Assessment of macular choroidal and retinal thickness: a cohort study in Tibetan healthy children.

This research investigates the distribution, progressive changes, and contributing factors of macular choroidal and retinal thickness in Tibetan children utilizing swept-source optical coherence tomography (SS-OCT). The Lhasa childhood study recruited 1632 students from seven primary schools in Lhasa. These participants underwent OCT and ophthalmological evaluations, encompassing retinal and choroidal thickness measurements, refractive error, axial length (AL), and systemic examinations. The median age of the scholars was 8.57 ± 0.50 years with a median spherical equivalent (SE) of 0.19 ± 1.28D. Multivariate regression analysis revealed that thinner macular choroid thickness was correlated with lower value of SE, worse best-corrected visual acuity, higher mean arterial blood pressure (MABP) and boys, while retinal thickness was associated with better image quality and lower value of SE. The choroid and retina were significantly thinner in myopic children. SE was positively related to the thickness of all choroidal and full retinal subregions. In comparison to baseline data from 20 months prior, most regions of the full retina had significantly thinned. Choroidal thickness of Tibetan children is thinner than that of same-age children from other regions. Thinning of retina, the outer-sector GCC and GCIPL may be specified as a follow-up and prognostic indicator for myopia.

Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population.

PURPOSE: To analyze the choroidal thickness between patients with keratoconus undergoing cross-linking treatment and a healthy population, as well as to determine the factors that influence choroidal thickness. METHODS: This was an observational, analytical, case-control study that was conducted from February 2021 to June 2021. Choroidal thickness was measured at different locations, including the subfoveal, nasal (1000 µm), temporal (1000 µm), superior (1000 µm) and inferior (1000 µm) locations using a Spectral-domain optical coherence tomography with enhanced depth imaging, which allowed us to obtain horizontal and vertical B-scans centered on the fovea. RESULTS: This study included 21 patients with keratoconus (mean age, 21.86 ± 5.28 years) and 28 healthy patients (mean age, 24.21 ± 4.71 years). Choroidal thickness was significantly greater in patients with keratoconus than in healthy patients in each of the following measured locations: subfoveal (P < 0.001); nasal (1000 µm) (P < 0.001), temporal (1000 µm) (P < 0.001), superior (1000 µm) (P < 0.001) and inferior (1000 µm) (P < 0.001) locations. Variables such as age (ρ = - 0.09; P = 0.50) and refraction (ρ = 0.14; P = 0.34) were not found to be associated with choroidal thickness. In a stepwise multiple linear regression, the group was the single variable correlated with choroidal thickness (ß = 0.88; P < 0.001). CONCLUSION: Choroidal thickness is thicker in keratoconus patients treated with cross-linking than in the healthy population. This finding could be associated with inflammatory choroidal mechanisms in keratoconus patients, but more studies are needed. Age and refractive error do not seem to influence choroidal thickness.

Assessment of the choroidal structure in pregnant women in the first trimester.

We investigated the anatomical differences in the choroidal structure between pregnant women in the first trimester of pregnancy and age-matched healthy nonpregnant women using enhanced depth imaging optical coherence tomography (EDI-OCT) and choroidal binarization analysis. The main parameters measured in the two study groups, namely, pregnant women in the first trimester and healthy nonpregnant women, were choroidal thickness and the choroidal luminal area. Binarization of the EDI-OCT images from each patient was performed, and the choroidal vascularity index (CVI) was calculated. The correlations between the baseline characteristics of the subjects and the CVI were investigated using linear mixed model analysis. As a result, there was no statistically significant difference in the mean age, best-corrected visual acuity, axial length, central retinal thickness, subfoveal choroidal thickness, systolic blood pressure (BP), or diastolic BP between the two study groups. Conversely, a significant difference was observed in the CVI (P = 0.012) between the two groups. The multivariate analysis identified a significant correlation between the CVI and the systolic BP (P = 0.0044, linear mixed test). Taken together, a larger choroidal luminal area was associated with a higher systolic BP, especially in the first trimester of pregnancy. Our findings may provide further insight into the choroidal changes that occur during pregnancy.

