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Purpose: To analyze the imaging characteristics and the clinical course of patients showing concomitant paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) post?blunt trauma. Methods: PAMM and AMN lesions post?blunt trauma diagnosed on enhanced depth imaging optical coherence tomography (EDI?OCT) were recruited for the study. Results: Thirteen eyes of 13 individuals with a history of blunt trauma were included in the study, of whom 11 (85%) were males. Mean age of the patients was 33.62 (range 16–67) years. Mean visual acuity at presentation and the last visit was 1.67 log of minimum angle of resolution (logMAR) and 0.82 logMAR, respectively. Mean interval between trauma and imaging was 5.08 (range 1–15) days. All patients had unilateral involvement, with the right eye being involved in 10 patients (77%). All patients had concomitant PAMM and AMN lesions. Conclusion: Presence of coincident PAMM and AMN suggests a common pathophysiologic etiology, but the description of concomitant PAMM and AMN in the setting of blunt trauma to eye is hitherto unreported. Identifying AMN in a setting of PAMM requires meticulous examination of the OCT and OCTA images. It can be a cause of suboptimal visual recovery in such eyes.
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AIM: To investigate the changes in peripapillary choroidal thickness(pCT)within 1a of the first episode of acute primary angle closure glaucoma(APACG).METHODS: A prospective cohort study. A total of 31 patients with APACG who admitted to the ophthalmology department of Shijiazhuang People's Hospital from October 2015 to September 2019 were selected, with 31 eyes in attack group, 31 fellow eyes in preclinical group and 30 cases(30 eyes)in control group. pCT of the three groups was measured respectively at the attack period, 1wk, 1, 3, 6mo and 1a after surgery.RESULTS: The pCT of the attack group was thicker than that in the attack period when at 1wk after surgery, and continued to become thinner within the following 1a(P<0.05). The pCT of the attack group was thicker than that of the other two groups during the attack period and at 1wk after surgery, while it became thinner at 1a(P<0.05). In the attack group, the average pCT was positively correlated with the duration of intraocular hypertension and negatively correlated with the anterior chamber depth(P<0.05).CONCLUSION: For patients with first episode of APACG, pCT was diffusely thickened during attack and at 1wk after surgery. The pCT returned to normal at 1mo, while it became thinner at 1a. Furthermore, the average pCT was positively correlated with the duration of intraocular hypertension, and the choroidal thickness may play an important role in the attack of APACG.
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In recent years, ophthalmology, as one of the medical fields highly dependent on auxiliary imaging, has been at the forefront of the application of deep learning algorithm. The morphological changes of the choroid are closely related to the occurrence, development, treatment and prognosis of fundus diseases. The rapid development of optical coherence tomography has greatly promoted the accurate analysis of choroidal morphology and structure. Choroidal segmentation and related analysis are crucial for determining the pathogenesis and treatment strategies of eye diseases. However, currently, choroidal mainly relies on tedious, time-consuming, and low-reproducibility manual segmentation. To overcome these difficulties, deep learning methods for choroidal segmentation have been developed in recent years, greatly improving the accuracy and efficiency of choroidal segmentation. The purpose of this paper is to review the features of choroidal thickness in different eye diseases, explore the latest applications and advantages of deep learning models in measuring choroidal thickness, and focus on the challenges faced by deep learning models.
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Purpose: To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age?matched healthy subjects. Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length?matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single?line horizontal?raster enhanced depth imaging – optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann–Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant. Results: The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from ?8.5D to +10.5D in the OA group and from ?8.0D to +10.0D in the control group. The mean axial length between the two groups (P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 ?m; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 ?m; P < 0.001) was significantly thinner in the OA group. Conclusion: Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism.
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Purpose: To investigate the choroidal vascularity index (CVI) and morphological features of the choroid in anisometropic amblyopia. Methods: In this prospective cross?sectional study, 39 patients with unilateral anisometropic amblyopic patients and 33 eyes of 33 healthy control participants were involved. These participants were examined in terms of axial length (AL), spherical equivalent (SE), central macular thickness (CMT), choroidal thickness (CT), total choroidal area (TCA), luminal area (LA), stromal area (SA), LA/SA ratio, and CVI. All parameters were compared between amblyopic eyes, healthy fellow eyes, and healthy control eyes. The Shapiro–Wilk tests, Chi?square test, the paired t?test, Wilcoxon signed?rank test, Mann–Whitney U test, Kruskal–Wallis test, and Pearson/Spearman correlation tests were used. Results: In the hyperopic patients; SE, subfoveal CT, nasal CT, temporal CT, TCA, LA, SA, and CMT were greater in amblyopic eyes than in healthy fellow eyes and control eyes (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively), and CVI, LA/SA ratio, and AL were smaller in amblyopic eyes than in healthy fellow eyes and control eyes ([P < 0.001, P = 0.006], P < 0.001, and P < 0.001, respectively). In the myopic patients, subfoveal CT, nasal CT, temporal CT, TCA, LA, SA values were statistically smaller in amblyopic eyes than in healthy eyes and control eyes ([P < 0.001, P = 0.002), [P = 0.004, P = 0.012], [P = 0.012, P = 0.032], [P < 0.001, P = 0.013], [P < 0.001, P = 0.024], and [P < 0.001, P = 0.047], respectively). The differences in the AL and choroidal parameters were due to myopia and hyperopia. Conclusion: The choroidal structural parameters of the amblyopic eyes were different from that of the healthy eyes.
