Association between axial length and choroidal thickness in early age-related macular degeneration

Sato, Maho; Minami, Sakiko; Nagai, Norihiro; Suzuki, Misa; Kurihara, Toshihide; Shinojima, Ari; Sonobe, Hideki; Akino, Kunihiko; Ban, Norimitsu; Watanabe, K.; Uchida, Atsuro; Shinoda, Hajime; Tsubota, Kazuo; Ozawa, Yoko

doi:10.1371/journal.pone.0240357

Cited by 11 publications

(9 citation statements)

References 30 publications

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“…The lack of evaluation of axial length was another limitation. Axial length is associated with myopic refractive error and influences choroidal thickness [ 29 ]. In this study, only refractive error was measured, which has a good correlation with axial length.…”

Section: Discussionmentioning

confidence: 99%

Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population

et al. 2022

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Purpose To analyze the choroidal thickness between patients with keratoconus undergoing cross-linking treatment and a healthy population, as well as to determine the factors that influence choroidal thickness. Methods This was an observational, analytical, case–control study that was conducted from February 2021 to June 2021. Choroidal thickness was measured at different locations, including the subfoveal, nasal (1000 μm), temporal (1000 μm), superior (1000 μm) and inferior (1000 μm) locations using a Spectral-domain optical coherence tomography with enhanced depth imaging, which allowed us to obtain horizontal and vertical B-scans centered on the fovea. Results This study included 21 patients with keratoconus (mean age, 21.86 ± 5.28 years) and 28 healthy patients (mean age, 24.21 ± 4.71 years). Choroidal thickness was significantly greater in patients with keratoconus than in healthy patients in each of the following measured locations: subfoveal (P < 0.001); nasal (1000 μm) (P < 0.001), temporal (1000 μm) (P < 0.001), superior (1000 μm) (P < 0.001) and inferior (1000 μm) (P < 0.001) locations. Variables such as age (ρ = − 0.09; P = 0.50) and refraction (ρ = 0.14; P = 0.34) were not found to be associated with choroidal thickness. In a stepwise multiple linear regression, the group was the single variable correlated with choroidal thickness (β = 0.88; P < 0.001). Conclusion Choroidal thickness is thicker in keratoconus patients treated with cross-linking than in the healthy population. This finding could be associated with inflammatory choroidal mechanisms in keratoconus patients, but more studies are needed. Age and refractive error do not seem to influence choroidal thickness.

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Section: Discussionmentioning

confidence: 99%

Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population

et al. 2022

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“…Whereas, hyperopic defocus reduced choroidal thickness and increased ocular elongation, myopic defocus increased choroidal thickness and inhibited ocular elongation. Furthermore, clinical studies have shown that choroidal thickness decreases significantly in high-myopia patients ( 17 , 18 ), and that subfoveal choroidal thickness is negatively correlated with axial length (AL) ( 19 ). Consequently, an increasing number of scientists believe that choroidal thickness can be used as a clinical biomarker for the onset and progression of myopia ( 20 , 21 ).…”

Section: Introductionmentioning

confidence: 99%

Vascular endothelial growth factor from retinal pigment epithelium is essential in choriocapillaris and axial length maintenance

et al. 2022

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Myopia, which prevalence is rapidly increasing, causes visual impairment; however, the onset mechanism of pathological axial length (AL) elongation remains unclear. A highly vascularized choroid between the retinal pigment epithelium (RPE) and sclera not only maintains physiological activities, but also contributes to ocular development and growth regulation. Vascular endothelial growth factor (VEGF) secreted from the RPE to the choroid is essential for retinal function and maintenance of the choriocapillaris. Herein, we demonstrated that the loss of VEGF secreted from the RPE caused abnormal choriocapillaris development and AL elongation, with features similar to those of the lens-induced myopia (LIM) mouse model, whereas VEGF overexpression by knocking-out von Hippel–Lindau (VHL) specific to the RPE expands the choriocapillaris and shortens the AL. Additionally, LDL Receptor Related Protein 2 (LRP2) deletion in the RPE downregulated VEGF expression and leads to pathological AL elongation. Furthermore, high myopia patients without choriocapillaris demonstrated longer ALs than did those with preserved choriocapillaris. These results suggest that physiological secretion of VEGF from the RPE is required for proper AL development by maintaining the choriocapillaris. The pinpoint application of VEGF to the choriocapillaris may become a potential intervention for the prevention and treatment of axial myopia progression.

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“…However, in clinical practice in Japan, a single drug administration is performed during the introductory period. A multiple-administration introduction period is not suitable for actual clinical practice; therefore, in this study, we chose the single-dose regimen during the introductory period [18,19]. This study was limited in that it was a single-institution retrospective study with a small number of Fig.…”

Section: Discussionmentioning

confidence: 99%

Effects of intravitreal injection of ranibizumab and aflibercept for branch retinal vein occlusion on the choroid: a retrospective study

et al. 2022

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Background Macular edema is found in more than half of branch retinal vein occlusion (BRVO) cases, leading to visual loss in most of these cases. Intravitreal injection of anti-vascular endothelial growth factor is currently the standard treatment for macular edema due to BRVO (BRVO-ME). The difference in the effects of aflibercept and ranibizumab on the choroid in BRVO-ME is unknown. Therefore, we analyzed the effects of intravitreal injection of ranibizumab and aflibercept on BRVO-ME. Methods We retrospectively observed changes in choroidal thickness in the subfoveal region in 36 patients with BRVO-ME who visited the Department of Ophthalmology at the Juntendo University Urayasu Hospital. The patients were treated with intravitreal injection of aflibercept or ranibizumab and followed up for 12 months or more. Results The observed point bifurcated into the affected and non-affected sides 500 μm from the fovea. The central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were 564.2 ± 268.5 μm and 228.8 ± 50.1 μm, respectively, in the ranibizumab group (16 patients, 16 eyes) and 542.4 ± 172.5 μm and 246.1 ± 59.1 μm, respectively, in the aflibercept group (20 patients, 20 eyes). The changes in CMT at 12 months were 324.0 ± 262.6 μm and 326.55 ± 187.2 μm in the ranibizumab and aflibercept groups, respectively, with no significant difference (p = 0.97). Similarly, the changes in SFCT over 12 months were not significant between the groups (ranibizumab, 41.9 ± 33.0 μm; aflibercept, 43.8 ± 43.8 μm, p = 0.89). Conclusion The effects of ranibizumab and aflibercept on choroidal thickness in BRVO-ME were the same regardless of the site. Although BRVO is a retinal disease, we hope that we can further explore the mechanism of BRVO-ME by observing changes in the choroid in the future.

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Association between axial length and choroidal thickness in early age-related macular degeneration

Cited by 11 publications

References 30 publications

Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population

Choroidal thickness assessment in keratoconus patients treated with cross-linking compared to healthy population

Vascular endothelial growth factor from retinal pigment epithelium is essential in choriocapillaris and axial length maintenance

Effects of intravitreal injection of ranibizumab and aflibercept for branch retinal vein occlusion on the choroid: a retrospective study

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