Enhanced Depth Imaging Optical Coherence Tomography: A New Way Measuring Choroidal Thickness in Pregnant Women

Evaluation of choroidal thickness and retinal nerve fiber layer thickness in Chinese pregnant women and healthy non-pregnant women

Purpose

To evaluate choroidal thickness and retinal nerve fiber layer (RNFL) thickness in different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT).

Methods

A prospective comparative study included 45 healthy pregnant women in the first trimester, 45 women in the second, 45 women in the third and 45 healthy non-pregnant women as the control group. Macular choroidal thickness was measured at three locations: The subfoveal, 1 ​mm temporal, and 1 ​mm nasal from the fovea with EDI-OCT. Peripapillary choroidal thickness (PPCT) and RNFL thickness parameters were automatically calculated by the Spectralis OCT.

Results

The subfoveal, temporal and nasal macular choroidal thickness were all significantly thicker in the second trimester, compared with those parameters in the first, the third trimesters and the control group (all P ​< ​0.05). The PPCT was significantly increased in the second trimeter compared with the control group at global, temporal, temporal inferior, nasal and nasal inferior positions (all P ​< ​0.05). The RNFL thickness was also significantly increased in pregnant women at nasal superior and nasal inferior quadrants (all P ​< ​0.05).

Conclusions

The choroidal thickness in pregnant women was found to be thicker than the control group, regardless of macular or optic disc location. Findings of RNFL thickening might indicate subclinical involvement of the central nervous system.

Relationship between proteinuria and optical coherence tomographic features of the chorioretina in patients with pre-eclampsia

This retrospective study aimed to evaluate the correlation between ophthalmologic factors and proteinuria in patients with pre-eclampsia using swept-source optical coherence tomography (OCT) and OCT angiography. In total, 61 pregnant patients diagnosed with pre-eclampsia were recruited during their hospital stay. The authors investigated the relationship between urine protein–creatinine ratio (PCR) and chorioretinal measurements including choroidal thickness (CT), choroidal vascularity index (CVI), foveal avascular zone (FAZ), vascular density (VD), ganglion cell layer+ (GCL+) and GCL++. The associations between mean arterial pressure (MAP) and ophthalmologic factors were also evaluated. Central subfield CT of the right eye (p = 0.031) and paracentral CT of both eyes were related to higher PCR (≥1.35 mg/mg). A significant association with PCR after logarithm transformation was noted (r = 0.284, p = 0.026). Retinal measurements (FAZ, VD, GCL+ and GCL++) and CVI were not related with PCR. There was a positive association between MAP and PCR after logarithm transformation (r = 0.296, p = 0.021); however, chorioretinal factors were not related with MAP. In pregnant women with pre-eclampsia, CT using OCT is a novel factor that is correlated with PCR. Ocular structural alteration in patients with pre-eclampsia may be one of systemic vascular changes caused by pre-eclampsia rather than hypertension.

Evaluation of choroidal thickness and choroidal vascularity index during pregnancy

OBJECTIVE

To assess the choroidal structural characteristics in the first and third trimesters in pregnant women using enhanced depth imaging optical coherence tomography and binarization method.

DESIGN

Prospective study.

PARTICIPANTS

Twenty-five eyes of 25 pregnant women in the first trimester (group 1) and 25 eyes of 25 pregnant women in the third trimester (group 2) were examined. Healthy age-matched 25 participants were enrolled as a control group (group 3).

METHODS

The choroidal thickness (CT) was measured at 3 points; subfoveal, 1500 μm nasal to the fovea, and 1500 μm temporal to the fovea. Total choroidal area, luminal area, stromal area, stroma/lumen ratio, and choroidal vascularity index (CVI) were measured by Image-J software.