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AIM:To compare the choroidal parameters in children and adolescents with different refractive status, and to investigate the associations between ocular biometrics and choroidal parameters.METHODS:A cross sectional study. A total of 121 healthy children and adolescents(121 right eyes)aged 3-18 years treated in the Second People's Hospital of Hefei were collected. The data were divided into three groups according to spherical equivalent refraction(SER): emmetropia(-0.50<SER≤+1.75D), low myopia(-3.00<SER≤-0.50D)and moderate-to-high myopia(SER≤-3.00D). Ocular biometrics were measured by using the IOL Master. Data of the choroidal structures extracted from a 6mm sub-macular region centered on the fovea, including choroidal thickness(CT), the total choroidal area(TCA), luminal area(LA), stromal area(SA)and choroidal vascularity index(CVI)were determined by image binarization of the enhanced depth imaging-optical coherence tomography(EDI-OCT). Comparing all biology parameters among the three groups, associations among demographic factors, ocular parameters, and choroidal structures were evaluated by using multiple linear regression analysis.RESULTS:TCA, LA, SA and CT were all different among the three groups before age correction(all P<0.001), and CVI was not different(P >0.05). TCA, LA, SA, CT and CVI were found to be statistically different among the three groups after age correction(all P<0.001), and there were differences in pairwise comparisons of TCA, LA, SA and CT among the three groups(all P<0.001), which were the highest in emmetropic eyes and lowest in moderate-to-high myopic eyes, However, the CVI in pairwise comparisons among the three groups showed that only the moderate-to-high myopia group was significantly lower than the emmetropic group(P=0.014). Multiple regression analysis showed that the LA was significantly associated with SER(P=0.020), whereas CT were significantly associated with the axial length(AL)(P=0.028).CONCLUSIONS: The choroidal LA and CVI tend to decrease in children and adolescents with higher myopia, indicating that the decrease of sub-foveal choroidal blood flow may be related to the progression of myopia.
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AIM: To compare the differences in choroidal structure between hyperopic amblyopia and normal children of the same age by the enhanced depth imaging optical coherence tomography(EDI-OCT)technique.METHODS: There were 35 cases in 50 eyes of children with hyperopic amblyopia visiting our hospital in January 2021 to December 2021 selected in the amblyopic group, and 30 cases in 51 eyes of healthy children who matched general data in the same period were selected in the control group. EDI-OCT examination was performed to measure the choroidal thickness(CT). After image processing, the total choroidal area(TCA), luminal area(LA), stromal area(SA)and choroidal vascularity index(CVI)were obtained.RESULTS: TCA(except inferior quadrant), SA(except inferior quadrant of the outer ring), LA and CT(except inferior and temporal quadrant )in the amblyopic group of each area were significantly larger than that in the control group(P<0.05), and there was no significant difference in CVI between the two groups except the temporal quadrant of the outer ring(P>0.05). There was no significant difference in CT for all degrees of hyperopic amblyopia, with the exception of the nasal quadrant(P>0.05).CONCLUSION: Hyperopic amblyopia is accompanied with abnormal choroidal structure. As the degree of hyperopia increases, TCA, LA and SA exhibit increasing trends. The changes in choroidal structure are presumed to be related to hyperopic amblyopia.
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A structurally and functionally intact choroid tissue is vitally important for the retina function. Although central retinal artery is responsible to supply the inner retina, choroidal vein network is responsible for the remaining one-third of the external part. Abnormal choroidal blood flow leads to photoreceptor dysfunction and photoreceptor death in the retina, and the choroid has vital roles in the pathophysiology of many diseases such as central serous chorioretinopathy, age-related macular degeneration, pathologic myopia, Vogt–Koyanagi–Harada disease. Biomarkers of choroidal diseases can be identified in various imaging modalities that visualize the choroid. Indocyanine green angiography enables the visualization of choroid veins under the retinal pigment epithelium and choroidal blood flow. New insights into a precise structural and functional analysis of the choroid have been possible, thanks to recent progress in retinal imaging based on enhanced depth imaging (EDI) and swept-source optical coherence tomography (SS-OCT) technologies. Long-wavelength SS-OCT enables the choroid and the choroid–sclera interface to be imaged at greater depth and to quantify choroidal thickness profiles throughout a volume scan, thus exposing the morphology of intermediate and large choroidal vessels. Finally, OCT angiography allows a dye-free evaluation of the blood flow in the choriocapillaris and in the choroid. We hereby review different imaging findings of choroidal diseases that can be used as biomarkers of activity and response to the treatment.
