Retinal and Choroidal Thickness in relation to C-Reactive Protein on Swept-Source Optical Coherence Tomography

Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography

AIM

To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography (SS-OCT).

METHODS

According to the body mass index (BMI) results, the adults enrolled in the cross-sectional study were divided into the normal group (18.50≤BMI<25.00 kg/m2), the overweight group (25.00≤BMI<30.00 kg/m2), and the obesity group (BMI≥30.00 kg/m2). The one-way ANOVA and the Chi-square test were used for comparisons. Pearson's correlation analysis was used to evaluate the relationships between the measured variables.

RESULTS

This research covered the left eyes of 3 groups of 434 age- and sex-matched subjects each: normal, overweight, and obesity. The mean BMI was 22.20±1.67, 26.82±1.38, and 32.21±2.35 kg/m2 in normal, overweight and obesity groups, respectively. The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group (P<0.05 for all), while the retinal thickness of the three groups did not differ significantly. Pearson's correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness, but no significant correlation was observed between BMI and retinal thickness.

CONCLUSION

Choroidal thickness is decreased in people with overweight or obesity. Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.

Retinal thickness and fundus blood flow density changes in chest pain subjects with dyslipidemia

AIM

To assess the retinal thickness and fundus blood flow density changes in chest pain patients with dyslipidemia using optical coherence tomography angiography (OCTA).

METHODS

All subjects with chest pain as the main symptom accepted a comprehensive ophthalmological examination. According to the serum lipid levels, the participants were divided into the control group and the dyslipidemia group. The retina thickness and fundus blood flow density were determined using OCTA.

RESULTS

The study enrolled 87 left eyes from 87 adults with dyslipidemia and 87 left eyes from age- and sex-matched participants without dyslipidemia. The retina of dyslipidemia subjects was significantly thinner than that of the controls in the inferior (P=0.004 and P=0.014, respectively) and temporal (P=0.015 and P=0.019, respectively) regions, both inner and outer layers. In terms of blood flow density in the macula or optic disk, there was a decreasing trend in the dyslipidemia group compared with the control group, especially in the inferior and temporal regions.

CONCLUSION

Dyslipidemia may contribute to the decrease in retinal thickness and fundus blood flow density. Further validation of the association between abnormal lipid metabolism and fundus microcirculation alterations needs to be carried out in chest pain patients.

Rates of Choroidal and Neurodegenerative Changes Over Time in Diabetic Patients Without Retinopathy: A 3-Year Prospective Study

PURPOSE

To evaluate the longitudinal changes of retinal neurodegeneration and choroidal thickness in diabetic patients with and without diabetic retinopathy (DR).

DESIGN

Prospective observational cohort study.

METHODS

This prospective observational cohort study recruited type 2 diabetic patients from a community registry in Guangzhou. All participants underwent annual ocular examinations via swept-source optical coherence tomography that obtained choroid thickness (CT), retinal thickness (RT), and ganglion cell-inner plexiform layer (GC-IPL) thickness. The changes in GC-IPL, CT, and RT between patients who developed incident DR (IDR) or remained non-DR (NDR) were compared during a 3-year follow-up.

RESULTS

Among 924 patients, 159 (17.2%) patients developed IDR within the 3-year follow-up. A reduction in GC-IPL, RT, and CT was observed in NDR and IDR; however, CT thinning in patients with IDR was significantly accelerated, with an average CT reduction of -6.98 (95% CI: -8.26, -5.71) μm/y in patients with IDR and -3.98 (95% CI: -4.60, -3.36) μm/y in NDR patients (P < .001). Reductions in average GC-IPL thickness over 3 years were -0.97 (95% CI: -1.24, -0.70) μm/y in patients with IDR and -0.76 (95% CI: -0.82, -0.70) μm/y in NDR patients (P = .025). After adjusting for confounding factors, the average CT and GC-IPL thinning were significantly faster in patients with IDR compared with those who remained NDR by 2.09 μm/y (95% CI: 1.01, 3.16; P = .004) and -0.29 μm/y (95% CI: -0.49, -0.09; P = .004), respectively. The RT in the IDR group increased, whereas the RT in the NDR group decreased over time, with the adjusted difference of 2.09 μm/y (95% CI: 1.01, 3.16; P < .001) for central field RT.

