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Oba T, Gulec ZEK, Çiçek MF, Uygunoglu U, Onder F. Retinal and peripapillary vascular density in episodic and chronic migraine cases without aura. Photodiagnosis Photodyn Ther 2023; 44:103809. [PMID: 37739046 DOI: 10.1016/j.pdpdt.2023.103809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Migraine is a neurovascular disease that can cause ocular and systemic ischemic damage. Despite from aura, a limited number of studies have considered the effect of the chronic migraine in cases without aura. Our aim was to evaluate the differences in the retinal and optic disk microvasculature among episodic and chronic migraine cases without aura using optical coherence tomography angiography (OCTA) imaging. METHODS 45 cases with migraine, and 25 control subjects were included in this prospective, cross-sectional study. OCTA was performed at 3 × 3 mm and 6 × 6 mm of the macula and at 4.5 × 4.5 mm of the optic disk. Retinal nerve fiber layer (RNFL) thickness, ganglion cell complex thickness, and vessel densities of the optic nerve and macula were compared among the three groups: a control group, an episodic migraine without aura (EMWOA) group, and a chronic migraine without aura (CMWOA) group. RESULTS In EMWOA group, circumpapillary vascular density (cpVD) was not decreased significantly in any quadrants (all, p>0.05). Compared to the control group, CMWOA group had significantly lower RNFL thickness in superior-temporal quadrants (p = 0.002 and 0.006, respectively), while cpVD differed only in the temporal quadrant and temporal inferior sector (p = 0.002 and p = 0.009, respectively). CONCLUSIONS Temporal peripapillary perfusion is valuable in the follow-up of chronic migraine cases. Longitudinal studies are needed to determine the place of OCTA in the follow-up of migraine.
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Affiliation(s)
- Turker Oba
- Department of Ophthalmology, Karaman Training and Research Hospital, Karaman, Turkey.
| | | | | | - Ugur Uygunoglu
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Feyza Onder
- Department of Ophthalmology, University of Health Science, Haseki Training and Research Hospital, Istanbul, Turkey
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Gediz BS, Erol YO, Gungor A, Ilhan B. The status of the choroid in patients with optic disc drusen. Int Ophthalmol 2022; 42:3891-3896. [PMID: 35788860 DOI: 10.1007/s10792-022-02409-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the subfoveal and peripapillary choroidal thickness (CT) and the choroidal vascularity index (CVI) in patients with optic disc drusen (ODD). METHODS This cross-sectional study examined the eyes of 17 patients with ODD and 18 healthy control subjects. The CT values were calculated manually from the images captured by enhanced depth imaging-optical coherence tomography (EDI-OCT). The CVI was defined as the proportion of the vascular area to the total choroidal area at the subfoveal and peripapillary areas after binarization of the EDI-OCT images. RESULTS It was found that the mean subfoveal CVI value in the ODD group was significantly lower than that in the control group (p = 0.006). The mean peripapillary CVI values were significantly lower in all of the quadrants in the ODD group when compared with the control group (p = 0.008 for the temporal quadrant, p = 0.014 for the nasal quadrant, p = 0.024 for the superior quadrant, and p = 0.038 for the inferior quadrant). Regarding the CT, there were no significant differences in the subfoveal and peripapillary CT values between the ODD group and the control group (p > 0.05 for all values). CONCLUSION The findings of this study indicate ODD to be associated with decreased subfoveal and peripapillary CVI, even though the subfoveal and peripapillary CT values were within the normal range. This result may prove important in relation to identifying a choroidal vascular network that appears to be morphologically normal but microstructurally impaired due to ODD. Further studies are required to verify the significance of CVI in the pathogenesis and complications of ODD.
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Affiliation(s)
- Berrak Sekeryapan Gediz
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ulucanlar Street, No:59, 06250, Ankara, Turkey.
