SD-OCT Choroidal Thickness in Advanced Primary Open-Angle Glaucoma

Sacconi, Riccardo; Deotto, Niccolo’; Merz, Tommaso; Morbio, Roberta; Casati, Stefano; Marchini, Giorgio

doi:10.1097/ijg.0000000000000661

Cited by 26 publications

(19 citation statements)

References 26 publications

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“…Recently, an abnormal increase in CT has been hypothesized to contribute to CSC [17], primary open angle glaucoma (POAG) [18], and primary angle closure glaucoma (PACG) [13]. Given its anatomical location, scleral inflammation can spread to the choroid, so CT was supposed to be affected due to inflammation in PS.…”

Section: Discussionmentioning

confidence: 99%

The clinical features of posterior scleritis with serous retinal detachment: A retrospective clinical analysis

Dong

Gan

Zhang

et al. 2018

Preprint

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Objective: To summarize the clinical features, systemic associations, risk factors and choroidal thickness(CT) changing in posterior scleritis (PS) with serous retinal detachment. Methods: This retrospective study included 23 patients with PS with retinal detachment from August 2012 to July 2017. All patients were documented with the Medical history and clinical features were recorded. The examinations included best corrected visual acuity (BACV), intraocular pressure（IOP）, fundus examination, routine eye examinations. Posterior coats thickness (PCT) was determined by B scan Ultrasound, the CT was measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). And clinical data were compiled and analyzed. Results: After application of extensive exclusion criteria, 23 patients with PS remained (13 females, 10 males). The average age at presentation was 29.5 ± 9.24 years old. Ocular pain and blurred vision were the two most common symptoms complained by patients. Anterior scleritis occurred in 12 patients, which was confirmed by Ultrasound Biomicroscopy (UBM) examination. Despite all patients displaying serous retinal detachment in their macula, no fluorescein leakage was observed in the macular. Optic disc swelling was documented in 10 of the 23 eyes. From B-scan ultrasound examination, the PCT increased with fluid in Tenon’s capsule demonstrated as a typical T-sign. The average PCT was 2.51 ± 0.85 mm in the PS-affected eye and only 1.09 ± 0.29 mm in the unaffected eye; this difference reached statistical significance. The subfoveal CT increased to an average of 442.61 ± 55.61μm, which correlated with axis length and PCT, but not with IOP. The BCVA and IOP did not correlate with either CT or the PCT. Conclusions: PS with serous retinal detachment presented with a variety of symptoms, such as pain and visual loss, and physical indicators. Typical T-sign detected by B-scan ultrasound was a useful confirmatory sign for PS diagnosis. Pathological increases in CT might be a potential predictive factor for inflammation.

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Section: Discussionmentioning

confidence: 99%

The clinical features of posterior scleritis with serous retinal detachment: A retrospective clinical analysis

Dong

Gan

Zhang

et al. 2018

Preprint

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“…This observation suggests that choroidal thickness occurs later in the disease course of pseudoexfoliation and that factors other than choroidal thinning may play a role in the conversion from PXS to PXG. Sacconi and associates24 have also reported choroidal thinning in advanced POAG. Nevertheless, due to limited information on the relationship between choroidal blood flow and choroidal thickness in humans, we are unable to conclude based on our results whether choroidal blood flow was normal in eyes with early stages of pseudoexfoliation despite having choroidal thickness within the normal range.…”

Section: Discussionmentioning

confidence: 88%

“…In the present study, glaucoma severity was the only factor that correlated with choroidal thickness in PXG eyes. Although the MD was not correlated with choroidal thickness in POAG eyes,25 one recent study showed choroidal thinning in advanced POAG24 and concluded that the longer duration of glaucoma may lead to ocular changes like vascular impairment and diffuse loss of choroidal vessels.…”

Section: Discussionmentioning

confidence: 94%

“…Therefore, choroidal circulation has been suggested to contribute to the pathophysiology of glaucomatous optic neuropathy. Findings regarding choroidal involvement in glaucoma (reflected as choroid thickness) have been discrepant, as several studies reported thinning of the macular or peripapillary choroid in patients with POAG or NTG,23,24 while other studies have failed to find a difference in choroidal thickness in glaucoma as compared with healthy subjects 21,25…”

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confidence: 99%

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Lamina Cribrosa and Choroid Features and Their Relationship to Stage of Pseudoexfoliation Glaucoma

