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Khanal S, Turnbull PR, Kim L, Phillips JR. Response of the human choroid to short-term changes in eyelid and periocular temperature. Clin Exp Optom 2024:1-7. [PMID: 39013558 DOI: 10.1080/08164622.2024.2377391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 07/03/2024] [Indexed: 07/18/2024] Open
Abstract
CLINICAL RELEVANCE Choroidal thickness measurement is gaining popularity in clinical practice and research as an early indicator of myopia progression. Understanding the influence of temperature on choroidal thickness changes will improve the reliability of the measures. BACKGROUND It has been suggested that environmental temperature may affect choroidal thickness and blood flow, with potential implications for ocular disease and refractive development. This study investigates the effect of changes in eyelid/ocular adnexa temperature on choroidal thickness. METHODS In a paired-eye study, 20 young, healthy subjects received a warm stimulus (heat pack) over one closed eye and simultaneously a cold stimulus (ice pack) over the other for 10 min. Eyelid temperatures were monitored with thermal probes, and optical coherence tomography scans of the retina and choroid were taken before and after heating and cooling, and then every 5 min during a 15-min recovery period. Retinal and choroidal thicknesses were measured across the macular region (6 mm), including the subfoveal (1 mm), parafoveal (1-3 mm), and perifoveal (3-5 mm) regions, and compared between the cooled and warmed eyes. RESULTS When the thermal stimuli were applied, eyelid surface temperatures changed predictably and remained significantly different (by approximately 10-15°C) between the eyes after 2 min (p < .001). Relative to the warmed eye, macular choroidal thickness in the cooled eye increased significantly after 10 min of treatment (p = .004). This choroidal thickening response occurred in the subfoveal, parafoveal, and perifoveal regions (all p < .05). Upon removal of the thermal stimuli, choroidal thickness rapidly returned to the baseline and was no longer different between the cooled and warmed eye (p = .641). CONCLUSION Cooling the anterior eye by application of a cold stimulus directly onto the closed eyelid caused a small but significant increase in choroidal thickness relative to warming the anterior eye, demonstrating that the choroid can modulate its thickness rapidly and transiently in response to local temperature changes.
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Affiliation(s)
- Safal Khanal
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Philip Rk Turnbull
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - Lucia Kim
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | - John R Phillips
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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2
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Cao Y, Gu X, Zhang Y, Zhao J, Zhu D. Assessment of the effects of myopic and hyperopic anisometropia on choroidal vascular structure in children using SS-OCTA. Ophthalmic Physiol Opt 2024; 44:525-536. [PMID: 38456753 DOI: 10.1111/opo.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To compare large- and medium-sized choroidal vascularity and the choriocapillaris (CC) flow area in children with different refractive errors using swept-source optical coherence tomography angiography (SS-OCTA). METHODS Forty-two anisometropic children were enrolled and divided into hyperopic anisometropia (HA) and myopic anisometropia (MA) groups. SS-OCTA was performed to analyse choroidal vascularity. Mean choroidal thickness (CT), choroidal vascularity volume (CVV), choroidal vascularity index (CVI) and CC flow area were compared between the two eyes. The inter-ocular differences between the two groups were also determined. RESULTS Mean CT and CVV were highest in eyes with shorter axial lengths in both refractive groups, and the difference between the two eyes was positively correlated with the difference in axial length at the foveal region. Significant differences in the CVI in the MA group were only found in the parafoveal region. Inter-ocular differences in the CC were significantly reduced in eyes with longer axial lengths in the foveal and parafoveal regions of the HA and MA groups, respectively. Comparing inter-ocular differences, CC was significantly greater in the parafoveal region of the MA group than the HA group. CONCLUSIONS All layers of choroidal vasculature were thinner in eyes with longer axial lengths in all groups. The inter-ocular CC difference was greater in the MA than in the HA group, with similar differences in axial length. This suggests that both medium-to-large choroidal vascular and choroidal capillaries may play a role in myopia development.
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Affiliation(s)
- Yiwen Cao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Xiaopeng Gu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Yadi Zhang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Jingjing Zhao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Dehai Zhu
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
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3
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Cui X, Buonfiglio F, Pfeiffer N, Gericke A. Aging in Ocular Blood Vessels: Molecular Insights and the Role of Oxidative Stress. Biomedicines 2024; 12:817. [PMID: 38672172 PMCID: PMC11048681 DOI: 10.3390/biomedicines12040817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Acknowledged as a significant pathogenetic driver for numerous diseases, aging has become a focal point in addressing the profound changes associated with increasing human life expectancy, posing a critical concern for global public health. Emerging evidence suggests that factors influencing vascular aging extend their impact to choroidal and retinal blood vessels. The objective of this work is to provide a comprehensive overview of the impact of vascular aging on ocular blood vessels and related diseases. Additionally, this study aims to illuminate molecular insights contributing to vascular cell aging, with a particular emphasis on the choroid and retina. Moreover, innovative molecular targets operating within the domain of ocular vascular aging are presented and discussed.
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Affiliation(s)
- Xiuting Cui
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
| | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
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Ostrin LA, Sah RP, Queener HM, Patel NB, Tran R, Shukla D, Mirhajianmoghadam H. Short-Term Myopic Defocus and Choroidal Thickness in Children and Adults. Invest Ophthalmol Vis Sci 2024; 65:22. [PMID: 38597724 PMCID: PMC11008753 DOI: 10.1167/iovs.65.4.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Purpose Studies report conflicting findings regarding choroidal thickness changes in response to myopic defocus in humans. This study aimed to investigate the choroidal response to myopic defocus in children and adults using automated analysis. Methods Participants (N = 46) were distance-corrected in both eyes and viewed a movie on a screen for 10 minutes. Two optical coherence tomography (OCT) radial scans were collected for each eye, then +3 diopters was added to one eye. Participants continued to watch the movie, OCT scans were repeated every 10 minutes for 50 minutes, and then recovery was assessed at 60 and 70 minutes. Defocus was interrupted for approximately two out of each 10 minutes for OCT imaging. OCT images were analyzed using an automated algorithm and trained neural network implemented in MATLAB to determine choroidal thickness at each time point. Repeated-measures ANOVA was used to assess changes with time in three age groups (6-17, 18-30, and 31-45 years) and by refractive error group (myopic and nonmyopic). Results Choroidal thickness was significantly associated with spherical equivalent refraction, with the myopic group having a thinner choroid than the nonmyopic group (P < 0.001). With imposed myopic defocus, there were no significant changes in choroidal thickness at any time point for any age group and for either refractive error group (P > 0.05 for all). Conclusions Findings demonstrate that, using the described protocol, the choroidal thickness of children and adults does not significantly change in response to short-term, full-field myopic defocus, in contrast to several previously published studies.
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Affiliation(s)
- Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, United States
| | - Raman P. Sah
- University of Houston College of Optometry, Houston, TX, United States
| | - Hope M. Queener
- University of Houston College of Optometry, Houston, TX, United States
| | - Nimesh B. Patel
- University of Houston College of Optometry, Houston, TX, United States
| | - Raphaella Tran
- University of Houston College of Optometry, Houston, TX, United States
| | - Divya Shukla
- University of Houston College of Optometry, Houston, TX, United States
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5
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Dastamooz S, Yam JC, Tham CCY, Wong SHS, Farahani MHD, Xueting K, Sit CHP. The effects of physical activity on pediatric eyes: A systematic review and meta-analysis. Prev Med 2024; 179:107845. [PMID: 38185223 DOI: 10.1016/j.ypmed.2023.107845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/16/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Examining the retina represents a non-invasive method to evaluate abnormalities pertaining to the nervous and cardiovascular systems. Evidence indicates that physical activity is a non-pharmacological intervention to enhance the nervous and cardiovascular systems. However, little is unknown about its effects on ocular characteristics in children and adolescents. The purpose of this study was to examine the effects of physical activity interventions on ocular characteristics in children and adolescents. METHOD The electronic bases Web of Science, Embase, Cochrane Library, PubMed, SPORTDiscus, CINAHL, and ERIC were searched from inception to May 2023. Incorporated were randomized controlled trials or quasi-experimental designs that had implemented acute or chronic physical activity interventions among children and adolescents to evaluate various eye-related attributes via clinical examinations or surveys. Two authors independently performed the data extraction and risk of bias assessment, utilizing the Physiotherapy Evidence Database checklist. RESULTS A total of 474 articles were identified, of which eight articles underwent a systematic review, and six were chosen for meta-analysis. Chronic physical activity interventions positively impacted central retinal artery equivalent (CRAE) with a small to moderate effect (SMD = 0.21; 95% CI 0.04 to 0.39, p = 0.034, I2 = 0%) and central retinal venular equivalent (CRVE) with a small effect (SMD = 0.098; 95% CI 0.08 to 0.11; p = 0.008, I2 = 0%). Intraocular pressure, kinetic visual acuity, and eye strain also improved significantly after physical activity interventions. DISCUSSION Participating in chronic physical activity programs appear to impact children and adolescents' eye-related attributes positively.