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@#AIM: To observe the choroidal thickness in nonarteritic anterior ischemic optic neuropathy(NAION)measured by enhanced depth imaging optical coherence tomography(EDI-OCT)and evaluate its clinical significance. <p>METHODS: Totally 30 patients diagnosed with NAION were studied and 60 individuals with normal fundus were set as control. Choroidal thickness was measured by EDI-OCT. Choroidal thickness of the affected eye and contralateral eye in patient group and right eye of the control group were evaluated and recorded. <p>RESULTS: Differences in age, gender and refractive status between NAION group and control were not significant(<i>P</i>>0.05). Choroidal thickness near fovea and optic disc in affected eye and contralateral eye in patient group was thinner compared to these of control group(<i>P</i><0.01). No statistical differences were observed in the choroidal thickness between affected eye and contralateral eye(<i>P</i>>0.05). <p>CONCLUSION: In NAION patients, choroidal thickness of affected eyes and unaffected contralateral eyes were significantly thinner compared to these of control group. Diminish of the observed choroidal thickness in this study might be explained by small vessels occlusion in posterior ciliary artery, which would affect the blood supply of the choroid.
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PURPOSE: To investigate the changes in choroidal thickness in diabetic retinopathy patients after panretinal photocoagulation (PRP). METHODS: This retrospective study included 42 eyes of treatment-naive, severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy patients undergoing 3-session PRP. At baseline and 1 and 2 months after completion of the PRP treatments, subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging optical coherence tomography. RESULTS: The mean SFCT at baseline was 261.52 +/- 77.98 microm, changing to 249.14 +/- 72.23 microm and 242.95 +/- 70.28 microm at 1 and 2 months, respectively (p 10%) in 9 eyes (21.43%) at 1 month and 8 eyes (19.05%) at 2 months after PRP. The mean SFCT showed no significant difference between increased mean CMT (238.22 +/- 57.59 microm and 240.00 +/- 67.71 microm at 1 and 2 months, respectively) and stable mean CMT groups (252.12 +/- 76.24 microm and 243.65 +/- 71.84 microm at 1 and 2 months, respectively; p > 0.05). CONCLUSIONS: Choroidal thickness decreased after PRP. There was no significant relationship between change in SFCT and CMT after PRP.
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Humans , Choroid , Diabetic Retinopathy , Light Coagulation , Retrospective Studies , Tomography, Optical CoherenceABSTRACT
Background: Spectral domain (SD) enhanced depth imaging optical coherence tomography (EDI‑OCT) is a useful tool for anatomic, cross‑sectional imaging of retinal conditions. Aims: The aim was to identify characteristic patterns of retinal and retinal pigment epithelial tumors on EDI‑OCT in children and adults. Settings and Design: Retrospective review. Materials and Methods: Analysis of published reports and personal observations using office‑based EDI‑OCT for adults and portable hand‑held SD OCT for infants and children. Results: Using EDI‑OCT, retinal tumors such as small retinoblastoma, astrocytic hamartoma, and hemangioblastoma arose abruptly from the retina, immediately adjacent to normal retina. Small exophytic retinoblastoma and retinal hemangioblastoma showed the full‑thickness, homogeneous retinal disorganization with surrounding normal retina “draping” over the margins. Retinoblastoma occasionally had intralesional cavities and surrounding subretinal fluid. Hemangioblastoma often had adjacent intraretinal edema and subretinal fluid. Astrocytic hamartoma arose within the nerve fiber layer and sometimes with a “moth‑eaten” or cavitary appearance. Retinal pigment epithelial (RPE) lesions such as congenital hypertrophy of RPE appeared flat with shadowing, occasional subretinal cleft, and abrupt photoreceptor loss. Congenital simple hamartoma showed an abrupt elevation from the inner retina with crisp, dark posterior shadowing. Combined hamartoma of the retina/RPE showed vitreoretinal traction causing “sawtooth mini‑peak” or gently “maxi‑peak” folding of the retina. RPE adenoma often produces remote macular edema or epiretinal membrane and the tumor has an irregular, “rugged” surface with deep shadowing. Conclusions: Enhanced depth imaging optical coherence tomography shows characteristic patterns that are suggestive of certain retinal and RPE tumors.
