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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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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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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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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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@#AIM:To measure the macular and peripapillary choroidal thickness(CT)in primary angle-closure disease(PACD)with enhanced depth imaging optical coherence tomography(EDI-OCT). To explore the characteristics of CT in each subtypes of PACD and to evaluate its role in the pathogenesis of PACD.<p>METHODS: This was a prospective clinical study. A total of 155 PACD eyes(82 patients)were enrolled in the study, including 24 PACS eyes(24 patients), 35 APAC eyes(28 patients), 38 CPAC eyes(30 patients), 58 eyes PACG(38 patients). 87 normal eyes(87 patients)were set up as control. The EDI-OCT was used to measure the macular and peripapillary choroidal thickness in all study patients. <p>RESULTS: PACD eyes exhibited thicker choroid than the control eyes at all macular locations(<i>P</i><0.05). Choroidal thickness of PACG was thinner than other PACD eyes in area except for 3mm nasal from the fovea(<i>P</i><0.05). Subfoveal choroidal thickness(SFCT)of APAC was thickest(357.17±61.49μm), followed by PACS group(318.04±56.52μm). PACG group presented the thinnest SFCT(263.55±67.87μm). The average macular CT at 1mm centered at the fovea was thinner than SFCT(<i>P</i><0.05)in all subgroups except for CPAC. The average macular CT at 3mm as well as 1mm centered at the fovea was thinner than SFCT in all subgroups(<i>P</i><0.05). There was no statistical differences in CT at peripapillary locations between PACD and controls groups(<i>P</i>>0.05).<p>CONCLUSION: In PACD and controls groups, the CT of subfoveal location was the thickest with decreasing thickness when moving eccentrically from the fovea. The thicker CT might be another anatomic characteristic of PACD. Increased CT in macular location might be a contributing factor of acute attacks. There was no characteristic distinction in the peripapillary CT of PACD when compared with normal controls.
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@#High myopia is a serious eye disease that jeopardizes the visual function of children because of the irreversible changes it caused to the fundus of the eye. High myopia needs to be detected, diagnosed and treated as early as possible, if not intervened in time, it may cause further aggravation or even blindness. However, screening for myopia often encounters the situation that children with low myopia at first who are found to have high myopia fundus changes by further examinations, and these insidious high myopia changes are easily overlooked in the diagnostic process. The study aims to summarize the literatures on choroidal thickness changes and their influencing factors in myopia children, which in order to provide relevant evidence for clinical studies in children with secretive high myopia.
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Purpose: Technological development of optic coherence tomography has enabled a detailed assessment of the optic nerve and deeper structures and in vivo measurements. The aim of this study was to compare the lamina cribrosa morphology of the optic nerve in idiopathic intracranial hypertension (IIH) and healthy individuals. Methods: The lamina cribrosa morphology of optic nerve in 15 eyes with IIH and 17 eyes of healthy individuals were compared. Four parameters such as Bruch membrane opening (BMO), lamina cribrosa thickness (LCT), prelaminar tissue thickness (PTT), and anterior lamina cribrosa surface depth (ALCSD) were retrospectively evaluated. Results: By enhanced depth imaging-optic coherence tomography (EDI-OCT), PTT and BMO were found to be significantly greater (574,35 � 169,20 ?m and 1787,40 � 140,87 ?m, respectively) in IIH patients than healthy individuals (187,18 � 132,15 ?m and 1632,65 � 162,58 ?m, respectively), whereas ALSCD was found to be significantly less in IIH patients (234,49 � 49,31 ?m) than healthy individuals (425,65 � 65,23 ?m). There was not a statistically significant difference regarding LCT between the IIH patients (238,59 � 17,31 ?m) and healthy individuals (244,96 � 15,32 ?m). Conclusion: Increased intracranial pressure causes morphological changes in lamina cribrosa. Assessment of lamina cribrosa with EDI-OCT is important for diagnosis and follow-up of patients with IIH. EDI-OCT is objective, reproducible, and cost-effective assistive imaging tool in IIH patients.
