Choroidal Control Technology: New Horizons in Maculopathy and Presbyopia.

PurposeTo compare the changes in subfoveal choroidal thickness between ranibizumab and aflibercept therapy for treatment‐naive wet age‐ related macular degeneration.MethodsThis retrospective, observational study included 47 eyes of treatment‐naive wet age‐related macular degeneration patients who were followed up for at least 6 months after initial injection. All eyes were treated with 3 consecutive monthly injection of ranibizumab or aflibercpt, and treated with PRN injection of anti‐vascular endothelial growth factor after 3 consecutive monthly injection. Subfoval choroidal thickness was measured using enhanced depth imaging optical chorence tomography.ResultsIn the ranibizumab injected group (25 eyes), mean changes in choroidal thickness was −9.80, −16.86, −25.08, −10.40 μm at 1, 2, 3, 6 months after initial injection respectively. In the aflibercept injection group (22 eyes), mean changes in choroidal thickness was −24.30, −32.73, −37. 52, −15.77 μm at 1, 2, 3, 6 months after initial injection respectively. The mean changes in subfoveal choroidal thickness was significantly greater in the aflibercept injected group (p < 0.05) at 1 month, but there was no significant difference between two group at 2, 3, and 6 months after initial injection (p > 0.05).ConclusionsSubfoveal choroidal thickness was decreased after ranibizumab and aflibercept therapy. The mean changes in subfoveal choroidal thickenss was greater in aflibercept injected group at 1 month, but there was no significant difference between two therapy at 2, 3, and 6 months after initial injection.

To analyze choroidal, Sattler's, and Haller's layer thickness maps in age-related macular degeneration (AMD) patients having eyes with bilateral large drusen and pigment changes (intermediate AMD), in patients having intermediate AMD eyes with neovascular fellow eyes (nAMD), and in healthy subjects using three-dimensional (3D) 1060-nm optical coherence tomography (OCT). Automatically generated choroidal thickness (ChT), retinal thickness, and Sattler's and Haller's layer thickness maps were statistically analyzed in 67 subjects consisting of intermediate AMD (n = 21), intermediate AMD (n = 22) with fellow nAMD eyes (n = 22), and healthy eyes (n = 24) with no age and axial eye length difference between groups of eyes (P > 0.05, ANOVA). Eyes were imaged by a prototype high-speed (60,000 A-scans/s) spectral-domain 3D 1060-nm OCT over a 36° × 36° field of view. The mean ± SD (μm) subfoveal ChT for healthy subjects and for bilateral intermediate AMD, unilateral intermediate AMD, and their nAMD fellow eyes was 259 ± 95 and 222 ± 98, 149 ± 60, and 171 ± 78, respectively. Choroidal thickness maps demonstrated significant submacular thinning in unilateral intermediate AMD in comparison to healthy and bilateral intermediate AMD eyes (P < 0.001, ANOVA, post hoc P < 0.001 and P < 0.05, respectively). Sattler's and Haller's layers were thinnest in intermediate AMDs that presented with nAMD fellow eyes (Kruskal-Wallis test P < 0.01). For the choroid and its sublayers, there was no difference between the intermediate AMD eyes and their fellow nAMD eyes (paired testing, P < 0.05). The 3D 1060-nm OCT choroidal imaging visualized significant changes in choroidal, Sattler's, and Haller's layer thickness in relation to the progression of AMD. This may be important for understanding the choroidopathy in the pathophysiology of AMD.