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Affiliation(s)
- Sima Dastamooz
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, China
| | - Clement C Y Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, China
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China
| | - Mohammad H D Farahani
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, China
| | - Ku Xueting
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China.
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Ostrin LA, Harb E, Nickla DL, Read SA, Alonso-Caneiro D, Schroedl F, Kaser-Eichberger A, Zhou X, Wildsoet CF. IMI-The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37126359 PMCID: PMC10153586 DOI: 10.1167/iovs.64.6.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The choroid is the richly vascular layer of the eye located between the sclera and Bruch's membrane. Early studies in animals, as well as more recent studies in humans, have demonstrated that the choroid is a dynamic, multifunctional structure, with its thickness directly and indirectly subject to modulation by a variety of physiologic and visual stimuli. In this review, the anatomy and function of the choroid are summarized and links between the choroid, eye growth regulation, and myopia, as demonstrated in animal models, discussed. Methods for quantifying choroidal thickness in the human eye and associated challenges are described, the literature examining choroidal changes in response to various visual stimuli and refractive error-related differences are summarized, and the potential implications of the latter for myopia are considered. This review also allowed for the reexamination of the hypothesis that short-term changes in choroidal thickness induced by pharmacologic, optical, or environmental stimuli are predictive of future long-term changes in axial elongation, and the speculation that short-term choroidal thickening can be used as a biomarker of treatment efficacy for myopia control therapies, with the general conclusion that current evidence is not sufficient.
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Affiliation(s)
- Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, United States
| | - Elise Harb
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
| | - Debora L Nickla
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, Massachusetts, United States
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Falk Schroedl
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Alexandra Kaser-Eichberger
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Xiangtian Zhou
- Eye Hospital and School of Optometry and Ophthalmology, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Christine F Wildsoet
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Lou L, Ostrin LA. The outdoor environment affects retinal and choroidal thickness. Ophthalmic Physiol Opt 2023; 43:572-583. [PMID: 36779486 PMCID: PMC10081136 DOI: 10.1111/opo.13107] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE Accumulating evidence suggests that time outdoors is protective against myopia development and that the choroid may be involved in this effect. The goal of this study was to examine the effect of 2 h of time outdoors in sunlight on retinal and choroidal thickness in adults. METHODS Twenty adults, ages 23-46 years, each participated in three experimental sessions on different days, consisting of 2 h of exposure to (1) indoor illumination (350 lux), (2) darkness (<0.1 lux) or (3) outdoor environment (6000-50,000 lux). Spectral-domain optical coherence tomography (SD-OCT) imaging was conducted at baseline, after 1 and 2 h of exposure, and after 1 and 2 h of follow-up. Choroidal, total retinal, photoreceptor outer segment + retinal pigment epithelium (RPE) and photoreceptor inner segment thicknesses were determined. RESULTS At 2 h, the choroid was significantly thinner during the outdoor compared with the indoor and dark conditions (p < 0.01) but was not significantly different at follow-up. Total retinal thickness was significantly thicker during and after the outdoor compared with the indoor and dark conditions. The outer segment + RPE was significantly thinner during the outdoor compared with the indoor condition but was not significantly different at follow-up. The inner segment was significantly thicker during the outdoor compared with the indoor and dark conditions during exposure and follow-up. CONCLUSIONS Spending 2 h outdoors under high-intensity sunlight resulted in an unexpected thinning of the choroid, which recovered post-exposure. Retinal thickness showed different responses to the outdoor and indoor environments and was sensitive to the duration of exposure.
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Affiliation(s)
- Linjiang Lou
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, Texas, USA
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Lin Z, Yu H, Shi C, Chen H, Lin G, Shen M, Wang C. Acute hyperglycemia compromises the responses of choroidal vessels using swept-source optical coherence tomography during dark and light adaptations. Front Endocrinol (Lausanne) 2023; 14:1049326. [PMID: 36843596 PMCID: PMC9947340 DOI: 10.3389/fendo.2023.1049326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
PURPOSE To clarify the effects of acute hyperglycemia on the responses of choroidal structural components and vascularity index during light modulation in healthy participants using techniques including image binarization and artificial intelligence (AI) segmentation based on swept-source optical coherence tomography (SS-OCT). METHODS Twenty-four eyes of 24 healthy participants were imaged at different stages after ambient light, 40 min of dark adaptation, and 5 min of light adaptation in two imaging sessions: control and after receiving 75 g of oral glucose solution. The choroidal structural parameters, including luminal volume (LV), stromal volume (SV), total choroidal volume (TCV), and choroidal vascularity index (CVI) within a 6 mm area were determined using a custom algorithm based on image binarization and AI segmentation of SS-OCT. These measurements were compared among the conditions after adjusting for axial length, age to identify the differences. RESULTS In the dark, CVI decreased (-0.36 ± 0.09%) significantly in acute hyperglycemia compared to the control condition. During the transition to ambient light, there was an increasing trend in the choroidal parameters compared with the control experiment. However, only TCV (0.38 ± 0.17 mm3) and LV (0.27 ± 0.10 mm3) showed a significant increase at the time point of 5 min after ambient light. CONCLUSION Analysis of choroidal structural parameters and CVI based on SS-OCT images is a potentially powerful method to objectively reflect subtle changes in neurovascular coupling between the choroid and photoreceptor during dark adaptation.
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Affiliation(s)
- Zhiyang Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Huankai Yu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ce Shi
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Hongling Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Guangqing Lin
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Meixiao Shen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
- *Correspondence: Meixiao Shen, ; Chenxiao Wang,
| | - Chenxiao Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Meixiao Shen, ; Chenxiao Wang,
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The Assessment of Acute Chorioretinal Changes Due to Intensive Physical Exercise in Senior Elite Athletes. J Aging Phys Act 2022; 31:497-505. [PMID: 36640780 DOI: 10.1123/japa.2022-0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/03/2022] [Accepted: 09/23/2022] [Indexed: 12/25/2022]
Abstract
Regular physical exercise is known to lower the incidence of age-related eye diseases. We aimed to assess the acute chorioretinal alterations in older adults following intense physical strain. Seventeen senior elite athletes were recruited who underwent an aerobic exercise on a cycle ergometer and macular scanning by optical coherence tomography. A significant thinning of the entire retina was observed 1 min after exercise, followed by a thickening at 5 min, after which the thickness returned to baseline. This trend was similar in almost every single retinal layer, although a significant change was observed only in the inner retina. Choroidal thickness changes were neither significant nor did they correlate with the thickness changes of intraretinal layers. The mechanism of how these immediate retinal changes chronically impact age-related sight-threatening pathologies that, in turn, result in a substantially reduced quality of life warrants further investigation on nontrained older adults as well.