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Background: Spectral domain enhanced depth imaging optical coherence tomography (EDI‑OCT) can provide anatomic localization of intraocular tumors. Aims: The aim was to identify topographical and intrinsic patterns of choroidal tumors on EDI‑OCT. Settings and Design: Retrospective review. Materials and Methods: Analysis of published reports and personal observations using office based EDI‑OCT. Results: Using EDI‑OCT, choroidal nevus displayed a smooth, dome‑shaped topography with overlying retinal pigment epithelium alterations, drusen, and occasional subretinal cleft demonstrating photoreceptor loss. Small choroidal melanoma showed smooth, moderately dome‑shaped topography, commonly with overlying shallow subretinal fluid that often depicted “shaggy” photoreceptors. Choroidal metastasis showed a minimally “lumpy, bumpy” surface topography and with overlying subretinal fluid and shaggy photoreceptors. Choroidal hemangioma showed a smooth, dome‑shaped topography, with expansion of the affected small, medium, and large choroidal vessels. Choroidal lymphoma showed varying topography with increasing tumor thickness as “flat, rippled, or undulating (seasick)” surface. Choroidal osteoma displayed a smooth undulating surface with visible intralesional horizontal lines suggestive of bone lamellae and occasional horizontal and vertical tubules with intralesional “spongy” flecks. Choroidal melanocytosis appeared as uniformly thickened choroid with increased stromal density surrounding the normal choroidal vascular structures. Conclusions: Enhanced depth imaging‑OCT can depict characteristic patterns that are suggestive of various choroidal tumors.
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PURPOSE: To evaluate the effect of diabetic retinopathy on choroidal thickness and the changes of choroidal thickness after intravitreal bevacizumab injection (IVB) in diabetic patients. METHODS: The present study included 105 patients (105 eyes). Patients were classified into 6 groups: control group (A); no change (B), mild (C), moderate (D), and severe (E) non proliferative diabetic retinopathy (NPDR); and proliferative diabetic retinopathy (PDR) (F), with 15 diabetic patients in each group. All patients underwent enhanced depth imaging spectraldomain optical coherence tomography (EDI OCT) to evaluate choroidal thickness. An additional 15 patients (15 eyes) with diabetic retinopathy treated with IVB were also included. These patients underwent EDI OCT before and 1 month after IVB. RESULTS: Mean choroidal thickness was significantly thinner in the moderate and severe NPDR, and PDR groups compared with the control group. Moreover, when comparing sequential stages of diabetic retinopathy progression, the choroidal thickness in the moderate NPDR stage and PDR stage was found to be significantly thinner than in the mild and severe NPDR, respectively. Additionally, choroidal thickness was 187.3 microm before IVB and significantly decreased to 168.9 microm 1 month after IVB (p < 0.05). CONCLUSIONS: Choroidal thickness is related to the severity of diabetic retinopathy and is significantly decreased after IVB.
Subject(s)
Humans , Antibodies, Monoclonal, Humanized , Choroid , Diabetic Retinopathy , Tomography, Optical Coherence , BevacizumabABSTRACT
PURPOSE: To determine the relationship between subfoveal choroidal thickness of fellow eyes and choroidal vascular hyperpermeability in unilateral central serous chorioretinopathy (CSC). METHODS: Thirty patients with unilateral CSC and 28 normal subjects underwent enhanced depth imaging spectral-domain optical coherence tomography to evaluate bilateral subfoveal choroidal thickness. The subfoveal choroidal thickness was measured from the outer RPE border to the inner sclera border. Choroidal vascular hyperpermeability was visualized with indocyanine green angiography (ICGA) and analyzed. RESULTS: The mean subfoveal choroidal thickness in the affected eyes (439.6 +/- 136.5 microm) was significantly thicker than that in fellow eyes (340.0 +/- 103.3 microm, p = 0.002), and both showed statistically significant difference compared with normal subjects (266.5 +/- 111.5 microm, p < 0.001, p = 0.019). The subfoveal choroidal thickness of fellow eyes with choroidal vascular hyperpermeability was 370.0 +/- 176.5 microm, which differed significantly (p = 0.037) from the choroid without choroidal vascular hyperpermeability. The choroidal thickness of acute CSC was 441.6 +/- 118.6 microm, and that of chronic CSC was 454 +/- 166.5 microm, a difference that was not statistically significant (p = 0.676). CONCLUSIONS: The subfoveal choroid with hyperpermeability was thicker than that without hyperpermeability on ICGA in the fellow eyes of patients with unilateral CSC. Enhanced depth imaging spectral-domain optical coherence tomography can indirectly evaluate the effects of choroidal hyperpermeability by noninvasively measuring the choroidal thickness.