Analysis of Choroidal Thickness in Age-Related Macular Degeneration Using Spectral-Domain Optical Coherence Tomography

Abstract

Purpose To understand the relationship between choroidal thickness and various disease factors in patients with age-related macular degeneration (AMD) using spectral-domain optical coherence tomography. Design Cross-sectional, retrospective analysis. Methods Fifty-seven eyes of 47 patients with wet and dry AMD seen between November 2009 and January 2010 at the New England Eye Center, Boston, Massachusetts, were analyzed. Choroidal thickness was measured by 2 independent observers at 11 sites with high-definition horizontal 1-line raster scans through the foveal center. A retrospective chart review was performed to obtain data concerning duration of disease, number of intravitreal anti–vascular endothelial growth factor injections, visual acuity, lens status, and concomitant retinal pathologic features. The Pearson correlation and Student t test were used for statistical analysis for assessment of choroidal thickness changes in wet and dry AMD. Results The choroid in eyes with wet and dry AMD demonstrated a wide range of thicknesses above and below the normal mean (range, 77.5 to 399.5 μm; standard deviation [SD], 90.2). Nearly one third (33.3%) of the eyes with AMD measured less than 1 SD below the mean. Eyes with wet AMD demonstrated a mean subfoveal choroidal thickness of 194.6 μm (SD, 88.4; n = 40) compared with 213.4 μm (SD, 92.2; n = 17) in the dry AMD group. The choroidal thickness in eyes with dry AMD was correlated inversely with age (r = −0.703; P = .002); however, analysis of the number of intravitreal anti–vascular endothelial growth factor injections, number of years of disease, and visual acuity failed to demonstrate any significant correlations with choroidal thickness. Conclusions This study demonstrated that choroidal thickness can be measured by spectral-domain optical coherence tomography and that variable choroidal thickness exists among patients with the clinical diagnosis of wet and dry AMD. However, it is unclear at this time why in some eyes, choroidal thickness either increases or decreases with the disease. Further studies need to be carried out to understand the significance of choroidal thickness with respect to visual function and disease progression over time.

Evaluation of choroidal thickness using enhanced depth imaging by spectral-domain optical coherence tomography in patients with pseudoexfoliation syndrome

“…It has been reported that choroidal thickness increases in patients with Voght-Koyanagi-Harada disease 20 and central serous chorioretinopathy 21 or decreases in patients with pathologic myopia, 10 age-related macular degeneration, 16 glaucoma, 22 and diabetic retinopathy. 23 These studies speculated that abnormal choroidal thickness may be associated with abnormal choroidal circulation.…”

“…Therefore, a precise clinical evaluation of choroidal morphology should be important for understanding the pathogenesis of many retinal and choroidal diseases. 16,17 To date, SD-OCT featuring high resolution and scanning speeds has allowed the choroid to be assessed in vivo. 12 N2: choroidal thickness at 1000 μm nasal to the fovea; N1: choroidal thickness at 500 μm nasal to the fovea; F: choroidal thickness at fovea; T1: choroidal thickness at 500 μm temporal to the fovea; T2: choroidal thickness at 1000 μm temporal to the fovea; T3: choroidal thickness at 1500 μm temporal to the fovea.…”

Optical Coherence Tomography–based Correlation Between Choroidal Thickness and Drusen Load in Dry Age-Related Macular Degeneration

“…Spectral domain OCT has previously been used to measure choroidal thickness in dry AMD, 7 but its ability to demonstrate a correlation between choroidal thickness and drusen load in dry AMD has not yet been illustrated. We also found a strong correlation between the drusen area and drusen volume.…”

“…6 High-definition SD-OCT has previously been used to measure choroidal thickness in AMD. 7 It has been demonstrated that enhanced depth imaging (EDI) SD-OCT, which produces an inverted image from 100 scans to improve signal-to-noise ratio, can be used to visualize the choroid even better. [8][9][10][11] The new technology has lead to better understanding of the role of choroid in various macular diseases, including central serious chorioretinopathy, 9-11 high myopia, 12,13 Vogt-Koyanagi-Harada disease, 14 and a variety of retinal dystrophies.…”

Evaluation of choroidal thickness using spectral-domain optical coherence tomography in migraine patients during acute migraine attacks: a comparative study

“…7,16 As a highly vascular ocular structure, the choroid is directly influenced by intraocular and perfusion pressure; therefore its real-time high-definition images are more likely to demonstrate the real-time vascular status of this tissue in vivo. 16 In previous studies, sildenafil citrate has been reported to increase choroidal thickness due to a vasodilatory effect of sildenafil citrate on the choroidal circulation. 17 This correlation was further investigated by Kim et al 18 using swept-scan high-frequency digital ultrasound to measure the ocular blood flow.…”