To investigate the influence of brief, repeated periods of clear vision on the changes in axial length and choroidal thickness in response to short-term imposed defocus. The right eye of 16 young adults was exposed to 60min episodes of continuous and interrupted defocus conditions (+3DS and -3DS) over five separate sessions, with the left eye optimally corrected for distance. For interrupted defocus, 2min episodes of clear vision were imposed before each 15min episode of myopic or hyperopic defocus (2/15min). For hyperopic defocus, the effect of frequency of clear vision exposure was also assessed by imposing 1min of clear vision before each 7.5min of defocus (1/7.5min). The right eye axial length and choroidal thickness were measured before, during and after each defocus condition. After 60min of continuous hyperopic defocus the eye elongated significantly by +9±9μm (p=0.02). When exposed to interrupted (2/15min) hyperopic defocus, axial elongation was significantly reduced by 77% compared to continuous hyperopic defocus (p=0.03), with a final change of only +2±10μm relative to baseline. During interrupted (1/7.5min) hyperopic defocus, axial elongation reduced slightly compared to continuous hyperopic defocus (+6±8μm relative to baseline, p=0.12). For continuous myopic defocus, a reduction in axial length occurred but was not statistically significant (p>0.05). A similar pattern of response was observed for choroidal thickness changes with continuous and interrupted (1/7.5min) hyperopic defocus conditions. Brief periods of clear vision can diminish axial elongation and choroidal thinning induced by hyperopic defocus exposure in human eyes. If hyperopic defocus contributes to myopia progression in humans, then interruption with brief periods of clear vision could reduce its myopiagenic effects.

Changes in Choroidal Thickness of Healthy Children during Myopia Progression over 4 Years: Boramae Myopia Cohort Study Report 5.

Choroidal blood perfusion could predict the sensitivity of myopia formation in Guinea pigs

The purpose of this study was to study changes in choroidal thickness (ChT) and choroidal blood perfusion (ChBP), and the correlation between them, in guinea pig myopia. The reliability of optical coherence tomography angiography (OCTA) for measuring ChT and ChBP was verified in guinea pigs, after cervical dislocation (n = 7) or temporal ciliary artery transection (n = 6). Changes in refraction, axial length, ChT, and ChBP were measured during spontaneous myopia (n = 9), monocular form-deprivation myopia (FDM, n = 13), or lens-induced myopia (LIM, n = 14), and after 4 days of recovery from FDM and LIM. The abolition (by cervical dislocation) or reduction (by temporal ciliary artery transection) of ChBP, and of the associated changes in ChT, were verified by OCTA, thus validating the method of measurement. In the spontaneous myopia group, ChT and ChBP were reduced by 25.2% and 31.9%, respectively. In FDM eyes, mean ± SD ChT and ChBP decreased significantly compared with the untreated fellow eyes (ChT fellow: 76.13 ± 9.34 μm versus 64.76 ± 11.15 μm for FDM; ChBP fellow: 37.87 ± 6.37 × 103 versus 30.27 ± 6.06 × 103 for FDM) and increased after 4 days of recovery (ChT: 77.94 ± 12.57 μm; ChBP: 37.41 ± 6.11 × 103). Effects of LIM were similar to those of FDM. Interocular differences in ChT and ChBP were significantly correlated in each group (FDM: R = 0.71, P < 0.001; LIM: R = 0.53, P < 0.001). ChT and ChBP were significantly decreased in all three models of guinea pig myopia, and they both increased during recovery. Changes in ChT were positively correlated with changes in ChBP. Therefore, it is possible that the changes of ChT are responsible for the changes of ChBP or vice versa.

Changes in choroidal and foveal retinal thickness after cataract surgery: Our results

