Early choroidal and retinal changes detected by swept-source oct in type 2 diabetes and their association with diabetic kidney disease: a longitudinal prospective study.

BACKGROUND: To evaluate structural changes in retina and choroid in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD). METHODS: T2D patients with mild or no diabetic retinopathy (DR) were followed for 3 years using structural SS-OCT and OCT angiography (OCT-A) taken every 6 months. Parameters were compared longitudinally and according to the DKD status on baseline. RESULTS: One hundred and sixty eyes from 80 patients were followed for 3 years, 72 with no DKD (nDKD) at baseline and 88 with DKD. Trend analysis of T2D showed significant thinning in GCL + and circumpapillary retinal fiber neural layer (cRFNL), choroid, and decreased vascular density (VD) in superficial plexus and central choriocapillaris with foveal avascular zone (FAZ) enlargement. Patients with no DKD on baseline presented more significant declines in retinal center and choroidal thickness, increased FAZ and loss of nasal and temporal choriocapillaris volume. In addition, the nDKD group had worse glycemic control and renal parameters at the end of the study. CONCLUSION: Our data suggests the potential existence of early and progressive neurovascular damage in the retina and choroid of patients with Type 2 Diabetes (T2D) who have either no or mild Diabetic Retinopathy (DR). The progression of neurovascular damage appears to be correlated with parameters related to glycemic control and renal damage.

Simultaneous evaluation of iris area and subfoveal choroidal thickness in Fuchs uveitis syndrome.

BACKGROUND/AIMS: To simultaneously evaluate iris area (IA) and subfoveal choroidal thickness (SFCT) in eyes with Fuchs Uveitis Syndrome (FUS). METHODS: We prospectively recruited a case series of patients with FUS at our institution, simultaneously measuring IA with anterior segment spectral domain optical coherence tomography (SD-OCT) and SFCT with enhanced depth imaging optical coherence tomography (EDI-OCT). Iris images were analyzed by ImageJ software. We tested the differences in intereye IA and SFCT with the healthy eye (HE) using the Wilcoxon test, and clinical interpretation was controlled by intraclass correlation coefficient (ICC) between two masked specialists. RESULTS: Sixteen patients with unilateral FUS were included. Six were female, and the age range was 37 to 67 (median age 48 years, IQR 41-60). ICC of 98.9%, with a lower confidence interval of 97%. Eyes with FUS had a significant thinning of the total iris median area (p < 0.002), restricted to the temporal and nasal areas compared to the HE (p < 0.01 and < 0.001, respectively). SFCT was also significantly thinner compared to the HE (p < 0.0001). A low correlation was found between iris and choroidal thinning in FUS eyes (rs = 0.21; p = 0.4). CONCLUSIONS: This study found reduced iris area and subfoveal choroidal thickness in eyes with FUS compared to the normal fellow eye.

Correlations between subfoveal choroidal thickness, macular thickness, and visual outcome in neovascular age-related macular degeneration using swept source OCT: insights from intravitreal aflibercept treatment.