| | - Yasemin Ozdamar Erol
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ulucanlar Street, No:59, 06250, Ankara, Turkey
| | - Anil Gungor
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ulucanlar Street, No:59, 06250, Ankara, Turkey
| | - Bayazit Ilhan
- Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, University of Health Sciences, Ulucanlar Street, No:59, 06250, Ankara, Turkey
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Chatziralli I, Milionis I, Christodoulou A, Theodossiadis P, Kitsos G. The Role of Vessel Density as Measured by Optical Coherence Tomography Angiography in the Evaluation of Pseudoexfoliative Glaucoma: A Review of the Literature. Ophthalmol Ther 2022; 11:533-545. [PMID: 35211880 PMCID: PMC8927482 DOI: 10.1007/s40123-022-00483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/07/2022] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION To review the existing literature about the optical coherence tomography angiography (OCTA) findings regarding peripapillary and macular vessel density (VD) in patients with pseudoexfoliative glaucoma (PXG). METHODS A comprehensive search of the PubMed database was conducted to include articles up to November 1, 2021, using an appropriate search algorithm. The retrieved articles were assessed for eligibility and filtered manually to exclude duplicates, while articles and book chapters cited in the reference lists of the eligible articles obtained by this method were reviewed so as not to miss any relevant studies. RESULTS There is consistency among the studies published so far that a significant decrease in peripapillary VD exists in eyes with PXG compared to controls, and macular VD has also been reported to be significantly lower in PXG eyes than controls. However, the existing literature remains controversial regarding OCTA findings in eyes with PXG compared to those with primary open-angle glaucoma (POAG). Several studies have found that peripapillary VD and macular VD were significantly lower in PXG than POAG, while other studies reported no significant difference. CONCLUSIONS Eyes with PXG were found to present decreased peripapillary and macular VD compared to control eyes, suggesting that a vascular component, including optic nerve hypoperfusion, may be implicated in the pathogenesis of PXG.
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Affiliation(s)
- Irini Chatziralli
- Second Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece.
| | - Ilias Milionis
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
| | | | - Panagiotis Theodossiadis
- Second Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, 12462, Haidari, Greece
| | - George Kitsos
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
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Belamkar AV, Dolan J, Olatunji S, Bhatti MT, Chen JJ, Mansukhani SA. The 'Fault' Lies in the Choroid: Peripapillary Intrachoroidal Cavitation Presenting with Progressive Vision Loss. Neuroophthalmology 2022; 46:254-257. [PMID: 35859631 PMCID: PMC9291674 DOI: 10.1080/01658107.2021.2009521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A 55-year-old male was referred to the Neuro-ophthalmology clinic due to gradual onset, progressive vision loss. On fundus examination a subtle yellow-orange peripapillary lesion was detected in the left eye. Optical coherence tomography with radial scanning illustrated retinal nerve fibre layer thinning as well as an area of intrachoroidal cavitation that corresponded to the lesion. Visual field testing showed a left inferior arcuate defect. Magnetic resonance imaging of the brain and orbit, and laboratory testing was unremarkable. Clinical examination, imaging, and testing were consistent with peripapillary intrachoroidal cavitation (PICC). Follow-up with serial visual field testing showed mild progression of the field defect. While PICC is not well understood in the literature, studies have reported associated risk factors including pathological myopia, older age, increased ocular axial length, chorioretinal atrophy, and vascular abnormalities. Importantly, glaucoma-like visual field defects as well as structural changes have been noticed in a high proportion of patients with PICC. While these alterations are evident, the pathogenic relationship between them is yet to be uncovered. Treatment with anti-glaucoma medications has been suggested, however, the evidence remains scarce for its true benefits. Care providers must be aware of the presentation of a yellow-orange peripapillary lesion with an associated visual field defect to accurately diagnose and manage this condition.
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Affiliation(s)
| | - Joseph Dolan
- Department of Ophthalmology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA
| | - Sunday Olatunji
- Department of Ophthalmology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA
| | - M. Tariq Bhatti
- Department of Ophthalmology,Mayo Clinic College of Medicine, Rochester, Minnesota, USA,Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - John J. Chen
- Department of Ophthalmology,Mayo Clinic College of Medicine, Rochester, Minnesota, USA,Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Sasha A. Mansukhani
- Department of Ophthalmology, Mayo Clinic Health System, Eau Claire, Wisconsin, USA,Department of Ophthalmology,Mayo Clinic College of Medicine, Rochester, Minnesota, USA,CONTACT Sasha A. Mansukhani Department of Ophthalmology, Mayo Clinic, Rochester, MN55905, USA
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Miraftabi A, Jafari S, Nilforushan N, Abdolalizadeh P, Rakhshan R. Effect of trabeculectomy on optic nerve head and macular vessel density: an optical coherence tomography angiography study. Int Ophthalmol 2021; 41:2677-88. [PMID: 33782847 DOI: 10.1007/s10792-021-01823-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the effect of trabeculectomy on peripapillary and macular vessel density (VD) using optical coherence tomography angiography (OCT-A) in patients with primary open-angle glaucoma. METHODS This is a prospective, interventional study on 32 glaucoma eyes (21 patients) who underwent trabeculectomy. Optic nerve head (ONH) and macular structural and OCT-A scans were performed before surgery and at one and six months postoperatively with the Avanti device (AngioVue System, Optovue Inc., Fremont, CA). The primary outcomes of interest were changes in global and regional peripapillary and macular VD. RESULTS The average (standard deviation) age and visual field mean deviation of the sample were 58.9(9.9) years and -14.5(9.0) dB, respectively. The average (standard deviation) baseline intraocular pressure significantly decreased from 24.5(10.4) mmHg to 9.6(2.1) mmHg, 6 months after the surgery (P< 0.001). The mean (standard deviation) whole image VD of ONH had increased from 37.6(8.3)% to 40.5(9.1)% at 6 months after the surgery (P = 0.01) while its changes were not significant at month 1 (38.1(9.5)%, P = 0.64). The average of radial peripapillary circle (RPC) VD increased from 36.5(10.3)% to 39.3(10.8)% at 6 months (P = 0.04) compared to 1-month post-trabeculectomy (37.0(11.4)%, P = 0.71). Similar patterns at postoperative months 1 and 6 were also observed in RPC VD at superior and inferior hemifields as well as nasal and temporal quadrants. The observed changes in VD of macular, foveal, peri-, and parafoveal were not significant at superficial or deep slabs at 1 and 6 months after trabeculectomy (all P values > 0.05). CONCLUSION Our study demonstrated significant improvements in peripapillary vessel density at 6-month following trabeculectomy.