PurposeTo determine the clinical significance of choroidal thickness and evaluate changes in choroidal thickness over time in eyes affected by ocular ischemic syndrome (OIS).MethodsMedical records of 16 patients diagnosed with OIS between November 2017 and August 2019 were retrospectively reviewed. In every nine areas of the Early Treatment Diabetic Retinopathy Study grid, we compared the differences in choroidal thickness between the eyes with OIS and unaffected eyes, and its change in the OIS eyes during the follow-up period using swept-source optical coherence tomography. We analyzed the best-corrected visual acuity, intraocular pressure, fluorescein angiography (FAG) parameters, systemic diseases, and the duration of symptoms. Correlation between FAG parameters and the choroidal thickness value ratio in the OIS eyes and the unaffected eyes, and changes in the choroidal thickness in the OIS eyes during follow-up were investigated.ResultsMedian age of the subjects was 67.5 years. In the OIS eyes, all FAG parameters were delayed at the initial examination. Best-corrected visual acuity and intraocular pressure were significantly different between the OIS and unaffected eyes. While the choroidal thickness in every nine areas of Early Treatment Diabetic Retinopathy Study in the OIS eyes was lesser than the unaffected eyes, the choroidal thickness of inner temporal, outer nasal, and outer temporal area showed statistically significant difference. During follow-up, changes in choroidal thickness of OIS eyes as well as correlation between the FAG parameters and the choroidal thickness value ratio between the OIS eyes and the unaffected eyes were not found to be statistically significant.ConclusionsThe choroidal thickness of the eyes with OIS was significantly less compared with the unaffected eyes. We inferred that choroidal thinning takes place in the early phase of the disease as the changes in choroidal thickness during the follow-up period were not significant.

To investigate the effect of acute diabetic control on choroidal thickness in patients with Type 2 diabetes. Seventeen eyes of 17 patients with Type 2 diabetes were included in this prospective observational study. The patients with Type 2 diabetes who were scheduled to undergo a program of intensive diabetic control underwent prototype high-penetration optical coherence tomography before and 2 weeks after the start of treatment. The choroidal thickness changes 2 weeks after the protocol of intensive diabetic control were assessed, and associated ophthalmologic and general parameters were explored. Seventeen eyes of 17 healthy volunteers were included to compare diabetic patients. The choroidal thickness also was measured in this group at baseline and after 2 weeks. And the intraobserver and interobserver reproducibility were verified using this control group. The intraobserver (intraclass coefficient, 0.992) and interobserver reproducibility (0.982) in our subfoveal choroidal thickness measurement were high. The mean subfoveal choroidal thickness after 2 weeks (226 ± 56 μm) was significantly greater than at baseline (215 ± 52 μm, P < 0.05); there was no difference between the baseline and 2-week values in the control group (baseline, 312 ± 113 vs. 2-week value, 307 ± 103 μm; P = 0.17). The changes in refractive error (P < 0.001), axial length (P < 0.01), and diastolic blood pressure (P < 0.01) were associated significantly with changes in choroidal thickness 2 weeks after the intensive control. The pretreatment body mass index (P < 0.05) and hemoglobin A1c (P < 0.005) also were associated significantly with increased choroidal thickness. Diabetic patients showed a significant increase of choroidal thickness after the intensive control. Various ophthalmologic and systemic parameters seem to affect the choroidal thickness changes. This may be related to the progression of retinopathy after acute glycemic control.

Temporal Relationship of Choroidal Blood Flow and Thickness Changes during Recovery from Form Deprivation Myopia in Chicks

Refractive-state-specific acute ocular structural changes induced by full-spectrum light in children with intermittent exotropia.

To describe the pattern and magnitude of diurnal variation of choroidal thickness (CT), its relation to systemic and ocular factors, and to determine the intervisit reproducibility of diurnal patterns. A prospective study was conducted on 12 healthy volunteers who each underwent sequential ocular imaging on two separate days at five fixed, 2-hour time intervals. Spectral domain optical coherence tomography (OCT) with enhanced depth imaging and image tracking was performed using a standardized protocol. Choroidal and retinal thicknesses were independently assessed by two masked graders. CT diurnal variation was assessed using repeated-measures ANOVA. A significant diurnal variation in CT was observed, with mean maximum CT of 372.2 μm, minimum of 340.6 μm (P < 0.001), and mean diurnal amplitude of 33.7 μm. Retinal thickness (mean, 235.0 μm) did not exhibit significant diurnal variation (P = 0.621). The amplitude of CT variation was significantly greater for subjects with thicker morning baseline CT compared with those with thin choroids (43.1 vs. 10.5 μm, P < 0.001). There were significant correlations between amplitude of CT and age (P = 0.032), axial length (P < 0.001), and spherical equivalent (P < 0.001). The change in CT also correlated with change in systolic blood pressure (P = 0.031). Comparing CT on two different days, a similar diurnal pattern was observed, with no significant difference between corresponding measurements at the same time points (P = 0.180). There is significant diurnal variation of CT, with good intervisit reproducibility of diurnal patterns on two different days. The amplitude of variation varies with morning baseline CT, and is correlated with age, axial length, refractive error, and change in systolic blood pressure.