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Evaluation of Optical Coherence Tomography Findings and Choroidal Thickness in Beta-Thalassemia Major Patients Using Chelation Therapy. BEYOGLU EYE JOURNAL 2022; 7:267-272. [PMID: 36628077 PMCID: PMC9794503 DOI: 10.14744/bej.2022.62534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/26/2022] [Accepted: 05/21/2022] [Indexed: 01/19/2023]
Abstract
Objectives This study aims to analyze the posterior segment of the eye in children with thalassemia major (TM) treated with chelation therapy. Methods Forty-four patients diagnosed with TM and 44 age- and gender-matched participants without systemic diseases were included in this cross-sectional comparative study. A complete ophthalmologic examination, including visual acuity and fundus examination, was performed on all participants. The study and control groups' optic coherence tomography (OCT) evaluation was performed with a spectral domain featured OCT device. Central macular thickness (CMT), macular volume, ganglion cell complex (GCC) thickness, retinal nerve fiber layer (RNFL) thickness, subfoveal choroidal thickness (CT), CT at 1 mm temporal to the fovea, CT at 1 mm nasal to the fovea, CT at the 1 mm temporal to the optic nerve head, and CT at the 1 mm nasal to the optic nerve head were compared between the study and control groups. Results The mean ages for the study group and for the control group were 15.2±6.2 and 14.2±4.9 years, respectively. The mean subfoveal CT was 287.73±47.04 µm in the TM group and 312.66±39.95 µm in the control group (p=0.014). CT at the nasal to the fovea and temporal to the optic nerve head was thinner in the TM group than in the healthy group. The mean CMT, macular volume, GCC thickness, and RNFL thickness of the study and the control groups were similar. No significant difference was found between the patients with and without deferoxamine therapy concerning macular thickness, GCC thickness, and macular and peripapillary CT. Conclusion Our results suggested that subfoveal, perifoveal, and peripapillary CTs were significantly thinner in children with TM than the control group. The use of deferoxamine did not cause a further reduction in CT.
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Lin CY, Wang I, Lin CJ, Lai CT, Bair H, Chen WL, Lin JM, Tien PT, Hsia NY, Tsai YY. Short-term anatomic response of the choroid to tropicamide in myopic patients. Medicine (Baltimore) 2022; 101:e30481. [PMID: 36123905 PMCID: PMC9478313 DOI: 10.1097/md.0000000000030481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We aimed to investigate how tropicamide alters subfoveal choroidal thickness (SFChT) and choriocapillaris flow density (CD) and determine the predictive factors of choroid thickness and vascular density in myopic eyes. This retrospective study was conducted from September 2018 to March 2019. SFChT was measured with enhanced depth spectrum-domain optical coherence tomography. The choriocapillaris was imaged using optical coherence tomography angiograms. Ocular parameters were measured thirty minutes before and after 1% tropicamide instillation. Twenty-five eyes of 15 patients (mean age 38.12 ± 6.35 years old and refractive error-8.57 ± 3.37 D) met the study criteria. The baseline linear regression model showed an association of thinner choroid with older age (P = .027) and high myopic patients (P = .001). Tropicamide substantially increased SFChT (P = .001), but had no significant influence on CD (P = .526). Moreover, SFChT variation after tropicamide instillation positively correlated with diopter changes in spherical equivalent (P = .005) and percentage changes in CD (P = .046). In myopic eyes, choroidal layer thickened substantially in response to tropicamide. The increase of SFChT only correlates with variations in spherical equivalent and CD. Short-term tropicamide installation altered both choroid thickness and choroid microvasculature, which implies an interplay among choroidal volume, perfusion, and ciliary muscle tone.
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Affiliation(s)
- Chih-Ying Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - I. Wang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ju Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Chun-Ting Lai
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- * Correspondence: Chun-Ting Lai, Department of Ophthalmology, China Medical University Hospital, No. 2 Yu-Der Road, Taichung 404, Taiwan (e-mail: )
| | - Henry Bair
- School of Medicine, Stanford University, United States of America
| | - Wen-Lu Chen
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Jane-Ming Lin
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Ning-Yi Hsia
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Yu Tsai
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
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Szalai I, Csorba A, Pálya F, Jing T, Horváth E, Bosnyák E, Györe I, Nagy ZZ, DeBuc DC, Tóth M, Somfai GM. The assessment of acute chorioretinal changes due to intensive physical exercise in young adults. PLoS One 2022; 17:e0268770. [PMID: 35613112 PMCID: PMC9132279 DOI: 10.1371/journal.pone.0268770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 05/08/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose
There is abundant evidence on the benefits of physical activity on cardiovascular health. However, there are only few data on the acute effects of physical exercise on the retina and choroid. Our aim was the in vivo examination of chorioretinal alterations following short intense physical activity by spectral domain optical coherence tomography (SD-OCT).
Methods
Twenty-one eyes of 21 healthy, young subjects (mean age 22.5 ± 4.1 years, 15 males and 6 females) were recruited. Macular scanning with a SD-OCT was performed before and following a vita maxima-type physical strain exercise on a rowing ergometer until complete fatigue. Follow-up OCT scans were performed 1, 5, 15, 30 and 60 minutes following the exercise. The OCT images were exported and analyzed using our custom-built OCTRIMA 3D software and the thickness of 7 retinal layers was calculated, along with semi-automated measurement of the choroidal thickness. One-way ANOVA analysis was performed followed by Dunnett post hoc test for the thickness change compared to baseline and the correlation between performance and thickness change has also been calculated. The level of significance was set at 0.001.
Results
We observed a significant thinning of the total retina 1 minute post-exercise (-7.3 ± 0.6 μm, p < 0.001) which was followed by a significant thickening by 5 and 15 minutes (+3.6 ± 0.6 μm and +4.0 ± 0.6 μm, respectively, both p <0.001). Post-exercise retinal thickness returned to baseline by 30 minutes. This trend was present throughout the most layers of the retina, with significant changes in the ganglion cell–inner plexiform layer complex, (-1.3 ± 0.1 μm, +0.6 ± 0.1 μm and +0.7 ± 0.1 μm, respectively, p <0.001 for all), in the inner nuclear layer at 1 and 5 minutes (-0.8 ± 0.1 μm and +0.8 ± 0.1 μm, respectively, p <0.001 for both), in the outer nuclear layer–photoreceptor inner segment complex at 5 minute (+2.3 ± 0.4 μm, p <0.001 for all) and in the interdigitation zone–retinal pigment epithelium complex at 1 and 15 minutes (-3.3 ± 0.4 μm and +1.8 ± 0.4 μm, respectively, p <0.001 for both). There was no significant change in choroidal thickness; however, we could detect a tendency towards thinning at 1, 15, and 30 minutes following exercise. The observed changes in thickness change did not correlate with performance. Similar trends were observed in both professional and amateur sportsmen (n = 15 and n = 6, respectively). The absolute changes in choroidal thickness did not show any correlation with the thickness changes of the intraretinal layers.
Conclusions
Our study implies that in young adults, intense physical exercise has an acute effect on the granular layers of the retina, resulting in thinning followed by rebound thickening before normalization. We could not identify any clear correlation with either choroidal changes or performance that might explain our observations, and hence the exact mechanism warrants further clarification. We believe that a combination of vascular and mechanic changes is behind the observed trends.
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Affiliation(s)
- Irén Szalai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Anita Csorba
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Fanni Pálya
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Tian Jing
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | | | - Edit Bosnyák
- Department of Health Sciences and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - István Györe
- Department of Health Sciences and Sport Medicine, University of Physical Education, Budapest, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Delia Cabrera DeBuc
- Miller School of Medicine, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America
| | - Miklós Tóth
- Department of Health Sciences and Sport Medicine, University of Physical Education, Budapest, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Márk Somfai
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Department of Ophthalmology, Stadtspital, Zürich, Switzerland
- Spross Research Institute, Zürich, Switzerland
- * E-mail:
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Effect of SCUBA Diving on Ophthalmic Parameters. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030408. [PMID: 35334584 PMCID: PMC8949343 DOI: 10.3390/medicina58030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Background and Objective: Several cases of central serous chorioretinopathy (CSC) in divers have been reported in our medical retina center over the past few years. This study was designed to evaluate possible changes induced by SCUBA diving in ophthalmic parameters and especially subfoveal choroidal thickness (SFCT), since the choroid seems to play a crucial role in physiopathology of CSC. Materials and Methods: Intraocular pressure (IOP), SFCT, pachymetry, flow-mediated dilation (FMD), blood pressure, and heart rate were measured in 15 healthy volunteer divers before diving, 30 and 60 min after a standard deep dive of 25 m depth for 25 min in a dedicated diving pool (NEMO 33). Results: SFCT reduces significantly to 96.63 ± 13.89% of pre-dive values (p = 0.016) 30 min after diving. It recovers after 60 min reaching control values. IOP decreases to 88.05 ± 10.04% of pre-dive value at 30 min, then increases to 91.42 ± 10.35% of its pre-dive value (both p < 0.0001). Pachymetry shows a slight variation, but is significantly increased to 101.63 ± 1.01% (p = 0.0159) of the pre-dive value, and returns to control level after 60 min. FMD pre-dive was 107 ± 6.7% (p < 0.0001), but post-dive showed a diminished increase to 103 ± 6.5% (p = 0.0132). The pre-post difference was significant (p = 0.03). Conclusion: Endothelial dysfunction leading to arterial stiffness after diving may explain the reduced SFCT observed, but SCUBA diving seems to have miscellaneous consequences on eye parameters. Despite this clear influence on SFCT, no clear relationship between CSC and SCUBA diving can be drawn.
