Evaluation of choroidal vascularity index and subfoveal choroidal thickness in eyes with chronic central serous chorioretinopathy and their normal fellow eyes / 中华实验眼科杂志

Objective:To observe the choroidal vascular changes of chronic central serous chorioretinopathy (cCSC), and analyze their correlations with central macular thickness (CMT).Methods:A cross-sectional study was adopted.Seventy-six eyes of 38 patients with monocular cCSC who were treated in Renmin Hospital of Wuhan University from March 2018 to December 2019 were enrolled, and 30 eyes of 30 normal control matched with age, gender, and spherical equivalent (SE) were included.Choroidal images of all subjects, and the CMT, subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), total choroidal area (TCA), choroidal stromal area (SA), and choroidal luminal area (LA) were measured by Heidelberg enhanced depth imaging optical coherence tomography.The differences in SFCT, LA, SA, TCA, CMT and CVI between the cCSC eye, fellow eye and normal eye, as well as the correlation between SFCT and CVI, SFCT and CMT, and CVI and CMT were analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University (No.WDRY2020-K234).Results:The CVI and the SFCT of the cCSC eyes, fellow eyes and normal eyes were (71.67±5.60)% and 483.82(409.01, 550.87)μm, (68.33±3.85)% and 444.66(351.25, 505.15)μm, (64.70±1.88)% and 373.46(327.98, 405.48)μm, respectively.The CMT, SFCT, TCA, LA, CVI in cCSC eyes were significantly higher than those in the contralateral eyes and normal control eyes, while SFCT, TCA, LA, CVI in the contralateral eyes were higher than those in normal control eyes (all at P<0.05). Pairwise comparison among the three groups showed no significant difference in SA (all at P>0.05). Correlation analysis showed that in cCSC eyes, SFCT was strongly positively correlated with CVI ( rs=0.703, P<0.001), and there was no correlation between CMT and SFCT ( rs=0.181, P=0.278), or CMT and CVI ( r=0.231, P=0.164). Conclusions:The SFCT and CVI are higher in cCSC and the fellow eyes compared with normal eyes, and the choroidal vessels are significantly dilated in cCSC patients.The SFCT and CVI of the cCSC eye are slightly higher in comparison with the fellow eye.CMT is not correlated with SFCT or CVI in cCSC eyes.

Changes in peripapillary choroidal thickness within one year of the first episode of acute primary angle closure glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

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&#x0026;#x003C;0.05). The pCT of the attack group was thicker than that of the other two groups during the attack period and at 1wk after surgery, while it became thinner at 1a(P&#x0026;#x003C;0.05). In the attack group, the average pCT was positively correlated with the duration of intraocular hypertension and negatively correlated with the anterior chamber depth(P&#x0026;#x003C;0.05).CONCLUSION: For patients with first episode of APACG, pCT was diffusely thickened during attack and at 1wk after surgery. The pCT returned to normal at 1mo, while it became thinner at 1a. Furthermore, the average pCT was positively correlated with the duration of intraocular hypertension, and the choroidal thickness may play an important role in the attack of APACG.

Research progress on the correlation between choroidal blood flow perfusion and myopia in children / 国际眼科杂志(Guoji Yanke Zazhi)

Myopia is the most common type of refractive error. At present, the characteristics of the low age and rapid growth of myopia in our country are obvious, and the myopia of adolescents and children has become a public health problem of concern to the whole society. Visual experience guides the development of children's refractive state and emmetropization. The occurrence and development of myopia is accompanied by changes in the structure of the eyeball, and the choroid has a thinning trend. The thickness change of the choroid may be determined by blood flow perfusion. Decreased choroidal blood flow perfusion may lead to scleral ischemia and hypoxia, and hypoxia induces scleral matrix remodeling and axial length growth. This article reviews the relationship between choroidal blood flow and myopia, and suggests the significance of paying attention to choroidal changes in the prevention and control of myopia.