RESULTS

The mean subfoveal and nasal CT were statistically significantly increased in group 1 compared with controls (p = 0.005 and p = 0.004, respectively). The mean temporal CT was statistically significantly increased in group 1 compared with groups 2 and 3 (group 1 vs group 2, p = 0.043; group 1 vs group 3, p = 0.011). The mean total choroidal area, stromal area, and luminal area were significantly increased in groups 1 and 2 compared with control group (p < 0.001, p < 0.001, p < 0.001, and p < 0.001, p = 0.002, p = 0.002, respectively). There were no statistically significant differences among groups in terms of mean stroma/lumen ratio and CVI (p = 0.148 and p = 0.312, respectively).

CONCLUSIONS

There was a significant increase in subfoveal, temporal, and nasal CT in the first trimester. Total choroidal, stromal, and luminal areas were significantly increased in the first and third trimesters.

[Morphometric study of the choroid in pregnant women with disorders of carbohydrate metabolism]

In recent years, much attention is being paid to studying the state of the choroid in various eye pathologies, but changes in the choroid of pregnant women with disorders of glucose metabolism remain unexplored.

PURPOSE

To study choroidal thickness in pregnant women with disorders of carbohydrate metabolism in the III trimester.

MATERIAL AND METHODS

The study included 376 pregnant women in the third trimester of pregnancy: 49 of them had type 1 diabetes (T1D), 248 had gestational diabetes (GD), and 79 were healthy pregnant women who comprised the control group. Three subgroups were distinguished among patients with GD, depending on the timing of the development of GD in the I (160 patients), II (56 patients), or III (32 patients) trimesters. Optical coherence tomography was performed to measure choroidal thickness in the foveal region.

RESULTS

In patients with GD, no significant differences in average indexes of choroidal thickness in subgroups with different timing of diabetes development were observed, however, the pregnant women of the GD subgroup with beginning of its development in the first trimester had the smallest indexes of average choroidal thickness. In pregnant women with GD who received insulin, choroidal thickness was lower than in patients who did not receive it, although statistical significance of that was not established. In patients with T1D and diabetic retinopathy (DR), choroidal thickness was significantly lower compared to patients with T1D without DR, GD and control groups. Obtained data indicates the presence of changes in the choroid and development of diabetic choroidopathy in pregnant women with T1D and DR.

CONCLUSION

The study of choroidal changes in pregnant women with disorders of carbohydrate metabolism can help identify criteria for manifestation of diabetic microangiopathy, choroidopathy, and predict the progression of DR.

Choroid and Retinal Nerve Fiber Layer Thickness in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

PURPOSE

We aimed at measuring the choroid and retinal nerve fiber layer thickness with optic coherence tomography (OCT) in patients diagnosed with chronic obstructive pulmonary disease (COPD).

METHODS

A total of 60 patients with COPD and 23 healthy controls were evaluated in the scope of this prospective, observational study. COPD patients were divided into two groups as those that were stable and those with an exacerbation based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. Subfoveal choroid thickness (SFCT) of the patients and the control group was compared by measuring the choroid thickness at points 1000 µm nasal and temporal to the fovea and the mean retinal nerve fiber layer (RNFL) thickness.

RESULTS

The subfoveal choroid thickness of the COPD patients in both the exacerbation and stable groups was found to be statistically significantly thinner than the control group (p=0.047 and p=0.046, resp.). No statistically significant difference was found between the subfoveal choroid thickness of the patients that were stable and those that had an exacerbation (p=0.813). No statistically significant difference was found between the mean RNFL, 1000 µm nasal, or 1000 µm temporal choroid thicknesses of the COPD patients and the control group (p=0.263, p=0.455, and p=0.611, resp.).

CONCLUSION

Decreased subfoveal choroid thickness was found in the COPD patients both during an exacerbation and in the stable period, when compared to the control group. The mean RNFL thickness was similar in the exacerbation and stable period of the stable COPD patients when compared to the control group. This suggests that ocular findings might be important in terms of COPD morbidity. This trial is registered with www.chictr.org.cn/enIndex.aspx.

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.