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Kim YH, Oh J. Comparison of choroidal hyperreflective spots on optical coherence tomography images between both eyes of normal subjects. Quant Imaging Med Surg 2022; 12:920-935. [PMID: 35111594 DOI: 10.21037/qims-21-637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/04/2021] [Indexed: 11/06/2022]
Abstract
Background Advancement of optical coherence tomography (OCT) technology allows for better in vivo visualization of the choroidal architecture, which comprises vessels and stroma. However, most OCT studies using image binarization methods have focused only on choroidal vessels represented by dark pixels. This study aimed to compare the distribution of choroidal hyperreflective spots on swept-source OCT (SS-OCT) images between both eyes of normal subjects. Methods In this observational comparative study, we included SS-OCT images of healthy subjects, which were prospectively obtained to compare images among the devices. SS-OCT images acquired using PLEX Elite 9000 and DRI-OCT Triton were analyzed. En-face OCT images were obtained at five different depth positions of the inner choroid at the macula. The mean reflectivity of the choroidal slabs, the number, total area, and circularity of hyperreflective spots were quantitatively compared between the devices and between both eyes of the same subjects. Results In 30 eyes of 15 healthy subjects, the mean reflectivity of the choroidal slabs varied with the scan depth on both devices (P<0.001 and P<0.001). Hyperreflective spots were similarly distributed in the images from both devices, but at different depths. The number and area of hyperreflective spots in the second and third layers of the DRI-OCT Triton were positively correlated with those in the fourth and fifth layers of the PLEX Elite 9000, respectively (all P<0.05). The intraclass correlation coefficients (ICC) for the area of hyperreflective spots were excellent for the third slab of the DRI-OCT and the fifth slab of the PLEX Elite (ICC =0.798; 95% CI, -0.576-0.904). The number and area of hyperreflective spots were correlated between both eyes in the third, fourth and fifth layers on DRI-OCT Triton (all P<0.05) and in the first, second, and fifth layers on PLEX Elite 9000 (all P<0.05). Conclusions Hyperreflective spots in en-face images from two different SS-OCT devices were similarly observed between both eyes of the same person. The distributions of spots between the two eyes of the same person were correlated. These findings suggest that the distribution of hyperreflective spots on the choroid reflects the choroidal characteristics of the subject.
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Affiliation(s)
- Young Ho Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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15
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Asmussen A, Smith BS, Møller F, Jakobsen TM. Repeatability and inter-observer variation of choroidal thickness measurements using swept-source optical coherence tomography in myopic danish children aged 6-14 years. Acta Ophthalmol 2022; 100:74-81. [PMID: 34126650 PMCID: PMC9291036 DOI: 10.1111/aos.14890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 02/27/2021] [Accepted: 04/11/2021] [Indexed: 11/08/2022]
Abstract
Purpose To estimate repeatability and inter‐observer variation of choroidal thickness measurements in myopic Danish children aged 7–14 years using swept‐source optical coherence tomography (SS‐OCT). Methods Thirty‐nine children were enrolled. Optical correction was single‐vision spectacles (SVS) or orthokeratology lenses (OKL). Three repeated 7 × 7 mm 3‐dimensional SS‐OCT macula scans and three repeated 9 mm SS‐OCT line scans were collected for each child using a DRI OCT Triton. Choroidal thickness was measured using three different methods: line scan method 1 (LM1), line scan method 2 (LM2) and 3D macula scan method (3DM). Segmentation was adjusted if needed. Coefficients of repeatability (CR) and limits of agreement (LoA) were calculated. Results The CRs ranged from 13.4 to 23.9 µm, 14.5 to 26.2 µm and 5.2 to 10.7 µm for LM1, LM2 and 3DM, respectively. The LoA ranged from −22.9 to +31.5 µm, −23.3 to +32.2 µm and −10.2 to +12.4 µm for LM1, LM2 and 3DM, respectively. Segmentation was adjusted in most scans (63%–92%). Mean choroidal thickness ranged from 142.2 ± 47.2 to 253.8 ± 60.9 µm and 190.1 ± 64.0 to 299.0 ± 55.8 µm for the SVS and OKL groups, respectively, measured by 3DM. Conclusion The 3DM was the most repeatable method in this paediatric population. It yielded a CR of 10.7 µm, confidence interval 2.4 µm, which makes the minimal detectable difference between two measurements 13.1 µm. Most inter‐observer variation could be explained by the intramethod variation. Segmentation adjustment on 3D macula scans did not increase CR on a group level.
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Affiliation(s)
| | | | - Flemming Møller
- Department of Ophthalmology Lillebaelt Hospital University Hospital of Southern Denmark Odense Denmark
| | - Trine M. Jakobsen
- Department of Ophthalmology Lillebaelt Hospital University Hospital of Southern Denmark Odense Denmark
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16
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Kim YH, Oh J. Choroidal Thickness Profile in Chorioretinal Diseases: Beyond the Macula. Front Med (Lausanne) 2021; 8:797428. [PMID: 34988102 PMCID: PMC8720884 DOI: 10.3389/fmed.2021.797428] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Enhanced depth imaging optical coherence tomography (EDI-OCT) and swept-source OCT (SS-OCT) have emerged as essential diagnostic tools in the study and management of various chorioretinal diseases. Evidence from early clinical studies using EDI-OCT and SS-OCT indicates that choroidal dysfunction plays a major role in the pathogenesis of chorioretinal diseases. Measurement of choroidal thickness (CT) has already become a major research and clinical method, and CT is considered as an indicator of choroidal status in a variety of ophthalmic diseases. Recently, CT measurement has also been proposed as a non-invasive marker for the early detection and monitoring of various systemic diseases. Among the several possible CT measurement locations, subfoveal CT has rapidly become a reliable parameter for measuring CT in healthy and diseased eyes. Moreover, recent advancements in OCT technology have enabled faster and wider imaging of the posterior part of the eye, allowing the various changes in CT as measured outside the macula to be shown accordingly. In this review, we first provide an overview of the results of clinical studies that have analyzed the healthy macular choroid and that in various chorioretinal diseases, and then summarize the current understanding of the choroid outside the macula. We also examine the CT profile as an index that encompasses both within and outside of the macula. Furthermore, we describe the clinical applications of ultrawide OCT, which enables visualization of the far periphery, and discuss the prospects for the development of more reliable choroidal parameters that can better reflect the choroid's characteristics.
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17
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Hoseini-Yazdi H, Read SA, Alonso-Caneiro D, Collins MJ. Retinal OFF-Pathway Overstimulation Leads to Greater Accommodation-Induced Choroidal Thinning. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 34636878 PMCID: PMC8525845 DOI: 10.1167/iovs.62.13.5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose To examine the interactions between accommodation and overstimulation of the retinal ON- and OFF-pathways, and their association with changes in choroidal thickness (ChT) and vascularity. Methods Optical coherence tomography imaging of the choroid of twenty young adults (ages 25 ± 5 years) was performed before and after a series of 30-minute-long viewing tasks, including reading a bright text on dark background (ON-pathway overstimulation) and dark text on bright background (OFF-pathway overstimulation), and a control task of viewing a movie with unbiased ON-/OFF-pathway activation. The viewing tasks were performed with relaxed, and 5 diopter (D) accommodation (induced by soft contact lenses) demands. Both reading texts were matched for the mean luminance (35 cd/m2), luminance contrast (87%), and letter size (approximately 11.8 arc minutes). The change in ChT from baseline associated with contrast polarity and accommodation was examined using linear mixed model analysis. Results The subfoveal ChT decreased significantly by −7 ± 1 µm with 5 D accommodation compared with relaxed accommodation (−3 ± 1 µm; P < 0.001), and by −9 ± 1 µm with OFF-pathway compared with ON-pathway overstimulation (−4 ± 1 µm; P = 0.002) and the control condition (−2 ± 1 µm; P < 0.001). Overstimulation of the OFF-pathway, but not the ON-pathway, resulted in a significantly greater choroidal thinning compared with the control condition, both at relaxed (−7 ± 1 µm; P = 0.003) and 5 D (−11 ± 1 µm; P = 0.005) accommodation levels. Similar changes were also observed for macular total, stromal, and luminal ChT. Conclusions Retinal OFF-pathway stimulation enhanced the choroidal thinning associated with accommodation, thereby providing a potential mechanism that involves accommodation and the retinal OFF-signaling pathway, linking near work and myopia.