Research progress on the application of deep learning in choroidal segmentation / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Effects of low-energy red light on choroidal thickness and spherical equivalent and axial length in myopic children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To systematically evaluate the effects of low-energy red light on choroidal thickness(ChT), spherical equivalent(SE), and axial length(AL)in myopic children.METHODS: A total of 8 databases, including Pubmed, Embase, Cochrane Library, Web of Science, CNKI, WanFang Database, VIP Database and China Biomedical Literature Database, were electronically retrieved to collect the clinical randomized controlled trial(RCT)of low-energy red light in myopia, with red light intervention as an experimental group and glasses as a control group. The retrieval time limit is from the establishment of the database to January 2023. According to the recommendation of the Cochrane Handbook, literature quality and risk of bias were evaluated. Revman5.4 software was used for Meta-analysis.RESULTS: Totally 8 RCT about red-light treatment with myopia were included. The sample size for ChT analysis contained 407 eyes in the red-light group and 425 eyes in the control group; SE analysis included 490 eyes in the red-light group and 518 eyes in the control group; sample size for AL analysis were 518 eyes in the red-light group and 539 eyes in the control group. The differences in ChT, SE and AL between the groups were statistically significant(ChT: WMD=37.81, 95%CI: 21.55～54.07, P&#x003C;0.001; SE: WMD=0.58, 95%CI: 0.46～0.71, P&#x003C;0.001; AL: WMD=-0.31, 95%CI: -0.39～-0.24, P&#x003C;0.001).CONCLUSION: Specific red light can promote the increase of ChT while inhibit SE and AL. However, its long-term efficacy and side effects remain unclear. The above conclusions need to be further clarified by more RCT with large samples.

Observation of vortex venous anastomosis in central serous chorioretinopathy / 中华眼底病杂志

Objective:To observe the anastomotic status of the vortex veins in patients with central serous chorioretinopathy (CSC).Methods:A cross-sectional study of clinical practice. From July 2021 to July 2022, 50 cases (50 eyes) of monocular CSC patients diagnosed through ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, there were 37 males (74.0%, 37/50) and 13 females (26.0%, 13/50), with the mean age of (44.30±9.59) years old. The course of disease from the onset of symptoms to the time of treatment was less than 3 months. The affected eye and contralateral eye of CSC patients were divided into the affected eye group and contralateral eye group, respectively. Fifty healthy volunteers of the same age and gender were selected as the normal control group with 50 eyes. The macular area scanning source optical coherence tomography (OCT) vascular imaging examination was performed with Visual Microimaging (Henan) Technology Co., Ltd. VG200D. Horizontal watershed vortex veins anastomosis rate and asymmetric vortex-venous dilation rate were observed by en face OCT. The device comes with software to calculate the central foveal choroidal thickness (SFCT), mean choroidal thickness (MCT), and choroidal vascular index (CVI). One-way analysis of variance and χ2 test were used to compare the three groups. When variances were unequal between groups, nonparametric tests were performed. Results:The SFCT values of the affected eye group, contralateral eye group, and normal control group were (567.12±129.02), (513.26±133.17), (327.64±97.40) μm, respectively; MCT were (407.38±97.54), (388.24±94.13), (275.46±60.55) μm, respectively; CVI were 0.34±0.05, 0.32±0.04, and 0.27±0.04, respectively; anastomosis rates of vortex veins were 98% (49/50), 78% (39/50), and 40% (20/50), respectively; asymmetric dilation rates of vortex veins were 96% (48/50), 88% (44/50), and 48% (24/50), respectively. The differences of SFCT ( F=53.974), MCT ( Z=51.415), CVI ( F=28.082), vortex vein anastomosis rate ( χ2=43.056), asymmetric dilation rate of vortex veins ( χ2=37.728) among three groups were statistically significant ( P<0.001). Compared with the contralateral eye group, the SFCT, MCT, CVI, vortex vein anastomosis rate, and vortex vein asymmetric dilation rate in the affected eye group were significantly higher than those in the contralateral eye group. Among them, the differences of SFCT ( t=2.054), CVI ( t=2.211), and vortex vein anastomosis rate ( χ2=9.470) were statistically significant ( P<0.05); the differences of MCT ( Z=7.490), asymmetric dilation rate of vortex veins ( χ2=2.714) were not statistically significant ( P=1.000, 0.140). Conclusions:SFCT, MCT, and CVI in the affected and contralateral eyes of monocular CSC patients significantly increase. The anastomotic rate and asymmetric dilation rate of the vortex vein in the opposite eye were lower than those in the affected eye.