Background/aimsWe studied the change in choroidal thickness (CT) and axial length (AL) after intraocular (IOP) changes produced by trabeculectomy.MethodsTwenty-one eyes of 20 patients were studied preoperatively, and then postoperatively at...

Purpose To report choroidal thickness (CT) changes using a SS OCT prototype following intravitreal bevacizumab injections.Methods Seventeen patients were treated by one single intravitreal 1.25 mg injection of bevacizumab (IVB). The macular area was examined using an SS‐OCT prototype system based on swept‐source OCT and was used to image the full‐thickness choroid and sclera. A CT profile of the macula was created by manually measuring CT (from the posterior edge of retinal pigment epithelium to the choroid/sclera junction) subfoveally, and three further determinations were performed every 750 μm temporal and nasal to the fovea. CT was determined immediately before and 24 hours after performing 1.25 mg IVB.Results Seventeen eyes from 17 patients (11 eyes with exudative age related macular degeneration, 4 eyes with retinal vein occlusion, 1 eye with myopic choroidal neovascularization, and 1 eye with diabetic macular edema) were examined. Nine patients were male and 8 were female. Mean age was 73 ± 11years range 53 to 88. Pearson correlation coefficient among observers averaged 0.90 (range 0.54 to 0.99). Changes in choroidal thickness were not significant for any of the determinations (Student t test for paired data). Changes in central foveal thickness were almost statistically significant (Student t test for paired data).Conclusion Our findings suggest that one single IVB does not seem to induce acute choroidal thinning.

We describe changes in choroidal thickness from age 11 to 16 years and its association with ocular biometrics and body development. In this longitudinal, population-based observational study, choroidal thickness was measured subfoveally and 1- and 3-mm temporal thereof using enhanced depth imaging spectral domain optical coherence tomography. Analyses were stratified by sex and adjusted for age and the time of day that the scan was performed. The study included 687 participants (304 boys). Median (interquartile range [IQR]) age was 11.5 (0.6) years at baseline and 16.6 (0.3) years at follow-up. Mean increase in choroidal thickness was 33, 27, and 11 μm at the three respective locations. The subfoveal choroid thickened less in eyes whose axial length increased more (boys, β = -85 μm/mm; 95% confidence interval [CI], -104 to -66, P < 0.0001; girls, β = -105 μm/mm; 95% CI, -121 to -89, P < 0.0001) and in eyes with a more negative refractive development (boys, 11 μm/diopters [D]; 95% CI, 4.0 to 18, P = 0.0022; girls, 22 μm/D; 95% CI, 16 to 27, P < 0.0001). Subfoveal choroidal thickness increased less in girls who underwent early puberty (Tanner stage 4 vs. 1; -39 μm' 95% CI, -72 to -5.9, P = 0.021) and who had a longer baseline axial length (β = -8.6 μm/mm; 95% CI, -15 to -2.7, P = 0.0043), and more in girls who grew taller (β = 0.9 μm/cm; 95% CI, 0.1 to 1.7, P = 0.026). The choroid increased in thickness from age 11 to 16 years. The increase was greater in girls with later sexual maturation and smaller in eyes that added more axial length and had a relatively negative refractive development.