BACKGROUND: Age-related macular degeneration (AMD) is a leading cause of visual impairment among individuals aged 50 and above, often resulting in irreversible vision loss (1). Currently, antiangiogenic therapy is the primary treatment approach for neovascular AMD (2). The choroid has gained significant attention in recent years due to its involvement in various ocular pathologies (7). The objective of this study was to evaluate visual acuity and correlate pre-treatment variables, such as foveal thickness and choroidal thickness, with post-treatment outcomes. MATERIALS AND METHODS: This study was designed as a prospective interventional study to investigate the changes in choroidal and macular thickness in patients with neovascular AMD who received intravitreal aflibercept injections. The study utilized medical records and employed Swept Source Optical Coherence Tomography (OCT-SS) for evaluation. The data was collected from patients treated in Presidente Prudente, Brazil, during a three-month load dose period. RESULTS: The best-corrected mean visual acuity significantly improved from 1.0 logarithm of the minimum resolution angle (logMAR) units to 0.55 logMAR after treatment with aflibercept (p < 0.001). Patients undergoing treatment exhibited a significant decrease in average macular thickness from 323 µm to 232 µm (p = 0.001), as well as a reduction in choroidal thickness from 206 µm to 172 µm (p = 0.031), while maintaining intraocular pressure within the normal range (p = 0.719) without significant variation. Statistically significant associations were found between the difference in pre- and post-treatment choroidal thickness and the pretreatment values of macular thickness (p = 0.005) and choroidal thickness (p = 0.013). There was also a statistically significant correlation between the difference in pre- and post-treatment macular thickness and the pretreatment macular thickness value (p < 0.001). CONCLUSION: In this study, aflibercept exhibited remarkable effectiveness in reducing macular and choroidal thickness, as evaluated using OCT-SS, and significantly improved visual acuity in patients with neovascular AMD. The assessment of both choroidal and macular changes, as well as their correlations, can provide valuable insights for clinicians, enabling them to make well-informed therapeutic decisions and effectively monitor treatment outcomes. Notably, this study contributes to the existing body of literature as the first to establish a correlation between pretreatment foveal thickness, variation in choroidal thickness, and post-treatment choroidal thickness.

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 thickness in pediatric patients with sickle cell disease: a cross-sectional cohort study.

BACKGROUND: To measure the retinal/choroidal thicknesses in the macular area of asymptomatic pediatric patients with sickle cell disease (SCD). METHODS: This cross-sectional cohort study included 40 children (79 eyes) with SCD and 19 control patients (36 eyes). All subjects underwent spectral-domain optical coherence tomography (SD-OCT) with enhanced-depth imaging OCT. Generalized Estimating Equations (GEE) were applied to compare the outcomes between groups. P ≤ 0.05 was considered significant. RESULTS: The choroidal thickness in the macular area in the study subfields was significantly thinner in the SCD eyes compared with control eyes (subfoveal subfield and temporal parafoveal subfield, p < 0.0001; nasal parafoveal subfield, p < 0.0001 temporal perifoveal subfield, p < 0.0001; and nasal perifoveal subfield, p < 0.0001). The variations in the retinal thickness were not significant. CONCLUSION: EDI-OCT showed that the macular choroidal thickness is thinner in asymptomatic pediatric patients with SCD.

Correlation between Subfoveal Choroidal Thickness and Anterior Segment Inflammation in Patients with Chronic Stage of Vogt-Koyanagi-Harada Disease.

PURPOSE: To correlate changes in subfoveal choroidal thickness (SCT) with the degree of anterior inflammatory activity in chronic Vogt-Koyanagi-Harada (VKH) disease. METHODS: Anterior segment inflammation was assessed using SUN anterior chamber cell grading criteria, and SCT was measured using EDI-OCT in patients with VKH at multiple visits. ANOVA was used to compare the mean SCT for each anterior chamber cell grade. Regression analysis was used to correlate the anterior segment cell grade and the SCT. RESULTS: 14 patients were included in the study. A total of 432 data points consisting of SCT and anterior segment cell values were analyzed. ANOVA demonstrated significant difference between the mean SCT for different anterior chamber cell grades (p < .0001). Regression analysis demonstrated significant correlation between SCT and grade of anterior chamber cells (R2 = 0.37, p < .001). CONCLUSIONS: Chronic VKH is characterized by a dynamic change in SCT that correlates with anterior segment inflammatory activity.

Macular and choroidal thicknesses in a healthy Hispanic population evaluated by high-definition spectral-domain optical coherence tomography (SD-OCT).

