Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy

doi:10.1097/IAE.0B013E31821801C5

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Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy

Journal Article•DOI•

Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy

Seong Woo Kim¹, Jaeryung Oh, Soon Sun Kwon¹, Junho Yoo¹, Kuhl Huh¹ - Show less +1 more•Institutions (1)

Korea University¹

01 Oct 2011-Retina-the Journal of Retinal and Vitreous Diseases (Retina)-Vol. 31, Iss: 9, pp 1904-1911

TL;DR: The choroid was thicker in eyes with polypoidal choroidal vasculopathy or central serous chorioretinopathy than in control or age-related maculopathy groups.

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Abstract: Purpose:To compare choroidal thicknesses among eyes with early age-related maculopathy (ARM), neovascular age-related macular degeneration, polypoidal choroidal vasculopathy, and central serous chorioretinopathy.Methods:Patients with age-related maculopathy (37 eyes), neovascular age-related macular

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Enhanced Depth Imaging Optical Coherence Tomography of the Choroid in Normal Eyes

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R. Margolis¹, Richard F. Spaide•Institutions (1)

Columbia University¹

28 Apr 2009-Investigative Ophthalmology & Visual Science

TL;DR: In this paper, the authors measured the macular choroid thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and evaluated the association of choroidal thickness and age.

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Abstract: PURPOSE 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. DESIGN Retrospective, observational case series. METHODS 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. RESULTS 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. CONCLUSIONS 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.

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1,008 citations

Journal Article•DOI•

Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis.

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Alejandra Daruich¹, Alexandre Matet¹, Ali Dirani¹, Elodie Bousquet², Min Zhao², Nicolette Farman², Frederic Jaisser², Francine Behar-Cohen² - Show less +4 more•Institutions (2)

University of Lausanne¹, Paris Descartes University²

01 Sep 2015-Progress in Retinal and Eye Research

TL;DR: The aim of this review is to recapitulate the clinical understanding of CSCR, with an emphasis on the most recent findings on epidemiology, risk factors, clinical and imaging diagnosis, and treatments options, and the novel mineralocorticoid pathway hypothesis.

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690 citations

Cites background from "Comparison of choroidal thickness a..."

...Compared to healthy subjects, increased choroidal thickness has been reported in both affected (Imamura et al., 2009; Jirarattanasopa et al., 2012b; Kim et al., 2011; Kuroda et al., 2013; Yang et al., 2013a) and fellow eyes of CSCR patients (Goktas, 2014; Maruko et al....
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...Compared to healthy subjects, increased choroidal thickness has been reported in both affected (Imamura et al., 2009; Jirarattanasopa et al., 2012b; Kim et al., 2011; Kuroda et al., 2013; Yang et al., 2013a) and fellow eyes of CSCR patients (Goktas, 2014; Maruko et al., 2011c; Yang et al., 2013b)…...
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...(Kim et al., 2011) 31 eyes: 26 acute CSCR 5 chronic CSCR 29 (age, gender, refractive error adjusted) Korea 367....
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...Author Number of eyes/CSCR type Number of control eyes (statistical adjustment/matching) Country Mean SFCT ± SD (mm) in CSCR eyes Mean SFCT ± SD (mm) in fellow eyes Mean SFCT ± SD (mm) in control eyes OCT type (Carrai et al., 2015) 40 active CSCR eyes e Italy 478 ± 114 e e Wide-field EDI-OCT (Hamzah et al., 2014) 56 eyes: 21 acute CSCR eyes 35 chronic CSCR eyes e Indonesia 336.6 ± 91.6 (acute, EDI-OCT) 332.0 ± 96.7 (acute, SS-OCT) 388.0 ± 103.4 (chronic, EDI-OCT) 392.6 ± 101.3 (chronic, SS-OCT) e e EDI-OCT SS-OCT (Goktas, 2014) 20 acute CSCR eyes 20 (age-matched) Turkey 461.4 ± 101.4 375.3 ± 103.7 (P < 0.001) 287.6 ± 62.5 (P < 0.001)a EDI-OCT (Oh et al., 2014) 52 eyes with unilateral classic CSCR e Korea 298.4 ± 58.7 264.4 ± 52.1 (P < 0.001) e EDI-OCT (Lehmann et al., 2013) 29 eyes 23 active CSCR 22 quiescent CSCR e France 491.5 e e EDI-OCT (Yang et al., 2013a) 68 eyes 35 acute CSCR 33 chronic CSCR 3233 (from The Beijing Eye Study (Wei et al., 2013)3)) China 478 ± 114 e 254 ± 107 EDI-OCT (Yang et al., 2013b) 15 eyes with unilateral CSCR 15 (age, gender, refractive error matched) China 455 ± 73 387 ± 94 (P ¼ 0.04) 289 ± 71 (P ¼ 0.005)a EDI-OCT (Kuroda et al., 2013) 35 classic CSCR 35 (age-matched) Japan 475 ± 138 e 372 ± 120 (P < 0.01) SS-OCT (Jirarattanasopa et al., 2012b) 44 eyes 23 Classic CSCR 17 Chronic CSCR 4 MPPE 17 (age-matched) Japan 374.3 ± 92.9 e 248.4 ± 77.4 (P < 0.001) SS-OCT (Kim et al., 2011) 31 eyes: 26 acute CSCR 5 chronic CSCR 29 (age, gender, refractive error adjusted) Korea 367.81 ± 105.56 e 241.97 ± 66.4 (P < 0.001) EDI-OCT (Maruko et al., 2011c) 66 eyes: e 39 acute CSCR e 27 chronic CSCR 177 (age-matched) Japan 414 ± 109 350 ± 116 (P < 0.001) 250 ± 75 (P < 0.001)a EDI-OCT (Imamura et al., 2009) 28 eyes: 6 classic CSCR 16 DRPE 30 (age-adjusted) USA 505 ± 114 e 287 ± 76 (P < 0.001) EDI-OCT SD ¼ standard deviation, SFCT ¼ Sub foveal choroidal thickness, DRPE ¼ diffuse retinal pigment epitheliopathy, MPPE ¼ multifocal posterior pigment epitheliopathy, WM ¼ whole macula, EDI ¼ enhanced-depth imaging, SS ¼ swept-source, OCT ¼ optical coherence tomography, CSCR ¼ central serous chorioretinopathy. a Compared to the fellow eye group....
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...Increased choroidal thickness in PCV eyes has also been reported in several case series comparing them to healthy eyes (Kim et al., 2011; Rishi et al., 2013) and AMD cases (Jirarattanasopa et al., 2012a; Kim et al., 2011; Koizumi et al., 2011; Rishi et al., 2013)....
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Journal Article•DOI•