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Demirtaş AA, Karahan M, Erdem S, Han ÇÇ, Keklikçi U. Effect of fasting on diurnal fluctuation of parafoveal and peripapillary vessel density and related oculodynamic and haemodynamic parameters. Photodiagnosis Photodyn Ther 2021; 33:102160. [PMID: 33383205 DOI: 10.1016/j.pdpdt.2020.102160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/26/2020] [Accepted: 12/18/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE To investigate the effects of Ramadan fasting on diurnal superficial-deep parafoveal vessel density (pfVD) and nerve head (NH)-radial peripapillary capillary (RPC) peripapillary vessel density (ppVD) using optical coherence tomography angiography (OCTA), as well as other related oculodynamic and haemodynamic parameters, and to compare these findings with those in the nonfasting period in healthy individuals. METHODS A total of 105 healthy individuals, 42 women and 63 men, were included in this prospective study. OCTA was used to examine the superficial-deep pfVD and NH-RPC ppVD. In the third week of Ramadan, OCTA readings were obtained twice daily at 08:00 and 16:00 hour (h) under fasting conditions and compared with nonfasting values 2 weeks after Ramadan. Both intraocular pressure (IOP) and blood pressure values were assessed accordingly. RESULTS The mean age (23-51) of individuals was 34.37 ± 7.04 years. In comparison with the 08:00 -h values, the 16:00 -h IOPs, superficial-deep pfVDs and RPC ppVDs were substantially reduced both during the fasting and nonfasting periods (P = 0.001, P = 0.009, P = 0.006, P = 0.006, P = 0.004, P = 0.004, P = 0.41, P = 0.032 and P = 0.021). No differences were found in the diurnal change of superficial-deep pfVDs, NH-RPC ppVDs, IOPs and mean ocular perfusion pressures (MOPPs) between the fasting and nonfasting periods, whereas the same was not true for mean arterial blood pressures (MABPs) (P = 0.049). CONCLUSIONS The parafoveal and peripapillary VDs (except for NHpp-VD) and IOPs were found to have decreased significantly throughout the day both in fasting and nonfasting periods. Our study confirms the diurnal changes in the IOPs, MOPPs, superficial-deep pfVDs and NH-RPC ppVDs under dehydration and normal terms.
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Ghassemi F, Berijani S, Roohipoor R, Mohebbi M, Babeli A, Gholizadeh A, Sabour S. Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography. Int J Retina Vitreous 2020; 6:62. [PMID: 33292768 PMCID: PMC7709440 DOI: 10.1186/s40942-020-00269-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/24/2020] [Indexed: 01/10/2023] Open
Abstract
Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.