PURPOSE: To report normal values of macular and choroidal thickness obtained from a healthy Hispanic population using Optovue (Optovue Inc, Freemont CA, USA) spectral domain optical coherence tomography (SD-OCT). DESIGN: Observational, cross-sectional, correlation study. METHODS: A total of 290 eyes (145 healthy subjects) were included; 69% of subjects were female. The median age was 39 ± 29 years (IQR), with a range between 18 and 89 years. The study sample was stratified into three age groups: Group 1, 18-40 years (50.3%), Group 2, 41-60 years (30.7%), and Group 3, older than 61 years (19%). Central macular, perifoveal (inner quadrants), and parafoveal (outer quadrants) thicknesses were estimated. In addition, central and peripheral choroidal thicknesses were estimated. Data analysis was performed to calculate the standardized mean difference according to the variance (Student's t-test) and its differences with Epidat 4.1. RESULTS: Median macular central thickness was 250 ±30 µm (IQR) with Optovue. Median central choroidal thickness was 263 ± 48 µm (IQR). Median central choroidal thickness was greater than mean peripheral thickness. Macular evaluation showed a statistically significant difference in central, perifoveal, and parafoveal thicknesses, with lower values being recorded for the study sample compared with the manufacturer's data. CONCLUSIONS: SD-OCT has become a useful tool to obtain high-resolution images of the macula and choroid. This method allows precise assessment of the retinal and choroidal layers to diagnose and follow up posterior segment diseases. We are reporting normal cut-off values of macular and choroidal thicknesses in healthy Hispanic subjects evaluated with Optovue SD-OCT as new diagnostic normal parameters for research and clinical activities.

Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation / Avaliação das medidas da espessura da coroide em pacientes com acentuado desviode septo nasal

Abstract Introduction: Chronic upper airway obstruction due to marked nasal septal deviation may cause chronic hypoxia. It may change the balance of the sympathetic-parasympathetic system and may affect blood flow in the choroid. Objective: To assess choroidal thickness measurements of patients with marked nasal septal deviation. Methods: The patients who had nasal obstruction symptoms diagnosed with marked nasal septal deviation by anterior rhinoscopy and nasal endoscopy and scheduled for septoplasty were included in the study. The control group consisted of age, sex and body mass index-matched healthy individuals. The choroidal measurements at the central fovea and 1000 µm away from the fovea in the nasal and temporal regions were performed using enhanced depth imaging optical coherence tomography. Results: In the study group, 52 eyes of 26 patients with a mean age of 26.34 ± 8.14 years were examined. In the control group, 52 eyes of 28 healthy individuals with a mean age of 26.69 ± 7.84 years were examined. There was no statistically significant difference in terms of choroidal thickness measurements between the groups (p > 0.05). Conclusion: Our results suggest that marked nasal septal deviation may not lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.

Resumo Introdução: A obstrução crônica das vias aéreas superiores devido a acentuado desvio do septo nasal pode causar hipóxia crônica. Pode alterar o equilíbrio do sistema simpático-parassimpático e afetar o fluxo sanguíneo na coroide. Objetivo: Avaliar as medidas da espessura da coroide em pacientes com acentuado desvio de septo nasal. Método: Foram incluídos no estudo pacientes que apresentavam sintomas de obstrução nasal, com diagnóstico de acentuado desvio de septo realizado por rinoscopia anterior e endoscopia nasal, e com septoplastia programada. O grupo controle consistiu de indivíduos saudáveis pareados por idade, sexo e índice de massa corporal. As medidas da coroide na fóvea central e a 1.000 µm da fóvea nas regiões nasal e temporal foram feitas com tomografia de coerência óptica com imagem de profundidade melhorada. Resultados: No grupo de pacientes, 52 olhos de 26 pacientes com média de 26,34 ± 8,14 anos foram examinados. No grupo controle, 52 olhos de 28 indivíduos saudáveis com média de 26,69 ± 7,84 anos foram examinados. Não houve diferença estatisticamente significante em termos de medidas da espessura da coroide entre os grupos (p > 0,05). Conclusão: Nossos resultados sugerem que desvios do septo nasal acentuados podem não levar à hipóxia significativa e ativação simpática, resultar na deterioração do fluxo sanguíneo coroidal e consequente espessamento da coroide.

Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation.