Changes of choroidal biomarkers in patients with central serous chorioretinopathy / 中华眼底病杂志

Objective:To quantitatively evaluate the changes of choroidal biomarkers in patients with central serous chorioretinopathy (CSC) and preliminarily explore its pathogenesis.Methods:Clinical cross-sectional study. From July 2021 to December 2022, 74 eyes of 65 patients with CSC (CSC group) confirmed by ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 46 patients (51 eyes) were male, 19 patients (23 eyes) were female. The duration from the onset of symptoms to the time of treatment was less than or equal to 3 months. A control group consisted of 40 healthy volunteers (74 eyes) matched in age and gender. Among them, 26 patients (50 eyes) were male, and 14 patients (24 eyes) were female. Using VG200D from Microimaging (Henan) Technology Co., Ltd., macular scanning source light coherence tomography angiography was performed, with scanning range 6 mm × 6 mm. According to the division of the diabetes retinopathy treatment research group, the choroid within 6 mm of the macular fovea was divided into three concentric circles centered on the macular fovea, namely, the central area with a diameter of 1 mm, the macular area with a diameter of 1-3 mm, and the surrounding area of the fovea with a diameter of 3-6 mm. The device comes with software to record the three-dimensional choroidal vascular index (CVI), choroidal vascular volume (CVV), perfusion area of the choroidal capillary layer (CFA), choroidal thickness (CT), and three-dimensional CVI, CVV, and CT in the upper, temporal, lower, and subnasal quadrants within 6 mm of the fovea. Quantitative data between the two groups were compared using an independent sample t-test. Qualitative data comparison line χ2 inspection. The value of receiver operating curve (ROC) analysis in predicting the occurrence of CSC, including CVI, CVV, CFA, and CT. Results:Compared with the control group, the CVI ( t=3.133, 4.814), CVV ( t=7.504, 9.248), and CT ( t=10.557, 10.760) in the central and macular regions of the affected eyes in the CSC group significantly increased, while the CFA ( t=-8.206, -5.065) significantly decreased, with statistically significant differences ( P<0.05); CVI ( t=7.129), CVV ( t=10.020), and CT ( t=10.488) significantly increased within 6 mm of the central fovea, while CFA ( t=-2.548) significantly decreased, with statistically significant differences ( P<0.05). The CVI ( t=4.980, 4.201, 4.716, 8.491), CVV ( t=9.014, 7.156, 7.719, 10.730), and CT ( t=10.077, 8.700, 8.960, 11.704) in the upper, temporal, lower, and lower nasal quadrants within 6 mm of the central fovea were significantly increased, with statistically significant differences ( P<0.05). In the CSC group, the maximum CVI and CVV were (0.39±0.10)% and (1.09±0.42) mm 3, respectively, on the nasal side of the affected eye. Upper CT was (476.02±100.89) μm. The nasal side CVI, CVV, and CT have the largest changes. The ROC curve analysis results showed that the area under the curve of CT, CVV, and CVI within 6 mm of the central region, macular region, and fovea was over than 0.5. Subcentral CT was the most specific for the diagnosis of CSC. Conclusion:Choroidal biomarkers CVI, CVV, and CT in CSC patients increase, while CFA decreases. Central CT is the most specific for the diagnosis of CSC.

Central macular thickness and subfoveal choroidal thickness changes on spectral domain optical coherence tomography after cataract surgery in pediatric population

Purpose: To evaluate the central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) changes on spectral domain optical coherence tomography (SD?OCT) after cataract surgery with intraocular lens (IOL) implantation in a pediatric population. Methods: This was a longitudinal, prospective, interventional study which included 90 pediatric patients who underwent cataract extraction with IOL implantation. Serial SD?OCT scans were done at postoperative day 1, 1?month, and 3?month follow?up. CMT and SFCT were measured at each visit. Results: A statistically significant increase in CMT was noted at 1 month (from 199.3 ?m to 210.04 ?m) post surgery, which declined over a 3?month period (202.70 ?m, P = 0.0001). In case of SFCT, a constant increase was observed for over 3 months of follow?up (baseline: 296.52 ?m; 1 month: 309.04 ?m; and 3 months: 319.03 ?m, P = 0.0001). The traumatic cataract group showed more pronounced changes in CMT and SFCT than the non?traumatic cataract group. No significant difference was observed regarding these parameters between those who underwent primary posterior capsulotomy (PPC) versus those who did not. None of the patients in the study group developed cystoid macular edema. These posterior segment–related anatomical changes did not affect the final visual outcomes. Conclusion: Cataract surgery induces potential inflammatory changes in the macula and choroid in pediatric patients. Such changes are more pronounced in trauma?related cases; however, they are not significant enough to affect the visual outcomes. Similarly, the additional surgical step of PPC does not induce significant anatomical or functional changes

Choroidal and retinal thickness variations in ocular albinism

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 ?m; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 ?m; 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.