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Affiliation(s)
- Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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18
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Yazdani N, Ehsaei A, Hoseini-Yazdi H, Shoeibi N, Alonso-Caneiro D, Collins MJ. Wide-field choroidal thickness and vascularity index in myopes and emmetropes. Ophthalmic Physiol Opt 2021; 41:1308-1319. [PMID: 34487376 DOI: 10.1111/opo.12875] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To study regional variations in choroidal thickness (CT), luminal thickness and stromal thickness of the choroid, and choroidal vascularity index (CVI) in low myopic and emmetropic eyes using wide-field optical coherence tomography (OCT). METHODS Sixty-nine healthy young adults between 20 and 38 years of age participated in this study, including 40 low myopes (mean ± SD spherical equivalent (MSE) refractive error: -3.00 ± 1.39 D, range: -6.00 to -0.62 D) and 29 emmetropes (MSE: -0.05 ± 0.09 D, range: -0.25 to +0.12 D). Wide-field CT, luminal thickness, stromal thickness and CVI were measured across five eccentricities (fovea, parafovea, perifovea; near-periphery and periphery) and four quadrants (nasal, temporal, inferior and superior), in vertical and horizontal meridians, while controlling for a range of extraneous factors potentially influencing the CT. Custom-written software was used to segment and binarize the OCT images. RESULTS Wide-field CT, luminal thickness and stromal thickness, averaged across all participants, exhibited significant topographical variation, with the foveal (379 ± 8 µm, 200 ± 4 µm, 179 ± 4 µm, respectively) and peripheral (275 ± 8 µm, 161 ± 4 µm, 114 ± 4 µm, respectively) regions presenting the thickest and thinnest regions (all p < 0.001). Wide-field CVI showed a progressively higher percentage (greater vascularity) with increasing eccentricity from the fovea towards the periphery (p < 0.001). Macular CT and stromal choroidal thickness were significantly thinner in myopes compared to emmetropes (p < 0.05). Myopes (55.7 ± 0.3%) showed a slightly higher CVI compared with emmetropes (54.4 ± 0.4%) (p < 0.05). CONCLUSIONS Low myopia in young adults was associated with significant choroidal thinning across the macular, but not extramacular regions, with this decrease in choroidal thickness mostly attributed to thinning in the stromal component of the choroid, rather than the luminal (vascular) component.
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Affiliation(s)
- Negareh Yazdani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.,Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nasser Shoeibi
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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19
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The impact of vascular risk factors on the thickness and volume of the choroid in AMD patients. Sci Rep 2021; 11:15106. [PMID: 34302055 PMCID: PMC8302717 DOI: 10.1038/s41598-021-94676-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/29/2021] [Indexed: 11/08/2022] Open
Abstract
Disturbances in choroidal microcirculation may lead to the onset and progression of age-related macular degeneration (AMD). We aimed to assess changes in the choroidal volume and thickness in the macular region in AMD eyes and to investigate whether coexisting vascular risk factors alter choroidal status. We enrolled 354 AMD patients (175 dry, 179 wet AMD) and 121 healthy controls. All participants underwent a complete ophthalmologic examination and assessment of choroidal thickness and volume. A multivariate analysis adjusted for age, sex, and smoking status revealed that wet AMD was an independent factor associated with higher average thickness of the central ring area (ATC) and average volume of the central ring area (AVC) and lower choroidal vascularity index (CVI) compared to controls (β = + 0.18, p = 0.0007, β = + 0.18, p = 0.0008, respectively) and to dry AMD (β = + 0.17, p = 0.00003 for both ATC and AVC and β = - 0.30 p < 0.0001 for CVI). ATC, AVC and average volume (AV) were lower in AMD patients with hypertension and ischaemic heart disease (IHD). The duration of hypertension was inversely correlated with ATC, AVC and AV (Rs = - 0.13, p < 0.05; Rs = - 0.12; p < 0.05, Rs = - 0.12; p < 0.05, respectively) while IHD duration negatively correlated with AV (Rs = - 0.15, p < 0.05). No such associations were observed in the control group. Our findings show that the choroidal vascular system in eyes with AMD is much more susceptible to damage in the presence than in the absence of systemic vascular disease.
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Delshad S, Collins MJ, Read SA, Vincent SJ. Effects of brief periods of clear vision on the defocus-mediated changes in axial length and choroidal thickness of human eyes. Ophthalmic Physiol Opt 2021; 41:932-940. [PMID: 33973255 DOI: 10.1111/opo.12833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the influence of brief, repeated periods of clear vision on the changes in axial length and choroidal thickness in response to short-term imposed defocus. METHODS The right eye of 16 young adults was exposed to 60 min episodes of continuous and interrupted defocus conditions (+3 DS and -3 DS) over five separate sessions, with the left eye optimally corrected for distance. For interrupted defocus, 2 min episodes of clear vision were imposed before each 15 min episode of myopic or hyperopic defocus (2/15 min). For hyperopic defocus, the effect of frequency of clear vision exposure was also assessed by imposing 1 min of clear vision before each 7.5 min of defocus (1/7.5 min). The right eye axial length and choroidal thickness were measured before, during and after each defocus condition. RESULTS After 60 min of continuous hyperopic defocus the eye elongated significantly by +9 ± 9 μm (p = 0.02). When exposed to interrupted (2/15 min) hyperopic defocus, axial elongation was significantly reduced by 77% compared to continuous hyperopic defocus (p = 0.03), with a final change of only +2 ± 10 μm relative to baseline. During interrupted (1/7.5 min) hyperopic defocus, axial elongation reduced slightly compared to continuous hyperopic defocus (+6 ± 8 μm relative to baseline, p = 0.12). For continuous myopic defocus, a reduction in axial length occurred but was not statistically significant (p > 0.05). A similar pattern of response was observed for choroidal thickness changes with continuous and interrupted (1/7.5 min) hyperopic defocus conditions. CONCLUSIONS Brief periods of clear vision can diminish axial elongation and choroidal thinning induced by hyperopic defocus exposure in human eyes. If hyperopic defocus contributes to myopia progression in humans, then interruption with brief periods of clear vision could reduce its myopiagenic effects.
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Affiliation(s)
- Samaneh Delshad
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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21
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Hoseini‐yazdi H, Vincent SJ, Collins MJ, Read SA, Alonso‐caneiro D. Repeatability of wide‐field choroidal thickness measurements using enhanced‐depth imaging optical coherence tomography. Clin Exp Optom 2021; 102:327-334. [DOI: 10.1111/cxo.12893] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/18/2018] [Accepted: 02/16/2019] [Indexed: 12/01/2022] Open
Affiliation(s)
- Hosein Hoseini‐yazdi
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - David Alonso‐caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
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22
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Kim YH, Lee B, Kang E, Oh J. Comparison of Regional Differences in the Choroidal Thickness between Patients with Pachychoroid Neovasculopathy and Classic Exudative Age-related Macular Degeneration. Curr Eye Res 2021; 46:1398-1405. [PMID: 33550884 DOI: 10.1080/02713683.2021.1887269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Purpose: To compare the regional differences in the choroidal thickness (CT) between patients with pachychoroid neovasculopathy (PNV) and classic exudative age-related macular degeneration (ceAMD).Materials and Methods: We included both eyes of patients with unilateral macular neovascularization (MNV) due to ceAMD or PNV. Unilateral eyes of normal subjects were also included as a normal control group. The regional difference in CT was defined as a difference between the macular and extramacular areas, and calculated as the ratio of subfoveal CT (SFCT) to nasal peripapillary CT (PCT).Results: In normal subjects, the choroid was 2.25 ± 0.10 times thicker at the macula than at the extramacular area. The SFCT and PCT were significantly affected by age (P < .001 and P < .001, respectively), whereas the regional difference in CT were independent of age (P = .076). Analysis of covariance including age, sex, and MNV group showed that regional difference in CT were significantly affected by sex, nasal peripapillary CT, and MNV group (P = .023, P < .001, and P < .001, respectively). The estimated marginal mean of the regional difference in CT was significantly smaller in the ceAMD group (1.671 ± 0.103) than in the normal control (2.250 ± 0.095, P = .003) and PNV groups (2.0880 ± 0.086, P < .001).Conclusions: Regional differences in CT were consistent with aging. However, the difference varied with the presence of PNV or ceAMD. Measurement of regional differences in CT provides additional information for characterizing the choroid in patients with MNV.