INTRODUCTION: Chronic upper airway obstruction due to marked nasal septal deviation may cause chronic hypoxia. It may change the balance of the sympathetic-parasympathetic system and may affect blood flow in the choroid. OBJECTIVE: To assess choroidal thickness measurements of patients with marked nasal septal deviation. METHODS: The patients who had nasal obstruction symptoms diagnosed with marked nasal septal deviation by anterior rhinoscopy and nasal endoscopy and scheduled for septoplasty were included in the study. The control group consisted of age, sex and body mass index-matched healthy individuals. The choroidal measurements at the central fovea and 1000µm away from the fovea in the nasal and temporal regions were performed using enhanced depth imaging optical coherence tomography. RESULTS: In the study group, 52 eyes of 26 patients with a mean age of 26.34±8.14 years were examined. In the control group, 52 eyes of 28 healthy individuals with a mean age of 26.69±7.84 years were examined. There was no statistically significant difference in terms of choroidal thickness measurements between the groups (p>0.05). CONCLUSION: Our results suggest that marked nasal septal deviation may not lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.

Subthreshold diode micropulse laser versus observation in acute central serous chorioretinopathy.

BACKGROUND: The purpose of this study was to evaluate subthreshold diode micropulse (SDM) laser as a treatment modality in acute central serous chorioretinopathy (CSC) and compare it with the current standard of care (observation). METHODS: A randomised controlled trial was conducted on 68 eyes (34 eyes in SDM laser group and 34 eyes in observation group) with acute CSC, with a single angiographic leak and duration of complaints less than two months. Detailed history, examination and investigations were performed at the baseline and at regular intervals until six months. RESULTS: Eyes in the laser group had significantly higher best-corrected visual acuity at two weeks (p = 0.002), four weeks (p < 0.001), eight weeks (p < 0.001), 16 weeks (p = 0.042) and six months (p = 0.008), and higher contrast sensitivity at eight weeks (p = 0.008), 16 weeks (p < 0.001) and six months (p < 0.001). A recurrent/persistent neurosensory detachment was observed at the end of six months in 11.76 per cent of SDM laser treated eyes versus 29.41 per cent of eyes in the observation group (p = 0.036). CONCLUSION: SDM laser produces faster and superior visual rehabilitation without any adverse effects. It also reduces the chances of CSC going into chronicity and recurrence compared to the current standard of care (observation).

Choroidal thickness in preeclampsia measured by spectral-domain optical coherence tomography.

PURPOSE: To compare choroidal thickness (CT) measurements in preeclamptic and healthy women in the third trimester of pregnancy using optical coherence tomography. METHODS: This cross-sectional study included 148 eyes of 74 women, divided into two groups: 27 healthy pregnant women in the third trimester (control group) and 47 age-matched pregnant women in the third trimester with preeclampsia (PE group). Of the 47 subjects in preeclampsia group, 26 were classified as having mild PE and 21 as having severe PE. Choroidal thickness was measured 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: Comparing CT of both groups, choroid always tended to be thicker in subjects with preeclampsia in comparison with healthy pregnant women, with statistical significance in nasal measures. Dividing PE group according to disease severity, women with severe preeclampsia tended to have thicker choroids in comparison with mild preeclamptic and healthy pregnant women. Choroid was also significantly thicker in preeclamptic patients with serous retinal detachment (SRD) in comparison with preeclamptic patients without SRD (P < 0.01 in all macular points). CONCLUSION: Our study showed that choroid tends to be thicker in patients with preeclampsia, with statistical significance only in nasal measures. In patients with SRD, however, choroid is markedly thicker at all points analyzed. From these findings we can hypothesize that preeclampsia can cause a choroidal thickening, which begins in the peripapillary area. As the imbalance increases, the entire choroid becomes thickened.

Comparative analysis of choroidal thickness in third trimester pregnant women.

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.

The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy

OBJECTIVES: To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy. METHODS: High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505. RESULTS: Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values. CONCLUSIONS: The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.