Role of Swept source optical coherence tomography in management of acute Vogt-Koyanagi-Harada’s disease

Purpose: To evaluate the role of swept?source optical coherence tomography (SS?OCT) in the management of acute Vogt–Koyanagi–Harada’s (VKH) disease. Methods: Retrospective analysis of SS?OCT images of acute VKH patients between January 2015 and February 2020 in a tertiary eye care hospital. Results: We studied 34 eyes of 17 patients with acute probable VKH disease. The mean age was 31.6 ± 10.4 years. Twelve patients were women. The mean follow?up was 17.1 ± 9.3 months. The mean visual acuity was 0.86 logMAR (Snellen equivalent: 6/45) at presentation and 0.18 logMAR (Snellen equivalent: 6/9) at the last follow?up. The mean subfoveal choroidal thickness (SFCT) was 784.97 microns at presentation, 431.40 microns at the first month of therapy, 453.94 microns at six months of therapy, and 405.83 microns at the last follow?up. Qualitative features noted on SS?OCT on presentation was subretinal fluid (SRF) in 29 (85%) eyes, subretinal hyperreflective dots in 34 (100%) eyes, subretinal septa in 33 (97%) eyes, RPE undulations in 21 (61.7%) eyes, posterior vitreous cells in 34 (100%) eyes, SRF around disc in 9 (26%) eyes, and disc swelling in 34 (100%) eyes. At the end of 1 year of follow?up, RPE undulations were absent in 30 eyes (88%) and disc swelling was notably absent in all 34 eyes (100%), though SRF around disc was noted in 4 eyes (11.7%) of 2 patients who had recurrences. Conclusion: SFCT, SRF around disc, RPE undulation, and disc swelling may be important indicators on SS?OCT to guide therapy and prognosticate recurrences in acute VKH.

Pseudodrusen reticulares y degeneración macular asociada a la edad / Pseudodrusen reticularis and age-related macular degeneration

Objetivo: Identificar la relación de los pseudodrusen reticulares con la degeneración macular asociada a la edad mediante imágenes tomográficas. Método: Estudio observacional, descriptivo y transversal en pacientes con pseudodrusen reticulares atendidos en consulta de retina a los que se les realizó tomografía de coherencia óptica espectral desde enero de 2009 hasta diciembre de 2014 en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer". La población estuvo constituida por 69 pacientes de 55 años y más con pseudodrusen reticulares en dichas imágenes. Resultados: Los pseudodrusen predominaron en pacientes con edades comprendidas entre los 70 y 79 años para un 49,3 por ciento. El sexo femenino fue el más numeroso con un 76,8 por ciento. De los 122 ojos con pseudodrusen, 86 presentaron algún signo de degeneración macular asociada a la edad representado por el 70,5 por ciento. El 58,1 por ciento de estos últimos tuvo la forma avanzada. La membrana neovascular tipo II fue la más frecuente con un 58,0 por ciento. El grosor coroideo se estimó disminuido en el 77,9 por ciento de los casos. Conclusiones: Los pseudodrusen reticulares mantienen una relación directa con la degeneración macular asociada a la edad e influyen en la progresión de esta(AU)