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Purpose@#To conduct an evaluation of juxtapapillary choroidal thickness of patients suspected with glaucoma obtained through spectral domain optical coherence tomography (SD-OCT) and correlate it with perimetry results.@*Methods@#Design: Cross-sectional Study. Population: 175 eyes diagnosed as “glaucoma suspect” had standard automated perimetry (SAP) to document the presence of functional glaucomatous damage using optimal near-point correction using the Humphrey Visual Field Analyzer II, 30-2 or 24-2 SITA-standard program. SD-OCT imaging of the retinal nerve fi ber layer (RNFL) was also done to look for structural glaucomatous damage and in using enhanced depth imaging of the optic nerve and the Cirrus caliper tool, choroidal thickness was measured at fi ve predetermined points temporal and nasal from the optic nerve. The population was classifi ed into two groups: Group 1 are those with structural or functional glaucomatous damage (n=68) and Group 2 were those without (n=107).@*Results@#One-Way Multivariate Analysis of Covariance was used in comparing the mean temporal and nasal choroidal thickness scores of the two groups. There are no statistical differences in terms of the mean temporal choroidal thickness (p=0.856) and mean nasal choroidal thickness (p=0.734) between patients with and without glaucomatous damage. The mean temporal and nasal choroidal thickness scores of the two groups at different juxtapapillary locations: 0 μm, 250 μm, 500 μm, 750 μm and 1000 μm away from the disc were also not statistically different.@*Conclusion@#Results show that from this present cohort of glaucoma suspect patients, juxtapapillary choroidal thickness is not correlated with structural and functional glaucomatous damage.
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Visual Field Tests , Tomography, Optical Coherence , Ocular HypertensionABSTRACT
@#AIM: To investigate the differences of the choroidal vascularity index between type 2 diabetes with diabetic retinopathy and non-diabetes patients.<p>METHODS: A retrospective cross-sectional study was performed at Beijing Friendship Hospital. Enhanced depth imaging spectral-domain optical coherence tomography(EDI-OCT)scans of 68 eyes of 68 type 2 diabetes who with diabetic retinopathy were compared with those of right eyes of 34 age- and gender-matched healthy controls. The choroidal images were binarized into luminal areas(LA)and stromal areas(SA). CVI was defined as the ratio of LA to total circumscribed subfoveal choroidal area. Mean choroidal thickness, mean retinal thickness and mean CVI between patients and controls were compared using <i>t</i>-test. <p>RESULTS: There were no significant differences in total circumscribed subfoveal choroidal area(0.53±0.14mm2 <i>vs</i> 0.49±0.15mm2), LA(0.35±0.09mm2 <i>vs</i> 0.32±0.10mm2), SA(0.17±0.05mm2 <i>vs</i> 0.17±0.06mm2), or subfoveal choroidal thickness(347.9±76.9μm <i>vs</i> 325.9±92.9μm)between patients with DR and controls(<i>P</i>>0.05). However, there was a significantly lower CVI in patients with diabetes as compared to controls(64.33%±3.25% <i>vs</i> 67.04%±2.46%, <i>P</i><0.001). The critical value was 63.59%.<p>CONCLUSION: CVI is a kind of biological indicators which can directly reflect the changes of choroidal internal structure, and it is more stable and reliable than SFCT. For type 2 diabetic patients who with diabetic retinopathy, CVI is lower than that of healthy people.