Evaluation of choroidal and retinal thickness measurements in adult hemodialysis patients using spectral-domain optical coherence tomography / Avaliação de medidas de coroide e espessura da retina em pacientes em hemodiálise adultos usando tomografia de coerência óptica de domínio espectral

ABSTRACT Purpose: To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods: In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (λ=840 mm; 26.000 A-scans/s; 5 µm resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 µm and 1000 µm nasal to the fovea and 500 µm, 1000 µm, and 1500 µm temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared. Results: The median choroidal thicknesses before and after hemodialysis were 182 µm (range, 103-374 µm) and 161 µm (range, 90-353 µm), respectively (P<0.001). The median retinal thicknesses were 246 µm (range, 179-296 µm) before and 248 µm (range, 141-299 µm) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540). Conclusion: Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.

RESUMO Objetivo: Avaliar o efeito da hemodiálise (HD) na espessura da retina (RT) e na espessura da coroide (CT) usando tomografia de coerência óptica de domínio espectral (SD-OCT). Método: Neste estudo prospectivo intervencionista foram incluídos 25 pacientes em HD (17 homens e 8 mulheres). Todos os participantes foram submetidos a SD-OCT com dispositivo de alta resolução (λ=840 mm; 26.000 A-scans/seg e resolução de 5 µm), antes e após HD. A CT foi medida perpendicularmente a partir da borda externa do epitélio pigmentar da retina até o limite coroide-esclera na fóvea e em mais de 5 pontos localizados 500 µm nasal à fóvea, 1.000 µm nasal à fóvea; 500 µm temporal à fóvea, 1.000 µm temporal à fóvea, e 1.500 µm temporal à fóvea. Dois médicos realizaram as medidas sem o conhecimento do diagnóstico. Os dados da CT e RT, antes e após a HD foram comparados. Resultados: As CTs medianas antes e após a HD foram 182 µm (variação de 103-374 µm) e 161 µm (variação de 90-353 µm), respectivamente (p<0,001). A RT foi 246 µm (variação de 179-296 µm) antes e 248 µm (variação de 141-299 µm) após a HD (p>0,05). A pressão arterial sistólica, pressão arterial diastólica, as médias de pressão arterial média, frequência cardíaca e pressão de perfusão ocular diminuíram significativamente após HD (p<0,001). A pressão intraocular não alterou significativamente (p=0,540). Conclusão: A HD parece causar uma redução significativa da CT, e não ter efeito sobre a RT. Esta redução significativa da CT pode ser devida à grande absorção de fluido durante a HD, o que pode resultar numa diminuição do fluxo sanguíneo ocular.

Medida del grosor central coroideo con tomografía óptica coherente de imagen de profundidad mejorada (EDI OCT) en ojos contralaterales de pacientes con coriorretinopatía serosa central (CSC) / Central choroidal thickness measured by enhanced depth imaging (EDI OCT) in fellow eyes of subjects with central serous chorioretinopathy (CSC)

Diseño: Estudio descriptivo y trasversal. Objetivos: Medición del grosor coroideomacular en el ojo contralateral (ojo sano) de pacientes con coriorretinopatía serosa central (CSC), utilizando tomografía óptica coherente de imagen de profundidad mejorada (EDI OCT). Pacientes y métodos: Fueron evaluados 32 ojos de 16 pacientes voluntarios, con diagnostico de coriorretinopatía serosa central (CSC) aguda. Ambos ojos fueron sometidos a estudio de tomografía óptica de dominio espectral con profundidad mejorada (EDI SD-OCT) con el Tomógrafo RTVue® (Optovue, USA). Se realizó escaneo horizontal de alta definición a través de la fóvea, tanto en el ojo afectado, como en el sano contralateral. Se realizaron 5 medidas del grosor coroideo. El promedio del grosor coroideo fue calculado y comparado, entre los ojos con CSC y el ojo contralateral. Resultados: El promedio de edad fue de 40+/-7 (rango entre 29 y 56 años). Quince de los 16 ojos sintomáticos eran derechos. Dos mujeres y 14 hombres. La media del grosor coroideo en el ojo sintomático fue de 470.4+/-35.7µm, y en el ojo contralateral el grosor fue de 413.4+/-47.1µm. La relación entre ambos ojos mostró una alta correlación (0,979) y una correlación estadísticamente significativa (p<0.001). Conclusión: La tomografía óptica coherente de dominio espectral con profundidad mejorada, es una herramienta útil en evaluar el grosor coroideo en pacientes con CSC, donde el grosor coroideo también aparece aumentado en el ojo contralateral.