Objective: To identify the relationship of reticular pseudodrusen with age-related macular degeneration using tomographic imaging. Methods: An observational, descriptive and cross-sectional study was conducted in patients with reticular pseudodrusen seen in retina consultation who underwent spectral optical coherence tomography from January 2009 to December 2014 at the Cuban Institute of Ophthalmology "Ramón Pando Ferrer". The population consisted of 69 patients aged 55 years and older with reticular pseudodrusen in these images. Results: Pseudodrusen predominated in patients between 70 and 79 years of age (49.3 percent). The female gender was the most numerous with 76.8 percent. Out of the 122 eyes with pseudodrusen, 86 showed some sign of age-related macular degeneration (70.5 percent). Out of the latter, 58.1 percent had the advanced form. Type II neovascular membrane was the most frequent with 58.0 percent. Choroidal thickness was estimated decreased in 77.9 percent of cases. Conclusions: Reticular pseudodrusen maintain a direct relationship with age-related macular degeneration and influence its progression(AU)

Retinal and choroidal vascular changes in newly diagnosed celiac disease: An optical coherence tomography angiography study

Purpose: To investigate the retinal and choroidal microcirculation changes in celiac disease (CD) patients via optical coherence tomography angiography (OCT?A). Methods: This cross?sectional study included 44 pediatric patients with newly diagnosed CD and 44 healthy pediatric subjects. The vascular densities (VD) of the superficial, deep, and choriocapillar plexuses (VDs, VDd, and VDcc, respectively) (%), the superficial and deep foveal avascular zones (FAZs and FAZd) (%), the central macular thickness (CMT) (?m), and the subfoveal choroidal thickness (SFCT) (?m) were measured with swept?source OCT?A in addition to a complete ophthalmological examination. Results: Mean ages of the CD patients and the healthy participants were 12.02 ± 2.9 and 13.6 ± 2.3 years, respectively. The central sectors of the VDs and VDd measurements were found to be significantly higher in the study group compared to the control group (p = 0.006; P = 0.001, respectively), and the temporal and nasal values of the VDcc measurements were significantly lower in the study group than in the control group (p ? 0.05 for both values). CMT and FAZ metrics did not differ between the groups (p ? 0.05). SFCT was significantly reduced (p = 0.001), and choroidal thinning was more considerable in female CD patients (p = 0.045). Conclusion: CD seems to affect macular and choroidal microcirculation. The reduced choriocapillaris plexus parameters and choroidal thickness may provide disease activity information.

Correlation between choroidal thickness and intraocular pressure control in primary angle-closure glaucoma

Purpose: To study the correlation between choroidal thickness (CT) and IOP control in primary angle?closure glaucoma (PACG). Methods: In total, 61 patients (102 eyes) with PACG underwent subfoveal CT (SFCT) scanning using enhanced depth imaging–optical coherence tomography. The subjects with PACG were further grouped as controlled IOP (?21 mm Hg on maximal medical therapy) and uncontrolled IOP (>21 mm Hg on maximal medical therapy). The average CT of the PACG eyes was calculated and compared between both groups. A correlation analysis was done between CT and intereye difference in CT with the disease parameters. Results: The mean CT was 274.38 ± 42.10 ?m in 102 PACG eyes. SFCT was significantly increased in the uncontrolled IOP group as compared with the controlled IOP group. The mean SFCT was 245.57 ± 62.10 ?m in the controlled group and 294.46 ± 51.05 ?m in the uncontrolled group (P < 0.01). Factors associated with a thicker choroid were younger age, high IOP, and higher optic nerve head cupping (P < 0.001). Neither the visual field?mean deviation (VF?MD) nor pattern standard deviation (PSD) was found to be associated with overall CT. The intereye asymmetry between CT was significantly associated with poor VF?MD and PSD. Conclusion: PACG eyes with thicker choroid may be a risk factor for poor IOP control on medical anti?glaucoma therapy. Thicker choroid as compared to the fellow eye is a poor prognostic sign and these eyes should be monitored closely

Changes of subfoveal choroidal thickness and choroidal volume in different stages of diabetic retinopathy through automated choroid segmentation / 中华实验眼科杂志