Assessment of macular choroidal thickness, central macular thickness and retinal nerve fiber layer in patients receiving oral isotretinoin treatment.

PURPOSE: To investigate the impact of oral isotretinoin therapy in choroidal thickness, central macular thickness (CMT), and retinal nerve fibre layer (RNFL) thickness using optical coherence tomography (OCT). PATIENTS AND METHODS: Choroidal thicknesses, CMT, and RNFL thickness of 64 eyes were evaluated at baseline and the end of the third month of isotretinoin therapy by spectral-domain OCT. For assessment of choroidal thickness, OCT measurements were obtained at the fovea with 6 additional measurements at adjacent locations (at 500-1000-1500 µm temporal to the fovea and 500-1000-1500 µm nasal to the fovea). RESULTS: There was not a statistically significant difference between the baseline and third-month follow-up measurements of choroidal thicknesses at seven distinct locations (p > 0.05). Similarly, RNFL thickness and CMT did not change with a mean dose of 30 (±6) mg per day isotretinoin therapy during follow-up (101.82 vs 102.24, p = 0.079; 217.77 vs 217.25, p = 0.731, respectively). CONCLUSION: After the use of oral isotretinoin for 3 months, no significant side effects have been observed in choroidal thickness, CMT, and RNFL thickness by OCT.

Choroidal Line Scan Measurements in Swept-Source Optical Coherence Tomography as Surrogates for Volumetric Thickness Assessment.

PURPOSE: To compare choroidal thickness of different areas on swept-source optical coherence tomography (SSOCT) line and cube scans for their interchangeable use. DESIGN: Validity analysis. METHODS: SSOCT line and cube scans were obtained from 21 patients with various choroidal thicknesses. Subfoveal center point choroidal thickness, mean central millimeter choroidal thickness, and mean 6-mm-area choroidal thicknesses were obtained from both eyes by 2 independent graders in a reading center setting. Cross-correlations were performed using Passing and Bablok regression models. A 95% confidence interval of slope that included 1 was considered to indicate no significant difference. Average choroidal thickness of center point, Early Treatment Diabetic Retinopathy Study grid subfields, and total grid area of 6 mm on both scans and the correlation between different areas served as main outcome measures. RESULTS: No significant difference between line scans/corresponding subfields of cube scans (outer nasal 0.92-1.11, inner nasal 0.88-1.06, central 0.94-1.11, inner temporal 0.95-1.12, outer temporal 0.93-1.17). No significant difference between subfoveal center point measurement/mean of choroidal thickness in the central millimeter of cube scans (0.89-1.08). Significant difference of subfoveal center point measurement or mean of central millimeter area of cube scans to entire 6-mm area of cube scans (1.01-1.53 and 1.03-1.38). CONCLUSIONS: Measurements on a single SSOCT horizontal line scan can represent the entire choroid but subfoveal center point measurements are only indicative for the central millimeter area. There is a consistent overestimation of choroidal thickness when trying to estimate overall choroidal thickness from any central measurement.

Assessment of choroidal thickness before and after steep Trendelenburg position using swept-source optical coherence tomography.

BACKGROUND: To evaluate changes in choroidal thickness before and after steep Trendelenburg position (STP, 40° head-down) using automated segmentation software to analyse swept-source optical coherence tomography (SS-OCT) data. METHODS: The eyes of 20 healthy volunteers underwent a three-dimensional wide scanning protocol with SS-OCT (Topcon, Tokyo, Japan) at baseline, immediately after STP was initiated, and 5, 10 and 15 min after STP; blood pressure and heart rate were measured concurrently. The predictive mean difference was calculated using a generalised linear mixed model that adjusted for potential confounders. RESULTS: Mean choroidal thickness significantly and transiently increased immediately (268.18±9.24 µm, p<0.01) and 5 min (264.25±9.30 µm, p=0.03) after STP, relative to baseline (256.51±9.20 µm). However, choroidal thickness decreased by 10 min (262.51±9.34 µm, p=0.15) and 15 min (261.38±9.40 µm, p=0.37) after STP. Mean arterial pressure also transiently increased from baseline (78.2±1.2 mm Hg) immediately after STP (79.9±1.1 mm Hg, p=0.01), but normalised by 5 min after STP (p>0.05 for all comparisons ≥5 min). CONCLUSIONS: Choroidal thickness significantly but transiently increases after adopting STP, as evaluated by automated layer segmentation analysis of SS-OCT data.

