Choroidal thickness profile in Retinitis Pigmentosa - Correlation with outer retinal structures.

PURPOSE: To compare the choroidal thickness (CT) of subjects with Retinitis Pigmentosa (RP) with age-matched healthy subjects and to correlate the visual acuity with retinal parameters including central macular thickness (CMT), inner segment/outer segment junction (IS/OS junction) integrity, external limiting membrane (ELM) integrity and choroidal thickness in subjects with RP. METHODS: Eighty-eight eyes (69 patients) with typical RP and 188 eyes of 104 healthy subjects were enrolled between September 2012 and January 2013. All subjects underwent a comprehensive ocular examination including choroidal imaging using enhanced depth imaging with spectral domain optical coherence tomography. Outcome measures were CT difference between RP and age-matched healthy subjects; and correlation of various factors such CMT, IS/OS junction integrity, ELM integrity, and CT with visual acuity. RESULTS: Among RP subjects, mean age was 31.39 ± 13.4 years with a mean BCVA of 0.99 ± 0.94 logMAR. Mean spherical equivalent was -0.6 ± 1.6D. Mean CMT was 148.48 ± 119 µm. Mean subfoveal CT was 296.9 ± 72 µm. Mean IS/OS and ELM integrity was 42.2 ± 46.6% and 43.75 ± 45.7%, respectively. The mean age was 40.0 ± 13.5 years with a mean spherical equivalent of 0.18 ± 0.6D for the normal age-matched healthy group. Mean subfoveal CT was 283.1 ± 47.8 µm. CT at various locations in patients of various ages in the RP group did not show any statistical significant difference (P = â‰«0.05) in comparison with age-matched healthy subjects. On multivariate regression, ELM percentage integrity had the strongest association with best corrected visual acuity, followed by IS/OS junction percentage integrity. Subfoveal choroidal thickness had very weak correlation with visual acuity as well other retinal parameters. There was a significant difference in the outer retinal structure integrity (p = 0.002) and CMT (p = 0.02) between the eyes with good (⩾20/200) and poor vision (<20/200), but not in subfoveal choroidal thickness (p = 0.3). CONCLUSIONS: Our study results did not show any significant difference in choroidal thickness between subjects with RP and age-matched healthy subjects. Choroidal thickness correlated better with the age but not with the vision or outer retinal structures in eyes with RP. Outer retinal structure integrity and CMT had a better correlation with visual acuity.

Choroidal thickness in diabetic patients of Indian ethnicity.

PURPOSE: To evaluate choroidal thickness (CT) change in various grades of diabetic retinopathy (DR) in comparison to age-matched healthy subjects. METHODS: This prospective observational study included 227 eyes of 125 subjects with diabetes (study group: 58 females) and 197 eyes of 110 age-matched healthy subjects (control group: 66 females). Collected data included age, gender, duration of diabetes, glycemic control, comprehensive ocular examination, fundus photography, and CT measurement on spectral domain ocular coherence tomography using enhanced depth imaging. RESULTS: Mean age in the study group was 57.0 ± 9.37 years (43-73 years). The mean age was 41.48 ± 5.43 years in the control group. Subjects with diabetes with (252.8 ± 55.6 microns) and without (261.71 ± 51.8 microns) retinopathy had significantly thinner choroids when compared to the control group (281.7 ± 47.7 microns; P = 0.032). Seventy-four of 227 eyes did not have any evidence of DR, 89 eyes had features of nonproliferative diabetic retinopathy (NPDR), and 33 eyes had treatment naïve proliferative diabetic retinopathy (PDR). Thirty-one PDR eyes had received previous laser photocoagulation. Subjects with diabetes without retinopathy had a greater subfoveal choroidal thickness (SFCT) than subjects with diabetes with retinopathy (P < 0.001). Eyes with PDR (243.9 ± 56.2 microns) had thinner SFCT than those with NPDR (238.98 ± 111.23 microns). There was no difference in the SFCT between treated (laser photocoagulation done; 251.784 ± 103.72 microns) and treatment naïve PDR (258.405 ± 89.47 microns, P = 0.23). CONCLUSIONS: Control eyes had greater SFCT compared to subjects with diabetes, with and without retinopathy. The thinning progressed with increasing severity of DR. Choroidal thinning may contribute to DR pathogenesis.