Central Serous Chorioretinopathy: Update on Pathophysiology and Treatment

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Benjamin P. Nicholson¹, Jason Noble², Jason Noble³, Farzin Forooghian⁴, Catherine B. Meyerle¹ - Show less +1 more•Institutions (4)

National Institutes of Health¹, University of Toronto², Sunnybrook Health Sciences Centre³, University of British Columbia⁴

01 Mar 2013-Survey of Ophthalmology

TL;DR: Although focal laser and photodynamic therapy are the current standard of care for persistent subretinal fluid in CSC, they are not appropriate in all cases, and the optimal timing of intervention remains unclear.

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505 citations

Journal Article•DOI•

Optical coherence tomography – current and future applications

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Mehreen Adhi¹, Jay S. Duker•Institutions (1)

Tufts Medical Center¹

01 May 2013-Current Opinion in Ophthalmology

TL;DR: Advances in OCT technology provide for better understanding of pathogenesis, improved monitoring of progression and assistance in quantifying response to treatment modalities in diseases of the posterior segment of the eye, as well as improving imaging of the choroid.

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Abstract: Purpose of review Optical coherence tomography (OCT) has revolutionized the clinical practice of ophthalmology. It is a noninvasive imaging technique that provides high-resolution, cross-sectional images of the retina, retinal nerve fiber layer and the optic nerve head. This review discusses the present applications of the commercially available spectral-domain OCT (SD-OCT) systems in the diagnosis and management of retinal diseases, with particular emphasis on choroidal imaging. Future directions of OCT technology and their potential clinical uses are discussed. Recent findings Analysis of the choroidal thickness in healthy eyes and disease states such as age-related macular degeneration, central serous chorioretinopathy, diabetic retinopathy and inherited retinal dystrophies has been successfully achieved using SD-OCT devices with software improvements. Future OCT innovations such as longer-wavelength OCT systems including the swept-source technology, along with Doppler OCT and en-face imaging, may improve the detection of subtle microstructural changes in chorioretinal diseases by improving imaging of the choroid. Summary Advances in OCT technology provide for better understanding of pathogenesis, improved monitoring of progression and assistance in quantifying response to treatment modalities in diseases of the posterior segment of the eye. Further improvements in both hardware and software technologies should further advance the clinician's ability to assess and manage chorioretinal diseases.