Evaluation of retinal and choroidal thickness by swept-source optical coherence tomography: repeatability and assessment of artifacts.

PURPOSE: To determine the repeatability of automated retinal and choroidal thickness measurements with swept-source optical coherence tomography (SS OCT) and the frequency and type of scan artifacts. DESIGN: Prospective evaluation of new diagnostic technology. METHODS: Thirty healthy subjects were recruited prospectively and underwent imaging with a prototype SS OCT instrument. Undilated scans of 54 eyes of 27 subjects (mean age, 35.1 ± 9.3 years) were obtained. Each subject had 4 SS OCT protocols repeated 3 times: 3-dimensional (3D) 6 × 6-mm raster scan of the optic disc and macula, radial, and line scan. Automated measurements were obtained through segmentation software. Interscan repeatability was assessed by intraclass correlation coefficients (ICCs). RESULTS: ICCs for choroidal measurements were 0.92, 0.98, 0.80, and 0.91, respectively, for 3D macula, 3D optic disc, radial, and line scans. ICCs for retinal measurements were 0.39, 0.49, 0.71, and 0.69, respectively. Artifacts were present in up to 9% scans. Signal loss because of blinking was the most common artifact on 3D scans (optic disc scan, 7%; macula scan, 9%), whereas segmentation failure occurred in 4% of radial and 3% of line scans. When scans with image artifacts were excluded, ICCs for choroidal thickness increased to 0.95, 0.99, 0.87, and 0.93 for 3D macula, 3D optic disc, radial, and line scans, respectively. ICCs for retinal thickness increased to 0.88, 0.83, 0.89, and 0.76, respectively. CONCLUSIONS: Improved repeatability of automated choroidal and retinal thickness measurements was found with the SS OCT after correction of scan artifacts. Recognition of scan artifacts is important for correct interpretation of SS OCT measurements.

Assessment of choroidal thickness and volume during the water drinking test by swept-source optical coherence tomography.

OBJECTIVE: To evaluate changes in peripapillary and macular choroidal thickness and volume after the water-drinking test (WDT) using swept-source optical coherence tomography (SS OCT). DESIGN: Prospective, cross-sectional, observational study. PARTICIPANTS: Fifty-six eyes of 28 healthy volunteers. METHODS: Participants underwent a 3-dimensional optic disc and macula scanning protocol with a prototype SS OCT (Topcon, Inc., Tokyo, Japan) at baseline and 15, 30, 45, and 120 minutes after the start of the WDT. The WDT consisted of drinking 1000 ml of water within 5 minutes. Objective measurements of the choroid were obtained with automated segmentation of the choroidal boundaries. MAIN OUTCOME MEASURES: Choroidal thickness and volume. RESULTS: Mean age ± standard deviation of participants was 35.6 ± 9.1 years. Intraocular pressure (IOP) increased from 14.9 ± 2.7 mmHg at baseline to a peak of 16.8 ± 3.0 mmHg 15 minutes after the WDT (P < 0.001). Mean baseline choroidal thickness and volume were 181.3 ± 50.8 µm and 6.19 ± 1.80 mm(3), respectively, at the optic disc and 217.4 ± 43.6 µm and 7.83 ± 1.55 mm(3), respectively, at the macula. After the WDT, peripapillary and macular choroidal thickness increased by a maximum of 5.7% (P<0.001) and 4.3% (P<0.001), respectively. Choroidal volumes increased by 6.4% (P<0.001) and 3.9% (P<0.001), respectively. There was no association between change in IOP and peripapillary (P = 0.27) or macular (P = 0.09) choroidal thickness. CONCLUSIONS: Using automated segmentation of SS OCT measurements, significant increases in choroidal thickness and volume are observed after the WDT in healthy subjects.