Moghimi

Nekoozadeh

Motamed-Gorji

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PurposeTo better understand the relationship of lamina cribrosa (LC) and choroid features to the severity of pseudoexfoliation glaucoma (PXG).MethodsIn this cross-sectional study, 137 eyes of 122 subjects (47 eyes with moderate/advanced PXG [mean deviation (MD), −15.0 ± 7.7 dB], 34 eyes with mild PXG [MD, −2.7 ± 1.5 dB], 32 aged-matched pseudoexfoliation syndrome [PXS] eyes, and 24 aged-matched control eyes) were investigated. Optic discs, LC thickness, and anterior LC depth (ALD; midsuperior, center, and midinferior) as well as peripapillary choroidal thickness were determined. Linear mixed modeling was used to adjust for age, sex, and axial length.ResultsA progressive decrease in LC thickness was found when comparing controls (271.9 ± 61.3 μm), PXS (212.6 ± 51.5 μm), mild PXG (180.8 ± 24.6 μm), and moderate/advance PXG (138.9 ± 37.5 μm) (P < 0.001). ALD was greater (P < 0.001) in moderate/advance glaucoma (306.7 ± 105.3 μm) and mild PXG (209.5 ± 79.7 μm) compared with PXS (155 ± 86.7 μm) and healthy controls (149.2 ± 103 μm). Although eyes with moderate/advance PXG had the thinnest choroid (117.2 ± 36.6 μm), choroidal thickness was comparable in mild PXG, PXS, and controls (150.0 ± 46.1, 159.7 ± 65.5, and 157.5 ± 51.1 μm, respectively; P = 0.002). Worse MD was the only factor associated with thinner LC (β = 2.344, P < 0.001) and choroid (β = 1.717, P = 0.009 μm) in PXG eyes. Higher IOP (β = 4.305, P = 0.013) and worse MD (β = −6.390, P < 0.001) were associated with deeper ALD in PXG.ConclusionsIn pseudoexfoliation, LC thinning is an early sign, and there is progressive thinning with advancing glaucoma. Choroidal thinning is observable only with moderate/advanced glaucoma. In PXG eyes, LC thickness, depth, and peripapillary choroidal thickness are associated with glaucoma severity.

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“…Song et al (13) evaluated peripapillary CT in open-angle glaucoma and detected significant choroidal thin- ning in the study population. Recently; Sacconi et al (14) assessed CT in advanced open-angle glaucoma, and found that subfoveal CT and temporal CT were significantly reduced in the patient group. In contrast, other studies and meta-analyses have failed to demonstrate significant choroidal thinning in patients with open-angle glaucoma, normal-tension glaucoma, and healthy controls (15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Macular choroidal thickness in patients with ocular hypertension as assessed by enhanced depth imaging optical coherence tomography

Topçu-Yılmaz¹

2019

Beyoglu Eye J

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The aim of this study was to evaluate the macular choroidal thickness (CT) in patients with ocular hypertension (OHT) using spectral domain optical coherence tomography (SD-OCT) and compare the results with healthy individuals. Methods: Thirty eyes of 30 patients newly diagnosed with OHT and 24 eyes of 24 healthy controls were included in this cross-sectional study. After a detailed ophthalmological examination, macular CT was measured with enhanced depth imaging optical coherence tomography (EDI-OCT) (Cirrus HD-OCT, Carl Zeiss Meditec AG, Jena, Germany) at the fovea and at positions 500 µ, 1000 µ, 1500 µ nasal and temporal to the fovea. The Mann-Whitney U test was used to compare the CT measurements between groups. The correlation between the mean deviation, pattern standard deviation, and retinal nerve fiber layer thickness (RNFL) and CT was evaluated with the Spearman correlation coefficient. Statistical significance was accepted as p<0.05. Results: The mean CT in the OHT group was significantly thinner than that of the controls at locations 1000 µ (250.13±69.53µ vs 275.92±47.34µ; p=0.02) and 1500µ (236.03±65.44µ vs 265.46±47.56µ; p=0.009) temporal to the fovea. The CT at the other measurement points was also thinner in eyes with OHT, but the difference failed to reach statistical significance. A moderately negative correlation was detected between the mean deviation and CT at locations 1000µ (r=-0.42; p=0.03) and 1500µ (r=-0.44; p=0.02) temporal to the fovea There was a moderate correlation between the average RNFL thickness and CT at locations 500µ (r=0.44; p=0.03), 1000µ (r=0.42; p=0.04) and 1500µ (r=0.56; p=0.005) temporal to the fovea. Conclusion: In the present study, the macular CT was thinner in patients with OHT and this thinning was statistically significant at the temporal macula. A longitudinal, prospective study involving multiple EDI-OCT measurements is required to further understand the relationship.

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SD-OCT Choroidal Thickness in Advanced Primary Open-Angle Glaucoma

Abstract: Patients affected by advanced POAG damage have a thinner choroidal thickness compared with normal subjects, using SD-OCT. We also confirmed that age and axial length were the main factors affecting choroidal thickness in these patients.

Cited by 26 publications

References 26 publications

The clinical features of posterior scleritis with serous retinal detachment: A retrospective clinical analysis

The clinical features of posterior scleritis with serous retinal detachment: A retrospective clinical analysis

Lamina Cribrosa and Choroid Features and Their Relationship to Stage of Pseudoexfoliation Glaucoma

Macular choroidal thickness in patients with ocular hypertension as assessed by enhanced depth imaging optical coherence tomography

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