Objective:To analyze the changes of subfoveal choroidal thickness (SFCT) and choroidal volume in type 2 diabetes patients with diabetic retinopathy (DR) through automated choroid segmentation.Methods:A cross-sectional study was conducted.Sixty-four patients (88 eyes) with type 2 diabetes diagnosed in The First Affiliated Hospital with Nanjing Medical University from May 2016 to May 2017 were enrolled, including 27 males (32 eyes) and 37 females (56 eyes), with an average age of (62.7±7.4) years and an average diabetes duration of (13.7±7.2) years.Best corrected visual acuity, slit lamp ophthalmoscopy, indirect ophthalmoscopy and spectral domain optical coherence tomography (SD-OCT) examination were carried out among all the patients.The patients were divided into non-DR (NDR) group (28 eyes), nonproliferative DR (NPDR) group (36 eyes) and proliferative DR (PDR) group (24 eyes) according to the Early Treatment Diabetic Retinopathy Study.Nineteen age-matched normal subjects (32 eyes) were enrolled as normal control group.SFCT and choroidal volume were measured through automated choroid segmentation based on SD-OCT with enhanced depth imaging.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of The First Affiliated Hospital with Nanjing Medical University (No.2017-SR-176).Results:Mean SFCT and choroidal volume of normal control group, NDR group, NPDR group and PDR group were (277.8±45.3)μm and (8.8±1.0)mm 3, (220.9±38.7)μm and (7.6±1.3)mm 3, (231.8±26.7)μm and (8.2±0.9)mm 3, (252.0±42.2)μm and (8.7±1.0)mm 3, respectively, with significant overall differences among the groups ( F=14.615, P<0.001; F=7.711, P<0.001). Mean SFCT and choroidal volume were significantly smaller in NDR and NPDR group than those in normal control group (both at P<0.05). Mean SFCT and choroidal volume of PDR group was greater than those of NDR group (both at P<0.05). Conclusions:SFCT and choroidal volume decrease during the early course of diabetes and increase significantly as DR worsens from NDR to PDR.

Effect of intravitreal anti-VEGF injection on choroidal thickness in patients with diabetic macula edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate for any detectable change in sub-foveal choroidal thickness following intravitreal injections of Ranibizumab or Aflibercept in patients with central involving diabetic macula edema(DME), evidenced by optical coherence tomography(OCT).<p>METHODS: Totally 17 patients with central involving DME who required and agreed to intravitreal anti-VEGF injection were invited to be the subject of this study. These injection-naive subjects were undergone three loading doses of monthly intravitreal anti-VEGF(Ranibizumab 0.5 mg/0.05 mL for 9 patients or Aflibercept 2 mg/0.05 mL for 8 patients)injection, and a clinic review appointment 1mo after the third injection. The changes of foveal choroidal thickness, visual acuity and central retinal thickness at 1mo were observed before and after treatment in 2 groups by enhanced depth image-optical coherence tomography(EDI-OCT). <p>RESULTS: We recorded a significant sub-foveal choroidal thinning and vision improvement after three loading doses of anti-VEGF(all <i>P</i><0.05). The thinning effect between Ranibizumab and Aflibercept group was insignificant(all <i>P</i>>0.05). There was no significant correlation between pre-treatment sub-foveal choroidal thickness and vision improvement(<i>r_s</i>=-0.269, <i>P</i>=0.296). There was also no significant correlation between choroidal thickness changes with vision improvement, central retinal thickness change and age of subjects(all <i>P</i> >0.05).<p>CONCLUSION: Intravitreal Ranibizumab and Aflibercept injections both leads to significant sub-foveal choroidal thinning in DME subjects. It was accompanied with significant vision improvement with no evidence of immediate detrimental effect of choroidal thinning. Future research with a longer study duration would help in establishing the duration and long term effect of choroidal thinning.

Distribution characteristics of choroidal thickness in normal population and the diagnostic cut-off value for pachychoroid / 中华实验眼科杂志

