Topographical variation of macular choroidal thickness with myopia

To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. Retrospective, observational case series. EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions. Show more

The purpose of the study was to evaluate the choroidal thickness in patients with central serous chorioretinopathy, a disease attributed to increased choroidal vascular hyperpermeability. Patients with central serous chorioretinopathy underwent enhanced depth imaging spectral-domain optical coherence tomography, which was obtained by positioning a spectral-domain optical coherence tomography device close enough to the eye to acquire an inverted image. Seven sections, each comprising 100 averaged scans, were obtained within a 5 degrees x 30 degrees rectangle to encompass the macula. The subfoveal choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border. The mean age of subjects undergoing enhanced depth imaging spectral-domain optical coherence tomography was 59.3 years (standard deviation, 15.8 years). Seventeen of 19 patients (89.5%) were men, and 12 (63.2%) patients had bilateral clinical disease. The choroidal thickness measured in 28 eligible eyes of the 19 patients was 505 microm (standard deviation, 124 microm), which was significantly greater than the choroidal thickness in normal eyes (P < or = 0.001). Enhanced depth imaging spectral-domain optical coherence tomography demonstrated a very thick choroid in patients with central serous chorioretinopathy. This finding provides additional evidence that central serous chorioretinopathy may be caused by increased hydrostatic pressure in the choroid. Show more

To study subfoveal choroidal thickness (SFCT) in adult Chinese subjects and its correlation with ocular biometric parameters, refractive error, and age. Population-based longitudinal study. The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6±9.8 years (range, 50-93 years). A detailed ophthalmic examination was performed, including spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging for measurement of SFCT. Subfoveal choroidal thickness. The SFCT measurements were available for 3233 subjects (93.2%). Mean SFCT was 253.8±107.4 μm (range, 8-854 μm). In multivariate analysis, SFCT increased with younger age (P<0.001; correlation coefficient r=4.12; beta coefficient=0.37), shorter axial length (P<0.001; r=44.7; beta coefficient=0.46), male gender (P<0.001; r=28.5; beta coefficient=-0.13), deeper anterior chamber depth (P<0.001; r=39.3; beta coefficient=0.13), thicker lens (P<0.001; r=26.8; beta coefficient=0.08), flatter cornea (P<0.001; r=46.0; beta coefficient=0.11), and better best-corrected visual acuity (BCVA) (logarithm of minimal angle of resolution; P=0.001; r=48.4; beta coefficient=0.06). In multivariate analysis, SFCT was not significantly associated with blood pressure, ocular perfusion pressure, intraocular pressure, cigarette smoking, alcohol consumption, serum concentrations of lipids and glucose, diabetes mellitus, and arterial hypertension. In the myopic refractive error range of more than -1 diopter (D), SFCT decreased by 15 μm (95% confidence interval [CI], 11.9-18.5) for every increase in myopic refractive error of 1 D, or by 32 μm (95% CI, 37.1-26.0) for every increase in axial length of 1 mm. For each year increase in age, the SFCT decreased by 4.1 μm (95% CI, 4.6-3.7) (multivariate analysis). Subfoveal choroidal thickness with a mean of 254±107 μm in elderly subjects with a mean age of 65 years decreased with age (4 μm per year of age) and myopia (15 μm per diopter [D] of myopia). It was also associated with male gender and the ocular biometric parameters of a deeper anterior chamber and thicker lens. The association between SFCT and BCVA indicates a functional aspect of SFCT. The author(s) have no proprietary or commercial interest in any materials discussed in this article. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved. Show more