CONCLUSIONS

The rate of retinal neurodegeneration and CT thinning were significantly different between the eyes that developed IDR and remained NDR during the 3-year follow-up, but both groups observed thickness reduction. This indicates that GC-IPL and CTs may decrease before the clinical manifestations of DR.

Inverse Relationship between Serum 25-Hydroxyvitamin D and Elevated Intraocular Pressure

Elevated intraocular pressure (EIOP) is the only major modifiable risk factor of glaucoma. While low serum vitamin D levels are considered a potential risk factor for glaucoma, there is conflicting evidence on the relationship between vitamin D and EIOP despite the possible linkage between vitamin D and intraocular pressure through oxidative stress and systemic inflammation. Therefore, the aim of this study is to verify the relationship between 25-hydroxyvitamin D [25(OH)D] and EIOP using data from 15,338 individuals who visited the health promotion center of an education hospital. The cubic spline curve revealed an inverse dose-dependent association between serum 25(OH)D level and EIOP. Using multiple logistic regression analysis, the fully adjusted odds ratio (OR) with 95% confidence interval (CI) for the EIOP of the serum 25(OH)D per increment was 0.97 (0.96-0.990). The fully adjusted ORs (95% CIs) for the EIOP of the 25(OH)D insufficiency and 25(OH)D sufficiency groups, compared to 25(OH)D deficiency group, were 0.72 (0.56-0.92) and 0.51 (0.34-0.78), respectively. The relationship remained significant in male and young age subgroups. In conclusion, the clinical assessment of intraocular pressure may prove helpful when treating patients with 25(OH)D deficiency, which may be a preventive strategy against the development of glaucoma.

Macular hole following phakic intraocular lens implantation: A case report

BACKGROUND

Phakic intraocular lens (pIOL) implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia. However, it is associated with multiple complications.

CASE SUMMARY

This report describes a case of full-thickness macular hole (MH) in a patient with a history of bilateral pIOL implantation for the correction of myopia of –12.00 diopters in both eyes 7 mo ago. The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.

CONCLUSION

In rare cases, MH can occur following pIOL. In this present case report, we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.

Evaluation of Choroidal Thickness Using Optical Coherent Tomography: A Review

The choroid is the main source of blood and nourishment supply to the eye. The dysfunction of the choroid has been implicated in various retinal and choroidal diseases. The identification and in-depth understanding of pachychoroid spectrum disorders are based on the tremendous progress of optical coherence tomography (OCT) technology in recent years, although visibility of choroid is challenging in the era of the time or spectral domain OCT. The recent rapid revolution of OCTs, such as the enhanced depth imaging OCT and the swept-source OCT, has greatly contributed to the significant improvement in the analysis of the morphology and physiology of the choroid precisely, especially to the choroid-scleral boundary and vasculature. The present review highlights the recently available evidence on the measurement methodology and the clinical significance of choroidal thickness in retinal or choroidal disorders.

Relationships of Rheumatoid Factor with Thickness of Retina and Choroid in Subjects without Ocular Symptoms Using Swept-Source Optical Coherence Tomography

Purpose

Researches have confirmed that the retinal and choroidal thickness in patients with autoimmune disease-associated uveitis displays significant changes. However, the relationships between rheumatoid factor (RF) and thickness of the retina and choroid in individuals without ocular manifestations remain unclear. The aim of this study is to assess the associations of RF with retinal and choroidal thickness.

Methods

The individuals enrolled in the cross-sectional research received full ocular examinations. The participants were classified as the RF (+) group (RF ≥ 15.0 IU/ml) and the RF (−) group (RF < 15.0 IU/ml) according to the serum RF titers. The thickness of the retina and choroid was measured by swept-source optical coherence tomography (SS-OCT).

Results

The study covered 65 right eyes of 65 individuals that are RF-positive and 130 right eyes of 130 age- and sex-matched individuals that are RF-negative. The RF (+) group showed decreased choroidal thickness that achieved statistical significance only in the outer inferior and outer temporal sectors, as compared to the RF (−) group. There was no statistically significant difference regarding the retinal thickness between the two groups. Pearson's correlation analysis revealed that the RF was significantly negatively related to the choroidal thickness in all areas. However, there was no significant correlation between the RF and the retinal thickness.

Conclusions

Serum RF titers are closely linked with choroidal thickness before the emergence of ocular symptoms. Research into the relationships may improve our understanding of the role of serum RF in the pathogenesis of uveitis.