comparison-between-glaucomatous-and-non-glaucomatous-eyes-l3bjdk56yt.pdf

Comparison between glaucomatous and non-glaucomatous eyes with unilateral retinal vein occlusion in the fellow eye.

Purpose: To investigate the risk factors associated with a progressive loss of visual function (LV) in medically treated advanced normal tension glaucoma (NTG).Methods: In this retrospective observational study, a total of 87 eyes of the 87 NTG patients with a baseline visual field (VF) mean deviation (MD) of worse than –10 decibel (dB) (average follow-up period: 5.3 years) were included. All the participants were categorized into two groups according to the baseline VF MD [group 1 (≥−16 dB) and group 2 (<−16 dB), respectively]. The participants were also divided into older (≥64 years) and younger (<64 years) groups according to the median split of baseline age. Hazard ratios (HRs) for the association between potential risk factors and LV were obtained using the Cox proportional hazards models.Results: Fifty-one eyes were classified as group 1 (VF MD; −13.5 ± 1.8 dB), and 36 eyes as group 2 (−21.0 ± 4.1 dB). LV occurred in 33 eyes (64.7%) in group 1 and in 29 eyes (80.6%) in group 2 during the fol...

Factors Associated with Loss of Visual Function in Medically Treated Advanced Normal Tension Glaucoma

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Papers

Relationship between the Lamina Cribrosa, Outer Retina, and Choroidal Thickness as Assessed Using Spectral Domain Optical Coherence Tomography

Comparison between glaucomatous and non-glaucomatous eyes with unilateral retinal vein occlusion in the fellow eye.

Factors Associated with Loss of Visual Function in Medically Treated Advanced Normal Tension Glaucoma