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Affiliation(s)
- Young Ho Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Boram Lee
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Edward Kang
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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23
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Li S, Pan Y, Xu J, Li X, Spiegel DP, Bao J, Chen H. Effects of physical exercise on macular vessel density and choroidal thickness in children. Sci Rep 2021; 11:2015. [PMID: 33479470 PMCID: PMC7820247 DOI: 10.1038/s41598-021-81770-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/11/2021] [Indexed: 11/09/2022] Open
Abstract
We used swept-source (SS) optical coherence tomography (OCT) and OCT angiography (OCTA) to investigate the effects of moderate physical exercise on retinal and choroidal vessel densities (VDs) and thicknesses in children. One eye in each of 40 myopic children (mean age, 11.70 years) and 18 emmetropic children (mean age, 11.06 years) were included. SS-OCT 6 × 6-mm radial scans and SS-OCTA 3 × 3-mm images were centered on the macula. Heart rate (HR), systolic and diastolic blood pressure, and intraocular pressure (IOP) were recorded before and immediately after a 20-min stationary cycling exercise and after a 30-min rest. The subfoveal choroidal thickness (SFCT), choroidal thickness (CT), and VD at the superficial and deep retinal layers, choriocapillaris, and deeper choroidal vessels were determined. SFCT and CT were significantly lower at all locations immediately after exercise (p < 0.001) and did not fully recover after rest (p < 0.05). VD was lower in the deep retinal layer after exercise (p = 0.02) and higher in the superficial layer after rest (p = 0.03) in myopic eyes while it was higher in the superficial (p < 0.01) and deep layer (p < 0.01) after rest in emmetropic eyes. No significant exercise-related changes in the superficial retinal VD, choroidal VD, or IOP were observed. ΔCT% and ΔSFCT% were significantly correlated with increases in HR in myopic group (p = 0.04 and p = 0.03, respectively). Exercise increased retinal VD after rest in emmetropic eyes, and caused significant CT thinning that lasted for at least 30 min in both emmetropic and myopic eyes.
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Affiliation(s)
- Shufeng Li
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Yiguo Pan
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Jingjing Xu
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Xue Li
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China
| | - Daniel P Spiegel
- R&D Vision Sciences AMERA, Essilor International, Singapore, Singapore
| | - Jinhua Bao
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
| | - Hao Chen
- Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
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Insa-Sánchez G, Fuentes-Broto L, Cobos A, Orduna Hospital E, Segura F, Sanchez-Cano A, Perdices L, Pinilla I. Choroidal Thickness and Volume Modifications Induced by Aerobic Exercise in Healthy Young Adults. Ophthalmic Res 2020; 64:604-612. [PMID: 33342973 DOI: 10.1159/000511201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Our aim was to evaluate the changes in choroidal thickness (CT) and volume (CV) following aerobic physical exercise in healthy young adults. METHODS This study included 72 eyes from healthy volunteers between 22 and 37 years old. Using the International Physical Activity Questionnaire, total physical activity was computed. Measurements using an autorefractometer, ocular biometry, and spectral-domain optical coherence tomography using the Enhanced Depth Imaging protocol were taken. OCT was performed as a baseline measurement and after performing 10 min of dynamic physical exercise (3 and 10 min post-exercise). The choroidal layer was manually segmented, and the CT and CV in different areas from the Early Treatment Diabetic Retinopathy Study grid were obtained. RESULTS In healthy adults, at 3 min post-exercise, CT was higher in the subfoveal, the 3-mm nasal, and the 6-mm superior areas. Between 3 and 10 min post-exercise, the CT was reduced in all areas, and in some areas, the values were even smaller than the baseline measurements. The CV values showed changes after exercise similar to those of thickness. The total CV recovery after exercise was related to sex and physical activity level. CONCLUSION Individuals with higher physical activity habits had greater CV at rest than those with lower physical activity levels. During exercise, healthy young people adjust CT and CV. At 3 min post-exercise, CT and CV increase. Women and individuals with greater physical activity levels reduce their total CV more than others during recovery.
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Affiliation(s)
- Gema Insa-Sánchez
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Pharmacology, Physiology and Legal and Forensic Medicine, Universidad de Zaragoza, Zaragoza, Spain
| | - Lorena Fuentes-Broto
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Pharmacology, Physiology and Legal and Forensic Medicine, Universidad de Zaragoza, Zaragoza, Spain
| | - Alberto Cobos
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Elvira Orduna Hospital
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain.,Department of Ophthalmology. Miguel Servet University Hospital, Zaragoza, Spain
| | - Francisco Segura
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain.,Department of Ophthalmology. Miguel Servet University Hospital, Zaragoza, Spain
| | - Ana Sanchez-Cano
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Lorena Perdices
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Isabel Pinilla
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.,Department of Ophthalmology. Lozano Blesa University Hospital, Zaragoza, Spain.,Department of Surgery, Gynecology and Obstetrics, Universidad de Zaragoza, Zaragoza, Spain
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Delshad S, Collins MJ, Read SA, Vincent SJ. The human axial length and choroidal thickness responses to continuous and alternating episodes of myopic and hyperopic blur. PLoS One 2020; 15:e0243076. [PMID: 33264356 PMCID: PMC7710071 DOI: 10.1371/journal.pone.0243076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/14/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the change in axial length (AxL) and choroidal thickness (ChT) in response to continuous and alternating episodes of monocular myopic and hyperopic defocus. METHODS The right eye of sixteen young adults was exposed to 60 minute episodes of either continuous or alternating myopic and hyperopic defocus (+3 DS & -3 DS) over six separate days, with the left eye optimally corrected for distance. During alternating defocus conditions, the eye was exposed to either 30 or 15 minute cycles of myopic and hyperopic defocus, with the order of defocus reversed in separate sessions. The AxL and ChT of the right eye were measured before, during and after each defocus condition. RESULTS Significant changes in AxL were observed over time, dependent upon the defocus condition (p < 0.0001). In general, AxL exhibited a greater magnitude of change during continuous than alternating defocus conditions. The maximum AxL elongation was +7 ± 7 μm (p = 0.010) in response to continuous hyperopic defocus and the maximum AxL reduction was -8 ± 10 μm of (p = 0.046) in response to continuous myopic defocus. During both 30 and 15 minute cycles of alternating myopic and hyperopic defocus of equal duration, the effect of opposing blur sessions cancelled each other and the AxL was near baseline levels following the final defocus session (mean change from baseline across all alternating defocus conditions was +2 ± 10 μm, p > 0.05). Similar, but smaller magnitude, changes were observed for ChT. CONCLUSIONS The human eye appears capable of temporal averaging of visual cues from alternating myopic and hyperopic defocus. In the short term, this integration appears to be a cancellation of the effects of the preceding defocus condition of opposite sign.