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476 citations

Additional excerpts

...Recent studies using three different SD-OCT devices [7,32,38] reported a significant increase in the thickness of the choroid in eyes affected with acute CSCR....
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Journal Article•DOI•

Central serous chorioretinopathy: a review of epidemiology and pathophysiology

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Gerald Liew¹, Godfrey J. Quin, Mark C Gillies, Samantha Fraser-Bell•Institutions (1)

University of Sydney¹

01 Mar 2013-Clinical and Experimental Ophthalmology

TL;DR: The main risk factors for CSCR are systemic corticosteroid use, type A personality, pregnancy and endogenous Cushing's syndrome, and the pathophysiology remains obscure, although disorders in both the choroidal circulation and retinal pigment epithelium are implicated.

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Abstract: Central serous chorioretinopathy (CSCR) is a common retinal cause of vision loss. This review surveys the epidemiology, risk factors, clinical presentation, natural history and pathophysiology of CSCR. Studies suggest an annual incidence rate of 10 per 100 000 in men, with CSCR occurring six times more commonly in men compared with women. Most acute CSCR cases resolve spontaneously within 2-3 months. Prognosis is highly dependent on presenting visual acuity; patients with initial visual acuities of 6/6 remain at that level, while patients with initial visual acuities of less than 6/9 recover on average two to three Snellen lines over the next few years. The main risk factors for CSCR are systemic corticosteroid use, type A personality, pregnancy and endogenous Cushing's syndrome. The pathophysiology of CSCR remains obscure, although disorders in both the choroidal circulation and retinal pigment epithelium are implicated.

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309 citations

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References

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Open Access

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Journal Article•DOI•

Enhanced depth imaging spectral-domain optical coherence tomography.

[...]

Richard F. Spaide¹, Hideki Koizumi¹, Maria C. Pozonni¹•Institutions (1)

Manhattan Eye, Ear and Throat Hospital¹

01 Oct 2008-American Journal of Ophthalmology

TL;DR: In this paper, a method to obtain images of the choroid using conventional spectral-domain optical coherence tomography (OCT) and to evaluate choroidal thickness measurements using these images was described.

...read moreread less

1,759 citations

Journal Article•DOI•

A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

[...]

Ron Margolis, Richard F. Spaide

01 May 2009-American Journal of Ophthalmology

TL;DR: The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions and seems to vary topographically within the posterior pole.

...read moreread less

1,099 citations

"Comparison of choroidal thickness a..." refers result in this paper

...4 years.(6) The mean CTs at the fovea in the above two studies(6,8) were thicker than those in our study....
[...]

Journal Article•

Enhanced Depth Imaging Optical Coherence Tomography of the Choroid in Normal Eyes

[...]

R. Margolis¹, Richard F. Spaide•Institutions (1)

Columbia University¹

28 Apr 2009-Investigative Ophthalmology & Visual Science

...read moreread less

1,008 citations

Journal Article•DOI•

Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy.

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Yutaka Imamura, Takamitsu Fujiwara, Ron Margolis, Richard F. Spaide

01 Nov 2009-Retina-the Journal of Retinal and Vitreous Diseases

TL;DR: Enhanced depth imaging spectral-domain optical coherence tomography demonstrated a very thick choroid in patients with central serous chorioretinopathy, providing additional evidence that central serously choroidal vascular hyperpermeability may be caused by increased hydrostatic pressure in the choroids.

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Abstract: PURPOSE 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. METHODS 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. RESULTS 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). CONCLUSION 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.

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889 citations

"Comparison of choroidal thickness a..." refers background or result in this paper

...Increased CT in CSC eyes may be explained by increased choriocapillary permeability, which would suggest the presence of increased hydrostatic pressure that could in turn lead to increased CT, RPE leaks, and serous retinal detachment.(9,15) According to Maruko et al,(14) immediately after photodynamic therapy, eyes with CSC show signs of increased exudation with increased CT....
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...However, similar results were presented in a previous report.(9) Imamura et al(9) reported that they were unable to identify a correlation between CT and age in CSC patients....
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Journal Article•DOI•

Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes.

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Takamitsu Fujiwara¹, Yutaka Imamura¹, Ron Margolis¹, Jason S. Slakter¹, Richard F. Spaide¹ - Show less +1 more•Institutions (1)

Manhattan Eye, Ear and Throat Hospital¹

01 Sep 2009-American Journal of Ophthalmology

TL;DR: The choroid in highly myopic eyes is very thin and undergoes further thinning with increasing age and degree of myopia, and abnormalities of the choroids may play a role in the pathogenesis of myopic degeneration.

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735 citations