Design: Descriptive and cross-sectional study. Objective: To measure macular choroidal thickness in fellow eyes of patients with central serous chorioretinopathy, using enhanced depth imaging optical coherence tomography (EDI OCT). Patients and methods: This is a descriptive, cross-sectional study. A total of 32 eyes of 16 patients were evaluated. Sixteen volunteers with acute central serous corioretinopathy (CSC) diagnosis underwent high-definition scanning using SD-OCT (RTVue®, Optovue, USA) with enhanced depth imaging technique (EDI OCT) in both eyes. One horizontal scan across the fovea was selected for each affected and healthy eye, five choroidal thickness measurements were taken. The average choroidal thickness was also calculated and compared among eyes with CSC and fellow eyes. Results: Mean age was 40+/-7 years (range between 29 and 56 years old). Fifteen of 16 symptomatic eyes where right eyes. Two women and 14 men were involved. The mean choroidal thickness in symptomatic eyes was 470.4+/-35.7 µm, and the fellow eyes thickness was 413.4+/-47.1 µm. The matching shows a high correlation (0,979) between paired samples and statistical signifi cance of its correlation (p<0.001). Conclusions: Enhanced depth imaging spectral-domain optical coherence tomography is a helpful tool for assessing choroidal thickness in fellow eyes of patients with CSC, where the choroid is as thickened as in affected eyes.

Peripapillary retinal nerve fiber layer and choroidal thickness in cirrhosis patients / Espessura da camada de fibras nervosas peripapilares da retina e coroide em pacientes com cirrose

ABSTRACT Purpose: To evaluate the effect of cirrhosis on peripapillary retinal nerve fiber layer and choroidal thickness with enhanced depth imaging optical coherence tomography. Methods: This cross sectional, single center study was undertaken at Bulent Ecevit University Ophthalmology department with the participation of internal medicine, Gastroenterology department. Patients who were treated with the diagnosis of cirrhosis (n=75) were examined in the ophthalmology clinic. Age and sex matched patients (n=50) who were healthy and met the inclusion, exclusion criteria were included in the study. Complete ophthalmological examination included visual acuity with Snellen chart, intraocular pressure measurement with applanation tonometry, biomicroscopy of anterior and posterior segments, gonioscopy, axial length measurement, visual field examination, peripapillary retinal nerve fiber layer, central macular and subfoveal choroidal thickness measurements. Results: The difference between intraocular pressure values was not statistically significant between cirrhosis and control group (p=0.843). However, mean peripapillary retinal nerve fiber layer thickness was significantly thinner in cirrhosis group in all regions (p<0.001) and subfoveal choroidal thickness was significantly thinner in cirrhosis group also (p<0.001). Moreover, central macular thickness of cirrhosis group was significantly thicker than the control group (p=0.001). Conclusion: Peripapillary retinal nerve fiber layer and subfoveal choroidal thickness was significantly thinner in cirrhosis patients.