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Affiliation(s)
- Samaneh Delshad
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
- * E-mail:
| | - Michael John Collins
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
| | - Scott Andrew Read
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
| | - Stephen James Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Kelvin Grove, Queensland, Australia
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Jnawali A, Mirhajianmoghadam H, Musial G, Porter J, Ostrin LA. The optic nerve head, lamina cribrosa, and nerve fiber layer in non-myopic and myopic children. Exp Eye Res 2020; 195:108041. [PMID: 32353426 PMCID: PMC7282968 DOI: 10.1016/j.exer.2020.108041] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/18/2022]
Abstract
The purpose of this study was to evaluate the optic nerve head, lamina cribrosa, retina, and choroid in school age children using spectral domain optical coherence tomography (SD-OCT) and to assess these structural parameters in relation to age, axial length, and refractive error. Healthy children, ages 11.15 ± 2.62 years (range 6-15 years, n = 53), underwent cycloplegic autorefraction, biometry, and SD-OCT imaging in both eyes. Images were analyzed using custom written programs in MATLAB, after adjustment for lateral magnification. Peripapillary retinal nerve fiber layer (RNFL) thickness, retinal and choroidal thicknesses, Bruch's membrane opening (BMO) area, minimum rim width (MRW), and anterior lamina cribrosa surface depth (ALCSD) were determined and analyzed with age, axial length, and refraction. Results show that axial length increased and refractive error became more myopic with increasing age (R2 = 0.25, β = 0.18, P < 0.0001 and R2 = 0.27, β = -0.37, P < 0.0001, respectively). Minimum foveal thickness and central 1 mm retinal thickness increased with increasing age (R2 = 0.15, β = 2.38, P < 0.01 and R2 = 0.11, β = 3.16, P < 0.05, respectively). Age-adjusted raw values for peripapillary RNFL thickness decreased with increasing axial length (R2 = 0.11, β = -3.18, P < 0.05); however, this relationship was not present when image magnification was corrected (R2 = 0.07, β = 2.72, P = 0.09). BMO area increased with myopic refractive error (R2 = 0.16, β = -0.10, P < 0.01). Age-adjusted vertical cup-to-disc ratio decreased with increasing axial length and myopic refractive error (R2 = 0.12, β = -0.05, P < 0.05 and R2 = 0.11, β = 0.03, P = 0.05, respectively). Mean MRW, mean ALCSD, and peripapillary choroidal thickness were not associated with age, axial length, or refraction. Mean MRW was significantly thinner in eyes with deeper ALCS (R2 = 0.41, β = -0.83, P < 0.0001). These findings provide normal values for retinal and optic nerve head parameters in school age children, and also suggest that ocular remodeling occurs in some structures in school age children with normal eye growth and during early stages of myopia development.
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Affiliation(s)
- Ashutosh Jnawali
- University of Houston College of Optometry, 4901 Calhoun, Houston, TX, 77004, USA
| | | | - Gwen Musial
- University of Houston Department of Biomedical Engineering, 4800 Calhoun, Houston, TX, 77204, USA
| | - Jason Porter
- University of Houston College of Optometry, 4901 Calhoun, Houston, TX, 77004, USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4901 Calhoun, Houston, TX, 77004, USA.
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27
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Yeung SC, You Y, Howe KL, Yan P. Choroidal thickness in patients with cardiovascular disease: A review. Surv Ophthalmol 2020; 65:473-486. [PMID: 31923478 DOI: 10.1016/j.survophthal.2019.12.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/24/2019] [Accepted: 12/30/2019] [Indexed: 02/09/2023]
Abstract
The choroid is a vascular network that supplies the bulk of the retina's oxygen and nutrient supply. Prior studies have associated changes in the thickness of the choroid with the presence of various cardiovascular diseases. This is the first review that summarizes current knowledge on the relationship between choroidal thickness and cardiovascular diseases while highlighting important findings. Acute hypertension increases choroidal thickness. Chronic hypertension and heart failure may decrease choroidal thickness, but controversy exists. Both coronary artery disease and carotid artery stenosis result in decreased choroidal thickness and blood flow. Carotid endarterectomy may reverse these changes. Choroidal thickening in early stages of carotid stenosis may arise from mechanisms compensating for ischemia. Hyperlipidemia is linked to choroidal thickening, while caffeine intake is linked to choroidal thinning. The effects of smoking and exercise are mixed. Changes in choroidal thickness have been linked to cardiovascular disease. Clarity regarding these changes could lead to the use of choroidal thickness changes as a noninvasive screening or prognostic test for pathological cardiovascular changes. Future studies should also investigate the effect of cardiovascular disease treatments on the choroid.
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Affiliation(s)
- Shanna C Yeung
- Department of Ophthalmology and Visual Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Yuyi You
- Save Sight Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Kathryn L Howe
- Division of Vascular Surgery, Department of Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Peng Yan
- Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada; Kensington Vision and Research Center, Toronto, Ontario, Canada.
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Chiang STH, Chen TL, Phillips JR. Effect of Optical Defocus on Choroidal Thickness in Healthy Adults With Presbyopia. Invest Ophthalmol Vis Sci 2019; 59:5188-5193. [PMID: 30372745 DOI: 10.1167/iovs.18-24815] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate changes in subfoveal choroidal thickness (SFCT) induced by retinal defocus in presbyopic adults. Methods Thirty-seven healthy presbyopic subjects (age 57.74 ± 4.06 years) with low refractive errors (+0.08 ± 1.09 Diopters [D]) viewed a distant target (video movie at 6 m) for 60 minutes on two occasions while SFCT was monitored with optical coherence tomography every 20 minutes. On each occasion, both eyes were optimally corrected for distance: one eye acted as control, while the other (experimental) eye viewed through an additional ophthalmic lens: a +2.00 D lens imposing myopic defocus on one occasion and a -2.00 D lens imposing hyperopic defocus on the other occasion. Results Baseline SFCT was not different between experimental and control eyes (226 ± 72 μm vs. 232 ± 75 μm; P = 0.28). Myopic defocus caused a significant (P < 0.001) increase in SFCT in the defocused eye by 20 minutes (and +10 ± 5-μm increase at 60 minutes: P < 0.001), while hyperopic defocus caused a significant decrease in SFCT by 20 minutes (and -10 ± 5-μm decrease at 60 minutes: P < 0.001) with no change in control eyes. Conclusions In presbyopic subjects, imposed myopic retinal defocus caused thickening of SFCT, while hyperopic defocus caused thinning of SFCT. This implies that uncorrected presbyopia, which is associated with hyperopic retinal defocus for near objects and which is highly prevalent in the developing world, would likely be associated with choroidal thinning and possibly reduced choroidal blood flow with prolonged periods in a near visual environment.
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Affiliation(s)
- Samuel T-H Chiang
- Department of Optometry, Asia University, Taichung, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Lan Chen
- Department of Optometry, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.,Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - John R Phillips
- Department of Optometry, Asia University, Taichung, Taiwan.,School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
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Ahn J, Ahn SE, Yang KS, Kim SW, Oh J. Effects of a high level of illumination before sleep at night on chorioretinal thickness and ocular biometry. Exp Eye Res 2017; 164:157-167. [PMID: 28887137 DOI: 10.1016/j.exer.2017.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 08/10/2017] [Accepted: 09/04/2017] [Indexed: 10/18/2022]
Abstract
The choroid is affected by many factors. One of the factors, change in illumination has been suggested to influence choroidal thickness. However, the effects of bright light before sleep at night on the human eye are not well established. The purpose of this study was to investigate the effects of a high level of illumination in the evening on ocular measurements. Twenty-seven men with myopia spent seven consecutive nights in the sleep laboratory. During the first two nights, subjects were exposed to light at 150 lux between 20:00 and midnight. Then, for five consecutive nights, they were exposed to ambient light at 1000 lux between 20:00 and midnight. Ocular parameters and their diurnal variations were compared between the two periods and the effects of a high level of illumination were analyzed. After subjects were exposed to 1000 lux of illumination, axial length increased with borderline significance (p = 0.064). Macular volume and retinal thickness did not change. However, subfoveal choroidal thickness after exposure to 1000 lux of illumination (245.37 ± 52.84 μm) was significantly lower than that after 150 lux of illumination (268.00 ± 57.10 μm), (p < 0.001). Significant diurnal variations were found in mean keratometry (p = 0.039), intraocular pressure (IOP, p = 0.003), ocular perfusion pressure (OPP, p < 0.0001), macular volume (p = 0.019), and subfoveal choroidal thickness (p < 0.0001). A high level of illumination had significant effects on only IOP and OPP (p = 0.027 and 0.017, respectively). Bright light exposure before sleep at an intensity as high as 1000 lux reduced subfoveal choroidal thickness in healthy young men. In conclusion, diurnal variation in choroidal thickness can be affected by bright light exposure before sleep.