Objective:To characterize the distribution characteristics of choroidal thickness in healthy normal subjects and to define the diagnostic cut-off value for pachychoroid.Methods:A cross-sectional study design was carried out.Four hundred and forty-six eyes of 230 healthy subjects from the pachychoroid disease spectrum (PCD) cohort in Beijing Tongren Hospital from April 2018 to June 2021, were enrolled for the choroidal thickness distribution analysis.Three hundred and fourteen eyes of 274 patients with PCD including 149 eyes of 113 patients with central serous chorioretinopathy, 95 eyes of 81 patients with polypoid choroidal vasculopathy, 70 eyes of 60 patients with neovascular age-related macular degeneration, along with 382 eyes of 199 normal subjects matched for refractive error, age and gender with PCD were selected for likelihood ratio analysis.Routine eye examinations including the best corrected visual acuity, intraocular pressure, slit-lamp microscopy, dilated fundus examination and color fundus photography were performed in all subjects.Swept-source optical coherence tomography (SS-OCT) of 9 mm×9 mm scanning mode was used to measure the subfoveal choroidal thickness (SFCT) automatically in nine macular regions according to the Early Treatment Diabetic Retinopathy Study classification system using TOPCON Advanced Boundary Segmentation (TABS) software.Pearson linear correlation analysis and Spearman rank correlation analysis were adopted to evaluate the correlations between SFCT and age, diopter.Multiple linear regression was employed to analyze the factors affecting SFCT.After age and refractive error adjustment, the likelihood ratio test was used to determine the diagnostic cut-off value for pachychoroid.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Beijing Tongren Hospital (No.TRECKY2016-054). Written informed consent was obtained from each subject prior to entering the cohort.Results:A negative correlation was found between SFCT and age in normal eyes ( r=-0.34, P<0.001), in both normal male and female subjects ( r=-0.43, P<0.001; r=-0.38; P<0.001). A weak positive correlation was found between SFCT and diopter ( rs=0.19, P<0.001). It was found that age and diopter were strongly correlated with SFCT (both at P<0.001). The cut-off values for pachychoroid in 20-39 years group, 40-59 years group, 60-79 years group and ≥80 years group were 320-330 μm, 330-340 μm, 250-275 μm and 200-225 μm, respectively.The percentages of eyes with pachychoroid in 20-39 years group, 40-59 years group and ≥60 years group were 14.71%(10/68), 24.48%(47/192) and 28.89%(55/184), respectively, showing statistically significant differences among them ( χ2=6.170, P=0.046; LR=6.579, P=0.037). The proportion of pachychoroid in ≥60 years group was significantly higher than that of 20-39 years group, showing a statistically significant difference ( χ2=5.982, P=0.014; LR=6.479, P=0.011). Conclusions:The distribution characteristics of pachychoroid vary in normal subjects over age.Age and diopter are the independent influencing factors of SFCT.

Changes in choroidal thickness and axial length in adolescents with myopic anisometropia after orthokeratology treatment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the changes of choroidal thickness(CT)and axial length(AL)in adolescents with myopic anisometropia before and after orthokeratology(OK lenses)treatment.METHODS: In this retrospective case-control study, 71 myopic participants who insisted on using OK lenses more than 6mo at night from June 2020 to September 2021 in Second People's Hospital of Shenzhen were enrolled. They were divided into three groups, including group A consisted of 31 myopic participants with non-anisometropic myopia with binocular lenses(A1 group: the right eyes, A2 group: the left eyes), group B consisted of 18 bilateral myopic anisometropes(B1 group: the eyes with high degree, B2: the eyes with low degree)and group C consisted of 22 unilateral myopic anisometropes(C1: the eyes with high degree, C2: the eyes with low degree). The length of axis, the CT values of subfoveal(SF)and the superior(S0.5, S1.0, S1.5), inferior(I0.5, I1.0, I1.5), temporal(T0.5, T1.0, T1.5)and nasal(N0.5, N1.0, N1.5)at 0.5, 1.0 and 1.5mm from the fovea before and after wearing lenses at 6mo were measured.RESULTS: After wearing lenses at 6mo, CT of all sites in group A1 was all thickening compared with that before wearing lenses(all P&#x003C;0.05), CT of all sites in group A2 was all thickening compared with that before wearing lenses, there was no difference compared with that before wearing lenses except for the SF, S1.5, T0.5 and T1.5 sites of the CT, the rest of the sites were different before and after wearing lenses(all P&#x003C;0.05), CT of T1.0, N1.5 and S1.5 sites in B1 group was thicker than that before wearing lenses(all P&#x003C;0.05), there was no difference in CT of all sites of the patients in group B2 before and after wearing lenses(all P&#x003E;0.05). Among them, the CT at SF, S0.5, S1.0, S1.5, I0.5, I1.0, I1.5, N0.5, N1.0 and N1.5 was thinner than before wearing lenses, but it was not statistically significant. There were differences in all sites of CT in group C1 compared with that before and after wearing lenses(all P&#x003C;0.05), for the CT of group C2, all the other sites except the points T1.5 and S1.5 was significantly thickened compared with that before wearing lenses(P&#x003C;0.05). The axis of patients in group B2 increased by 0.12±0.14mm after wearing lenses at 6mo compared with that before wearing lenses(all P&#x003C;0.001). The axis of group C2 increased by 0.20±0.17mm after wearing lenses at 6mo compared with that before wearing lenses(all P&#x003C;0.001). The interocular axial difference in group B and C decreased from 0.54±0.27, 0.88±0.39mm before wearing lenses to 0.47±0.20, 0.62±0.39mm after wearing lenses at 6mo(all P&#x003C;0.05). There was no significant in the interocular axis difference of group A1 and A2 before and after wearing lenses(P&#x003E;0.05).CONCLUSION: For adolescents with myopic anisometropia patients after long-term wearing OK lenses have CT thickening in high degree eyes, but no thickening in low-degree eyes, and even thinning. At the same time, wearing OK lenses can slow axis elongation and reduce interocular anisometropia difference in axis, which is an effective clinical method to control the development of anisometropia.