Choroidal thickness profi le in healthy Indian subjects.

Purpose: The aim was to study choroidal thickness (CT) and its profile based on location in healthy Indian subjects using Cirrus high definition (HD) optical coherence tomography. Materials and Methods: A total of 211 eyes of 115 healthy subjects with no retinal or choroidal disease were consecutively scanned using Cirrus HD 1 line raster scan mode without pupillary dilation. Eyes with any ocular disease or axial length (AXL) >24 mm or <20 mm were excluded. Experienced technician measured CT from the lower border of the retinal pigment epithelium (RPE) to the lower border of choroid. CT was measured from the posterior edge of the RPE to the choroid/sclera junction at 500-µm intervals up to 3000 µm temporal and nasal to the fovea. Generalized estimating equations were used to evaluate the correlation between CT at various locations and age, AXL, spherical equivalent, and macular thickness. Results: Mean age was 42.8 ± 13.6 years. Mean AXL was 22.84 ± 0.78 mm. Median spherical equivalent was 0.16 ± 0.64 D. Mean central macular thickness was 216.4 ± 30.03 µm. Choroidal was thinnest nasally and thickest subfoveally. On multivariate regression, age was the most significant factor affecting subfoveal CT (P = 0.000). Regression analysis showed an approximate decrease in CT of 1.18 µm every year. Conclusions: Our study provides CT profile in Indian healthy subjects in various age groups. CT depends on its location, subfoveal being the thickest and nasal being the thinnest. Age is a critical factor, which is negatively correlated with CT.

Choroidal thickness in macular telangiectasia type 2.

PURPOSE: To assess the choroidal thickness changes in eyes with macular telangiectasia Type 2 and their relationship with the integrity of outer retinal structures and visual acuity. METHODS: This is a prospective observational study that included 81 eyes (41 subjects) with macular telangiectasia Type 2, including 21 women who underwent enhanced depth choroidal imaging. The choroidal thickness measurements were made at the fovea and at 5 points with an interval of 500 µm in both directions, nasal and temporal from the fovea, and were compared with age-matched healthy subjects. Masked observers assessed the outer retinal structure integrity. Stepwise regression was used to find the relationship between age, spherical equivalent, central macular thickness, integrity of the inner segment/outer segment junction, external limiting membrane integrity, and subfoveal choroidal thickness (SFCT). RESULTS: The mean age of the subjects was 55.2 ± 7.8 years in study subjects. The mean SFCT was 274.6 ± 45.7 µm. There was no significant difference between the SFCT in eyes with macular telangiectasia Type 2 and age-matched healthy subjects (P = 0.38). There was no correlation between the visual acuity (r = 0.008); integrity of inner segment/outer segment (r = 0.54); external limiting membrane (r = 0.47); central macular thickness (r = 0.31) and SFCT. CONCLUSION: Choroidal thickness did not vary between eyes with macular telangiectasia Type 2 and age-matched healthy subjects. There was no correlation between SFCT and visual acuity, and integrity of the outer retinal structures and central macular thickness.

Review of endogenous endophthalmitis during pregnancy including case series.

Endogenous endophthalmitis during pregnancy is a rare condition with few reports of such infections in the peri- and post-partum period. We reviewed the literature on endogenous endophthalmitis in pregnancy and also report a series of four patients who presented to our institution from January 2011 to September 2011. We retrospectively reviewed four patients who developed endogenous endophthalmitis either during pregnancy (two patients) or in the post-partum period (two patients--one after abortion and one after normal term delivery). Presenting visual acuity ranged from finger counting at 3 m to no perception of light. Positive cultures included Bacillus mycoides (vitreous) and Klebsiella pneumoniae (urine). Vitrectomy was performed in three patients. In one patient, the vision improved to 20/20. On reviewing the literature and our experience we concluded that endogenous endophthalmitis related to pregnancy is a rare entity with visual prognosis generally being poor. Fluoroquinolones are best avoided. Cephalosporins and amphotericin B are generally the preferred drugs.