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Affiliation(s)
- Jaemoon Ahn
- Department of Ophthalmology, Korea University College of Medicine, 73, Inchon-ro, Sungbuk-gu, Seoul 02841, South Korea
| | - Soh-Eun Ahn
- Sungmo Eye Hospital, 409, Haeundae-ro, Haeundae-gu, Busan 48064, South Korea
| | - Kyung-Sook Yang
- Department of Biostatistics, Korea University College of Medicine, 73, Inchon-ro, Sungbuk-gu, Seoul 02841, South Korea
| | - Seong-Woo Kim
- Department of Ophthalmology, Korea University College of Medicine, 73, Inchon-ro, Sungbuk-gu, Seoul 02841, South Korea
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, 73, Inchon-ro, Sungbuk-gu, Seoul 02841, South Korea.
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Kinoshita T, Mori J, Okuda N, Imaizumi H, Iwasaki M, Shimizu M, Miyamoto H, Akaiwa K, Semba K, Sonoda S, Sakamoto T, Mitamura Y. Effects of Exercise on the Structure and Circulation of Choroid in Normal Eyes. PLoS One 2016; 11:e0168336. [PMID: 27973598 PMCID: PMC5156418 DOI: 10.1371/journal.pone.0168336] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/28/2016] [Indexed: 12/15/2022] Open
Abstract
Aims To determine the effects of dynamic exercise on the circulation and the luminal and stromal areas of the choroid in normal eyes. Methods This was a prospective interventional study of 38 eyes of 38 normal subjects enrolled by invitation. The systolic and diastolic blood pressures, heart rate, intraocularpressure, mean ocular perfusion pressure (MOPP), choroidal blood velocity, and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before, and immediately after mild dynamic exercise. The same measurements were recorded after 10 min of rest. The choroidal blood velocity was measured bylaser speckle flowgraphy, and the mean blur rate was used for the evaluations. The horizontal EDI-OCT images of the subfoveal choroid were converted to binary images. The central choroidal thickness (CCT), total cross sectional choroidal area, luminal areas, stromal areas, and the ratio of luminal area to total choroidal area (L/C ratio) were determined from these images. Results The systolic and diastolic blood pressures, heart rate, MOPP, and the mean blur rate were significantly increased immediately after the exercise and significantly decreased 10 minutes after the exercise. There wereno significant changes in the mean CCT, the mean total choroidal area, the mean luminal and stromal areas, and the mean L/C ratio after the exercise. Conclusions Our results suggest that a rest period is needed before measurements of blood flow velocity but not necessary for the EDI-OCT imaging to determine the choroidal thickness and area.
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Affiliation(s)
- Takamasa Kinoshita
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.,Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Junya Mori
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Natsuki Okuda
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Hiroko Imaizumi
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Masanori Iwasaki
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Miho Shimizu
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Hirotomo Miyamoto
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Kei Akaiwa
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kentaro Semba
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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Natarajan S. The world is your oyster! Indian J Ophthalmol 2016; 64:793. [PMID: 27958199 PMCID: PMC5200978 DOI: 10.4103/0301-4738.195589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Sundaram Natarajan
- Editor, Indian Journal of Ophthalmology, Chairman, Managing Director, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala (West), Mumbai, Maharashtra, India
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32
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Öner V, Bulut A, Büyüktarakçı Ş, Kaim M. Response to Re: Associations between choroidal thickness, axial length and spherical equivalent in a paediatric population. Clin Exp Optom 2016; 100:101-102. [PMID: 27781294 DOI: 10.1111/cxo.12489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Veysi Öner
- Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Asker Bulut
- Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Şeyma Büyüktarakçı
- Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Muhammet Kaim
- Department of Ophthalmology, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
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Uzun S, Pehlivan E. Choroidal and Retinal Thickness in Children With Different Refractive Status Measured by Swept-Source Optical Coherence Tomography. Am J Ophthalmol 2016; 169:298-299. [PMID: 27498602 DOI: 10.1016/j.ajo.2016.06.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 06/06/2016] [Indexed: 11/29/2022]
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Sayin N, Kara N, Pekel G, Altinkaynak H. Response to: Choroidal thickness changes after dynamic exercise as measured by spectral-domain optical coherence tomography. Indian J Ophthalmol 2016; 64:474-5. [PMID: 27488163 PMCID: PMC4991187 DOI: 10.4103/0301-4738.187687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Nihat Sayin
- Department of Ophthalmology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
| | - Necip Kara
- Department of Ophthalmology, Gaziantep University, Gaziantep, Turkey
| | - Gokhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Hasan Altinkaynak
- Department of Ophthalmology, Ataturk Training and Research Hospital, Ankara, Turkey
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35
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Comments To: Choroidal Thickness in Systemic Arterial Hypertension. Eur J Ophthalmol 2016; 26:e64. [DOI: 10.5301/ejo.5000747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2016] [Indexed: 11/20/2022]
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36
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Kaya A, Sağdiç SK, Topal T. Reason of Choroidal Thickening in Rheumatoid Arthritis May be Temperature Rise of the Body. Ocul Immunol Inflamm 2016; 25:292. [PMID: 27002345 DOI: 10.3109/09273948.2016.1142576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Abdullah Kaya
- a Department of Ophthalmology , Anıttepe Military Dispansery , Ankara , Turkey
| | - Sercan Koray Sağdiç
- b Department of Ophthalmology , GATA Haydarpasa Training Hospital , Istanbul , Turkey
| | - Tuncay Topal
- b Department of Ophthalmology , GATA Haydarpasa Training Hospital , Istanbul , Turkey
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Aksoy Y, Diner O, Sevinc MK, Kaya A. Comment on: Choroidal thickness is affected by smoking and mydriatics. Indian J Ophthalmol 2016; 64:100-1. [PMID: 26953039 PMCID: PMC4821113 DOI: 10.4103/0301-4738.178156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yakup Aksoy
- Department of Ophthalmology, Girne Military Hospital, Girne, TRNC, Cyprus
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Kaya A. Association Between Choroidal Thickness and Metabolic Activity on Positron Emission Tomography in Eyes With Choroidal Melanoma. Am J Ophthalmol 2016; 163:197-198. [PMID: 26778662 DOI: 10.1016/j.ajo.2015.12.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 12/10/2015] [Accepted: 12/31/2015] [Indexed: 11/30/2022]
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Reply. Am J Ophthalmol 2016; 163:198-199. [PMID: 26778663 DOI: 10.1016/j.ajo.2015.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 12/30/2015] [Accepted: 12/31/2015] [Indexed: 11/24/2022]
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Yildirim Y, Kaya A, Kar T. Temperature control role of the choroid may affect choroidal thickness after dynamic exercise. Indian J Ophthalmol 2016; 63:930. [PMID: 26862102 PMCID: PMC4784085 DOI: 10.4103/0301-4738.176033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Abdullah Kaya
- Department of Ophthalmology, GATA HaydarpasaTraining Hospital, Istanbul, Turkey
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Uzun S, Yolcu U, Ilhan A. Comment on: Choroidal thickness changes after dynamic exercise as measured by spectral-domain optical coherence tomography. Indian J Ophthalmol 2016; 64:407-8. [PMID: 27380989 PMCID: PMC4966387 DOI: 10.4103/0301-4738.185634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Venugopal N. Comment on: Bilateral angle closure glaucoma: Differential diagnosis. Indian J Ophthalmol 2015; 63:870. [PMID: 26669346 PMCID: PMC4730706 DOI: 10.4103/0301-4738.171976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- N Venugopal
- Department of Neuro-ophthalmology, Clinic and Glaucoma Service, AG Eye Hospital, Puthur, Tiruchirappalli, Tamil Nadu, India
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Sayin N, Kara N, Pekel G, Altinkaynak H. Authors' response. Indian J Ophthalmol 2015; 63:930-1. [PMID: 26862103 PMCID: PMC4784086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Nihat Sayin
- Department of Ophthalmology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey,Correspondence to: Dr. Nihat Sayin, Atakent Mahallesi, 4. Cadde, C 2-7 Blok, Kat: 3 Daire: 13, Kücükcekmece, Istanbul, Turkey. E-mail:
| | - Necip Kara
- Department of Ophthalmology, Gaziantep University, Gaziantep, Turkey
| | - Gokhan Pekel
- Department of Ophthalmology, Pamukkale University, Denizli, Turkey
| | - Hasan Altinkaynak
- Department of Ophthalmology, Ataturk Training and Research Hospital, Ankara, Turkey
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Authors' reply. Indian J Ophthalmol 2015; 63:871. [PMID: 27049144 PMCID: PMC4730707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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