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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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Objective To observe the efficacy and safety of conbercept in the treatment of central serous chorioretinopathy (CSC) by EDI-OCT.Methods From July 2015 to July 2017,42 patients (44 eyes) of central serous choriodal retinopathy received intravitreal injection of conbercept (0.5 mg,0.05 mL).Then,the best corrected visual acuity was recorded before injection and 1 week,4 weeks and 12 weeks after treatment;meanwhile,EDI-OCT was used to measure subfoveal choroidal thickness at different time points.Results In CSC patients,the BCVA of 1 week,4 weeks and 12 weeks after treatment were 0.57 ±0.23,0.62 ±0.23 and 0.59 ±0.71,respectively,which were significantly higher than those before treatment [(0.43 ± 1.11)] (all P ＜ 0.05).The subfoveal choroidal thickness was (308.17 ± 16.52) μm,(286.54 ± 37.52) μm and (274.58±41.38)μm at 1 week,4 weeks and 12 weeks after treatment,respectively,which were significantly lower than those before treatment [(346.31 ± 59.43) μm] (all P ＜ 0.05).Conclusion It is safe and effective for conbercept injection in the treatment of CSC.
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·AIM: To compare choroidal thickness at the macula in eyes with unilateral idiopathic full - thickness macular holes (FTMH) with that of unaffected fellow eyes, and eyes of normal control patients. ·METHODS: Cross-sectional study. Thirty patients with unilateral idiopathic FTMH and thirty age, sex, and race-matched controls were recruited. Axial lengths were measured using laser interferometry. Enhanced depth imaging optical coherence tomography images were obtained using Heidelberg spectral - domain optical coherence tomography. Choroidal thickness was measured at the fovea, and at 1 mm and 2 mm nasally, temporally, superiorly and inferiorly from the center of the fovea. Statistical analysis was performed using independent and paired t-tests, chi-square tests, and Pearson correlation tests (P<0.05). ·RESULTS:The mean subfoveal choroidal thickness was 201.0±44.0 μ m in the FTMH group,225.3± 51.4 μ m in the fellow eye group and 262.3±70.3 μ m in the control group. The choroid was thinner in FTMH eyes at all locations when compared to control eyes(P<0.05). The fellow eye group also had thinner choroids than the control group at all locations except at 1 mm and 2 mm nasal to the fovea (P<0.05). Choroidal thickness in the FTMH group was lower than in the fellow eye group, but the differences were not statistically significant (P > 0.05). Choroidal thickness was generally highest subfoveally and lowest nasally. Subfoveal choroidal thickness was negatively correlated with age (r = -0.278, P = 0.032), and axial length (r=-0.328,P=0.011). ·CONCLUSION:Choroidal thickness is lower in both eyes of patients with unilateral FTMH compared to healthy control eyes.
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AIM:To evaluate the potential posterior segment effects of topical application of brimonidine-purite 0.15％ through measurement of choroidal thickness (CT) in healthy eyes using enhanced depth imaging spectraldomain optical coherence tomography (EDI-SD-OCT).METHODS:Thirty-two eyes of 32 healthy subjects were included in this prospective,placebo controlled interventional clinical trial.They received one drop of topical preservative-free artificial tears as placebo for the first day and one drop of brimonidine-purite 0.15％ for the second day.Intraocular pressure,ocular perfusion pressure (OPP),and EDI-SD-OCT were performed at baseline,at 1,3 and 5h after the treatments.RESULTS:Compared to the measurements obtained at baseline,the CT measurements obtained after the topical application of brimonidine-purite 0.15％ significantly increased at the sub-fovea (P=0.001),at temporal 1500 μm to the fovea (P=0.003) and at nasal 1500 μm to the fovea (P=0.003).Choroidal thickness was unchanged in placebo group during the study (P ＞0.05).There was no significant reduction in the OPP in both groups (P ＞0.05).There were no adverse events during the study.CONCLUSIONS:Contrary to expectations,topical administration of brimonidine-purite 0.15％ resulted with thickening of sub-foveal,temporal and nasal CT.This might be related to altered auto-regulation mechanisms in choroidal vessels.
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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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Diabetic retinopathy is a series of typical pathological changes in retinal microvasculature caused by diabetes,which seriously affects the visual acuity and quality of life of patients.The development of spectral-domain optical coherence tomography provides a new approach to elucidate the pathogenesis of diabetic retinopathy,and this paper will give a brief review on the latest progress in the relationship between choroidal thickness measured by optical coherence tomography and diagnosis-treatment of diabetic retinopathy.