murphy@cmu.edu

Purpose-To measure choroidal thickness and to determine parameters associated with it.Design-Cross-sectional study. Participants-Seventy-four glaucoma patients and glaucoma suspects.Methods-Spectral domain optical coherence tomography (SDOCT) scans were obtained to estimate average choroidal thickness in a group of glaucoma suspects and glaucoma patients. Average thickness was calculated from enhanced depth SDOCT images and manually analyzed with Image J software. Open angle glaucoma, open angle glaucoma suspect, primary angle closure glaucoma, primary angle closure, and primary angle closure suspect were defined by published criteria. Glaucoma suspects had normal visual fields bilaterally. Glaucoma was defined by specific criteria for optic disc damage and visual field loss in at least one eye. The most affected eye was analyzed for comparisons across individuals, while right/left and upper half/lower half comparisons were made to compare thickness against degree of visual field damage.Main Outcome Measured-Average macular and peripapillary choroidal thickness measured using SDOCT.Results-The choroidal-scleral interface (CSI) was visualized in 86% and 96% of the macular and peripapillary scans, respectively. In multivariable linear regression analysis, the macular choroid was significantly thinner in association with 4 features: longer eyes (22 µm Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptOphthalmology. Author manuscript; available in PMC 2012 August 1. Conclusion-Age, axial length, central corneal thickness, and diastolic ocular perfusion pressure are significantly associated with choroidal thickness in glaucoma suspects and glaucoma patients. Degree of glaucoma damage was not consistently associated with choroidal thickness.

Medical and surgical treatments for open-angle glaucoma lower intraocular pressure and reduce the risk for optic nerve damage over the short to medium term. Which treatments best prevent visual disability and improve patient-reported outcomes is unclear.

Decades of epidemiologic research into open-angle glaucoma have elucidated several risk factors related in some way to the disease. As more and more risk factors are identified, however, assessing their individual and collective contributions in a particular patient is becoming increasingly complicated. To help organize our knowledge of risk in glaucoma we first review some concepts of risk and then propose a scheme that places known risk factors into categories (state of the individual, ocular anatomy and physiology, signs of disease, non-glaucoma medications, and personal behaviors) and also indicates how each factor interacts with disease (incidence, prevalence, progression, therapy.) We also describe methods for using risk factors in clinical practice and describe ways that a large and complex body of knowledge can be applied to individual patients.