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Affiliation(s)
- Fariba Ghassemi
- Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran. .,Retina & Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sahar Berijani
- Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
| | - Ramak Roohipoor
- Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran.,Retina & Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Mohebbi
- Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran.,Retina & Vitreous Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Babeli
- Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
| | - Alireza Gholizadeh
- Eye research center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
| | - Siamak Sabour
- Cornea Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Clinical Epidemiology, School of Health and Safety, Safety Promotion and Injury Prevention Research Centre, Tehran, Iran.,Department of Clinical Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alonso-Martín B, de-Lucas-Viejo B, Gimeno-Carrero M, Ferro-Osuna M, Sambricio J. Diagnosis by multimodal imaging in peripapillary pachychoroid syndrome: A case report. Arch Soc Esp Oftalmol (Engl Ed) 2020; 95:248-253. [PMID: 32197871 DOI: 10.1016/j.oftal.2020.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
The case is reported of a 73-year-old male presenting with the recently described peripapillary pachychoroid syndrome. This syndrome is included in the pachychoroid diseases, which is a relatively new condition characterised by increased choroidal thickness with attenuation of the choriocapillary layer located above dilated choroidal vessels. It is associated with progressive malfunction of the retinal pigment epithelium and neovascularisation. The case is presented with a multimodal image, in which some tests show signs not previously described. In addition, a description is presented of the asymmetric outcome of both eyes after multiple treatments, since the left eye has a very severe affectation, and is refractory to the treatment.
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Affiliation(s)
- B Alonso-Martín
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - B de-Lucas-Viejo
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Gimeno-Carrero
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España
| | - M Ferro-Osuna
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España
| | - J Sambricio
- Servicio de Oftalmología, Hospital Universitario 12 de Octubre, Madrid, España
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Marticorena-Álvarez P, Clement-Fernández F, Iglesias-Ussel L. Peripapillary intrachoroidal cavitation in pathological myopia. Arch Soc Esp Oftalmol 2014; 89:316-319. [PMID: 24269422 DOI: 10.1016/j.oftal.2013.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 06/03/2013] [Accepted: 06/07/2013] [Indexed: 06/02/2023]
Abstract
CASE REPORT A 54 year old woman with pathological myopia, presented with an elevated, yellowish-white lesion at the inferior border of the myopic conus in her left eye. The optical coherence tomography (OCT) demonstrated an intrachoroidal hyporeflective space. The fluorescein angiography examination (FA) showed early hypofluorescence with delayed staining, with no leakage of contrast. DISCUSSION Recognition of «peripapillary intrachoroidal cavitation» as an own entity associated with pathological myopia is important to avoid confusion with other possible retinal lesions which require further investigation and treatment.
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Affiliation(s)
| | - F Clement-Fernández
- Servicio de Oftalmología, Hospital Universitario de La Princesa, Madrid, España
| | - L Iglesias-Ussel
- Servicio de Oftalmología, Hospital Universitario de La Princesa, Madrid, España
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Hosseini H, Nilforushan N, Moghimi S, Bitrian E, Riddle J, Lee GY, Caprioli J, Nouri-Mahdavi K. Peripapillary and macular choroidal thickness in glaucoma. J Ophthalmic Vis Res 2014; 9:154-61. [PMID: 25279115 PMCID: PMC4181196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 08/05/2013] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To compare choroidal thickness (CT) between individuals with and without glaucomatous damage and to explore the association of peripapillary and submacular CT with glaucoma severity using spectral domain optical coherence tomography (SD-OCT). METHODS Ninety-one eyes of 20 normal subjects and 43 glaucoma patients from the UCLA SD-OCT Imaging Study were enrolled. Imaging was performed using Cirrus HD-OCT. Choroidal thickness was measured at four predetermined points in the macular and peripapillary regions, and compared between glaucoma and control groups before and after adjusting for potential confounding variables. RESULTS The average (± standard deviation) mean deviation (MD) on visual fields was -0.3 (±2.0) dB in controls and -3.5 (±3.5) dB in glaucoma patients. Age, axial length and their interaction were the most significant factors affecting CT on multivariate analysis. Adjusted average CT (corrected for age, axial length, their interaction, gender and lens status) however, was not different between glaucoma patients and the control group (P=0.083) except in the temporal parafoveal region (P=0.037); nor was choroidal thickness related to glaucoma severity (r=-0.187, P=0.176 for correlation with MD, r=-0.151, P=0.275 for correlation with average nerve fiber layer thickness). CONCLUSIONS Choroidal thickness of the macular and peripapillary regions is not decreased in glaucoma. Anatomical measurements with SD-OCT do not support the possible influence of the choroid on the pathophysiology of glaucoma.
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Affiliation(s)
- Hamid Hosseini
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA
| | - Naveed Nilforushan
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA,Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sasan Moghimi
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA,Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elena Bitrian
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA
| | - Jay Riddle
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA
| | - Gina Yoo Lee
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA
| | - Joseph Caprioli
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Jules Stein Eye Institute, UCLA, Los Angeles, CA, USA,Correspondence to: Kouros Nouri-Mahdavi, MD. Jules Stein Eye Institute, UCLA, 100 Stein Plaza, Los Angeles, CA 90095, USA; Tel:+1 310 794 1487, Fax: +1 310 794 6616;
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