Research progress on related factors of occult myopia / 国际眼科杂志(Guoji Yanke Zazhi)

Occult myopia refers to a special type of myopia, which is caused by the axial length beyond the normal range of children's normal age, and the corneal curvature is lower than the normal range of children with the normal age range of the vision. Because the vision of occult myopia children is within the normal range, it is easy to be ignored in myopia screening. Without timely myopia prevention and control, occult myopia is very easy to develop into dominant myopia, not only the visual development is seriously affected, but visual function will also produce irreversible changes. It is found that the axial length, corneal curvature, retina and chorioid of occult myopia are different from those of ordinary myopia. The change of these indicators can be used to assist the diagnosis and observe their development process. The purpose of this paper is to summarize the research progress at home and abroad on ocular axis length, corneal curvature, macular retinal thickness, macular choroidal thickness and other related factors in children with occult myopia, in order to provide references for related clinical research.

Changes of choroidal structure in children with hyperopic amblyopia observed by EDI-OCT technique / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the differences in choroidal structure between hyperopic amblyopia and normal children of the same age by the enhanced depth imaging optical coherence tomography(EDI-OCT)technique.METHODS: There were 35 cases in 50 eyes of children with hyperopic amblyopia visiting our hospital in January 2021 to December 2021 selected in the amblyopic group, and 30 cases in 51 eyes of healthy children who matched general data in the same period were selected in the control group. EDI-OCT examination was performed to measure the choroidal thickness(CT). After image processing, the total choroidal area(TCA), luminal area(LA), stromal area(SA)and choroidal vascularity index(CVI)were obtained.RESULTS: TCA(except inferior quadrant), SA(except inferior quadrant of the outer ring), LA and CT(except inferior and temporal quadrant )in the amblyopic group of each area were significantly larger than that in the control group(P&#x003C;0.05), and there was no significant difference in CVI between the two groups except the temporal quadrant of the outer ring(P&#x003E;0.05). There was no significant difference in CT for all degrees of hyperopic amblyopia, with the exception of the nasal quadrant(P&#x003E;0.05).CONCLUSION: Hyperopic amblyopia is accompanied with abnormal choroidal structure. As the degree of hyperopia increases, TCA, LA and SA exhibit increasing trends. The changes in choroidal structure are presumed to be related to hyperopic amblyopia.

Research progress of choroidal thickness and myopia prevention and control / 国际眼科杂志(Guoji Yanke Zazhi)

@#Myopia refers to the refraction state in front of macular fovea when the external parallel light falls through the refractive system of the eye. Myopia has seriously affected the healthy growth of teenagers,so that prevention and control of myopia have become a hot issue of social concern. Studies generally agreed that myopia has a close relationship with choroid changes, and the choroid thickness shows a gradual thinning trend with the increase of diopter and ocular axis. Evidence-based medical studies have proved that effective methods for myopia prevention and control(orthokeratology, defocus lens, atropine eye drops, illumination, posterior scleral reinforcement, <i>etc</i>.)showed choroid thickening effect, suggesting that choroid thickening is a protective factor for myopia control. In order to provide a reference for the change of choroid thickness as an evaluation index of myopia prevention and control efficacy, this paper reviews the effect of current effective methods of myopia prevention and control on choroid thickness.