RESUMO Objetivo: Avaliar o efeito da cirrose na camada de fibras nervosas da retina e na espessura da coroide através da tomografia de coerência óptica com imagem de profundidade aprimorada. Métodos: Este estudo transversal, de único centro, foi realizado no departamento de Oftalmologia da Universidade Bulent Ecevit com a participação do departamento de medicina interna em gtastroenterologia. Os pacientes que foram tratados com o diagnóstico de cirrose (n = 75) foram examinados na clínica da oftalmologia. Foram incluídos pacientes correspondentes em idade e sexo (n = 50) que fossem saudáveis e possuíssem o critério de inclusão exigido pelo estudo. Realização de exame oftalmológico completo: acuidade visual com tabela de Snellen, a medida da pressão intraocular com tonometria de aplanação, biomicroscopia do segmento anterior e posterior, gonioscopia, medida do comprimento axial, exame de campo visual, camada de fibras nervosas da retina, macular central e medidas de espessura de coroide. Resultados: A diferença entre os valores de pressão intraocular não foram estatisticamente significativos entre os grupos cirrótico e controle (p=0,843). Entretanto, a espessura da camada de fibras nervosas da retina foi significativamente mais fina no grupo cirrótico em todas as regiões (p=0,001) e a espessura subfoveal da coroide também foi significativamente mais fina no grupo cirrótico (p=0,001). Além disso, a espessura macular central do grupo cirrótico foi significativamente mais grossa do que no grupo de controle (p=0,001). Conclusão: Por fim, as espessuras das camadas de fibras nervosas da retina e subfoveal da coroide foram significativamente mais finas nos pacientes com cirrose.

Atrofia coroidea relacionada con la edad en pacientes hispanos: serie de casos / Age-related choroidal atrophy in hispanics patients: a case series

Propósito: describir los hallazgos y la medición del grosor coroideo subfoveal utilizando tomografía óptica coherente de imagen de profundidad mejorada (EDI OCT), en paciente hispanos con sospecha clínica de atrofia coroidea relacionada con la edad (ARCA). Métodos: estudio descriptivo y trasversal en 17 pacientes con impresión clínica de ARCA, basados en: disminución de la agudeza visual de reciente aparición, alteraciones pigmentarias en la macula, apariencia de fondo de ojo atigrado y atrofia peripapilar a pesar de no ser miope. A todos se les realizó examen oftalmológico completo, que incluía: Agudeza visual mejor corregida (BCVA), biomicroscopía con lámpara de hendidura y evaluación del fondo de ojo bajo dilatación. A estos pacientes se les realizó fotografía digital del fondo de ojo y tomografía óptica coherente de imagen de profundidad mejorada (EDI OCT). Se realizó un total de 5 mediciones del grosor coroideo en el área macular en cada ojo. Resultados: se evaluaron 26 ojos de 14 pacientes, con una edad media de 70,86 años (DS± 8,46 años). El 57.14% fueron mujeres y el 42.86% hombres. El promedio de la agudeza visual fue 20/47 (0,38 LogMAR), el 80.2% presentaron manifestación binocular. La media del grosor coroideo fue 119,53 µm (DS±49,68µm). No hubo correlación estadísticamente signifi cativa entre la BCVA y grosor coroideo (P=0.407). Conclusión: la atrofia coroidea relacionada con la edad es una condición que puede presentarse en pacientes hispanos de edad avanzada. Afecta igualmente a hombres y mujeres, es usualmente bilateral y el grado de adelgazamiento de la coroides no predice la agudeza visual final.

Purpose: to describe the findings and measure the subfoveal choroidal thickness with Enhanced Depth Imaging (EDI) OCT in hispanics subjects with clinical impression of age-related choroidal atrophy (ARCA). Methods: a descriptive and cross-sectional study of 17 subjects with clinical impression of ARCA: based on recently decreased visual acuity, pigmentary alterations in the macula, a tessellated fundoscopic appearance, and peripapillary atrophy despite being not myopic. All patients had a comprehensive ocular examination, including BCVA, biomicroscopic and fundus examination. They underwent color fundus photography and EDI OCT. A total of 5 measurements were took of each eye. Results: twenty six eyes were included from 14 patients, with a mean age 70,86 years (SD ± 8,46 years). The 57,14% were female and 42.86% male. The mean visual acuity was 20/47 (0,38 LogMAR Equivalent), 80.2% had bilateral disease. The mean choroidal thickness was 119,53 µm (SD ± 49,68 µm). There was no statistically significant correlation between BCVA and choroidal thickness (p =0,407). Conclusions: the ARCA is a condition that can be present in elderly Hispanics subjects. Affects equally male and female, it is usually bilateral and the degree of choroidal thinning does not predict the final visual acuity.

Imágenes de la coroides por tomografía de coherencia óptica en sujetos sanos y con enfermedades coriorretinales / Images of choroid by optical coherence tomography in healthy subjects and chorioretinal diseases

Objetivos: Describir las imágenes de la coroides por tomografía de coherencia óptica (TCO) de dominio espectral en sujetos sanos y con enfermedades coriorretinales. Materiales y métodos: Estudio de serie de casos. Se evaluaron 67 casos que incluyeron sujetos sanos oculares y pacientes con enfermedades coriorretinales. Las tomografías realizadas incluyeron un barrido de la retina y coroides a nivel de la mácula de manera convencional y otro usando el protocolo de profundidad de imagen mejorada (PIM). El espesor coroideo se midió desde el borde exterior del epitelio pigmentario de la retina hasta el reborde escleral interno. Resultados: De los 67 casos, 12 (17.4%) fueron sujetos sanos oculares, 10 (14,5%) con coriorretinopatía serosa central (CSC), 23 (33,4%) degeneración macular relacionada con la edad (DMRE), 9 (13,0%) miopía magna. 13 (18.8%) vasculopatía polipoidal coroidea. Existen diferencias en la calidad de las imágenes con TCO convencional y las realizadas con PIM, permitiendo describir solo coriocapilaris en algunos casos mientras que con el protocolo PIM se puede apreciar el grosor total coroideo. La coroides es de mayor espesor en la vasculopatía polipoidal coroidea (353,92 ± 68,66 µm) y en la CSC (408,81 ± 95,56 µm) que en los sujetos sanos (251,97 ± 66.37 µm) (p<0,05) y está disminuida en DMRE forma seca (124.69 ± 34.02 µm) (p<0,05), al igual que en la miopía magna (118.47 ± 34.02 µm) (p<0,05). Conclusiones: Las imágenes de TCO de la coroides por PIM es una técnica reproducible que permite describir y medir su espesor, estando disminuida en la DMRE, y miopía magna; e incrementada en vasculopatía polipoidal y la CSC.

Objectives: Describe the images of the choroid by optical coherence tomography (OCT) spectral domain in healthy subjects and chorioretinal diseases. Materials and methods: Case series study. We evaluated 67 cases involving healthy ocular subjects and patients with chorioretinal diseases. The scans included a sweep of the retina and choroid at level of the macula conventionally, and other using enhanced depth imaging (EDI). The choroid thickness was measured from the outer edge of the retinal pigment epithelium to the internal scleral rim. Results: Of the 67 cases, 12 (17.4%) were healthy ocular subjects, 10 (14.5%) with central serous chorioretinopathy (CSC), 23 (33.4%) agerelated macular degeneration (AMD), 9 (13.0%) with myopia, 13 (18.8%) with polypoidal choroidal vasculopathy. There are differences in the quality of images with conventional OCT and those with EDI, allowing only to describe the choriocapillaris in some cases while the EDI protocol can appreciate the total thickness of the choroid. The choroid is thicker in polypoidal choroidal vasculopathy (353.92 ± 68.66 microns) and CSC (408.81 ± 95.56 microns) than in healthy subjects (251.97 ± 66.37 mm) (p<0.05) and is decreased in the dry AMD (124.69 ± 34.02 microns) (p<0.05), as well as in the myopia (118.47 ± 34.02 microns) (p<0.05). Conclusions: OCT images of the choroid by PIM is a reproducible technique for describing and measuring its thickness, being decreased in AMD and myopia, and was increased in the polypoidal vasculopathy and CSC.