Choroidal Thickness and Open-Angle Glaucoma: A Meta-Analysis and Systematic Review

Zhang, Zhengwei; Min, Yu; Wang, Rui; Dai, Ying; Wu, Zhifeng

doi:10.1097/ijg.0000000000000275

Cited by 46 publications

(31 citation statements)

References 53 publications

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“…Using enhanced depth imaging optical coherence tomography (EDI-OCT), other authors found no significant differences in choroidal thickness around the optic nerve between glaucoma patients and healthy controls. [23,24] However, our results indicate that ONH oxygen saturation in choroidal circulation decreases significantly with increasing RNFLT. We speculated that the choroidal oxygen saturation values obtained in this study are related to retinal transmission function rather than glaucomatous damage as determined by RNFLT.…”

Section: Discussionmentioning

confidence: 57%

Retinal and choroidal oxygen saturation of the optic nerve head in open-angle glaucoma subjects by multispectral imaging

Al-wesabi²,

Zhang³

2016

Medicine

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The aim of this study was to determine whether differences exist in oxygen supply to the optic nerve head (ONH) from the retinal and choroidal vascular layers in patients with primary open angle glaucoma (POAG) using multispectral imaging (MSI).This ia an observational, cross-sectional study.Multispectral images were acquired from 38 eyes of 19 patients with POAG, and 42 healthy eyes from 21 matched volunteers with Annidis’ RHA multispectral digital ophthalmoscopy. Superficial and deeper oxygen saturation of the optic disc was represented by the mean gray scale values on the retinal and choroidal oxy-deoxy maps, respectively. Statistical analysis was performed to detect differences in ONH oxygen saturation between the 2 groups. Oxygen saturation levels in the eyes of POAG patients with severe glaucoma were compared to those of fellow eyes from the same subjects. Linear correlation analysis was performed to assess the association between ONH oxygen saturation and systemic and ocular parameters.No statistical difference was found in retinal and choroidal oxygen saturation between the POAG and control groups. In the glaucoma patients, retinal oxygen saturation was lower for eyes with worse visual fields than in those with good visual fields (t = 4.009, P = 0.001). In POAG patients, retinal oxygen saturation was dependent on mean defect of visual field and retinal nerve fiber layer thickness (RNFLT) (r = 0.511, 0.504, P = 0.001, 0.001, respectively), whereas the choroid vasculature oxygen saturation was inversely related to RNFLT (r = −0.391, P = 0.015). An age-dependent increase in retinal oxygen saturation was found for both the POAG and control groups (r = 0.473, 0.410, P = 0.007, 0.003, respectively).MSI revealed a significant correlation between functional and structural impairments in glaucoma and retinal oxygen saturation. MSI could provide objective assessments of perfusion impairments of the glaucomatous ONH. This is a preliminary indication of the effectiveness of MSI for studying POAG.

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Section: Discussionmentioning

confidence: 57%

Retinal and choroidal oxygen saturation of the optic nerve head in open-angle glaucoma subjects by multispectral imaging

Al-wesabi²,

Zhang³

2016

Medicine

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“…[13,21,34] However, analyzing the 6 peripapillary sectors separately showed that there was a significant difference in the temporal peripapillary choroidal area between normal and 10° tubular visual field POAG eyes. In patients with POAG, the high IOP may put pressure on the blood supply of the retina, leading to ischemia of the nerve fiber and glaucomatous damage.…”

Section: Discussionmentioning

confidence: 99%

“…Most of these studies indicated no significant difference in the mean peripapillary choroidal thickness between normal and POAG eyes. [13–15] However, those studies did not divide the patients with POAG into subgroups according to the visual field.…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, the peripapillary choroid provides the only blood supply to the prelaminar area and all the retinal nerve fibers would come through this area to the lamina cribrosa, [13] including the papillomacular bundle, which locates temporal to optic papilla and transfers the nerve impulse from the fovea to the optic papilla. Nevertheless, most previous studies only assessed the total peripapillary choroidal thickness rather than the thickness in different peripapillar sector.…”

Section: Introductionmentioning

confidence: 99%

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Choroidal area assessment in various fundus sectors of patients at different stages of primary open-angle glaucoma by using enhanced depth imaging optical coherence tomography

Yan¹,

Song²,

Guo³

et al. 2017

Medicine

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To compare the choroidal area in different eye fundus sectors of subjects with normal eyes, early-stage primary open-angle glaucoma (POAG) eyes, and 10°tubular visual field POAG eyes using enhanced depth imaging optical coherence tomography.Twenty-five normal, 25 early-stage POAG, and 25 ten-degree tubular visual field POAG eyes were recruited. Enhanced depth imaging optical coherence tomography was used to measure the choroidal area in different fundus sectors (fovea; 10°superior, inferior, temporal, and 24°superior, inferior, temporal, nasal to the fovea) and the peripapillary sector.There were neither significant differences in the choroidal area at any of the 8 measured fundus sectors, nor significant differences in the percentage change between the choroidal area of the fovea and other 7 measured fundus sectors among the 3 groups (all P > 0.05). For the total peripapillary choroidal area, no significant difference was found among the 3 groups (P > 0.05); however, the temporal peripapillary choroidal area of 10°tubular visual field POAG eyes was significantly thicker than that of normal eyes (4,46,213 ± 1,16,267 vs 3,74,164 ± 1,21,658 mm 2 ; P = 0.048). Our study showed that there was no significant difference in the choroidal area of the 8 measured fundus sectors among normal, early-stage POAG, and 10°tubular visual field POAG eyes, suggesting that there might be no blood redistribution from the peripheral choroid to the subfoveal choroid. However, the thicker temporal peripapillary choroidal area might play a role in the central visual acuity protection in patients with POAG.Abbreviations: BCVA = best corrected visual acuity, DBP = diastolic blood pressure, EDI-OCT = enhanced depth imaging optic coherence tomography, IOP = intraocular pressure, MD = mean deviation, POAG = primary open-angle glaucoma, RNFL = retinal nerve fiber layer, RPE = retinal pigment epithelium, SBP = systolic blood pressure, SD-OCT = spectral domain optic coherence tomography.

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“…Additionally, due to choroid changes in high myopia (21), patients with a refractive error greater than 6 diopters were excluded. Glaucoma was not considered an exclusion criterion as an association between NPH and normal tension glaucoma (NTG) is postulated in previous studies (12) and the presence of glaucoma as well as the degree of glaucomatous damage does not influence choroid thickness parameters (22–24). …”

Section: Methodsmentioning

confidence: 99%

Spectral Domain-Optical Coherence Tomography As a New Diagnostic Marker for Idiopathic Normal Pressure Hydrocephalus

et al. 2017

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Purpose Characterized by a progressive onset of gait disturbances, dementia, and urinary incontinence, idiopathic normal pressure hydrocephalus (iNPH) is considered a rare, but under-diagnosed disease. Non-invasive diagnostic markers are still insufficient to enable the diagnosis of iNPH with certainty and yet early treatment with ventriculoperitoneal (VP) shunting can reverse symptoms and stop disease progression. Vascular circulation abnormalities in iNPH may be reflected by changes in subfoveal and peripapillary choroidal thickness (PPChT). This study uses spectral domain-optical coherence tomography (SD-OCT)-based measures of retinal and choroidal thickness to test this hypothesis and to assess ophthalmological non-invasive markers for iNPH. Methods Twelve patients who displayed neurological and neuroradiological characteristics of iNPH were subject to a full ophthalmological examination including enhanced depth imaging (EDI) SD-OCT. Of the 12 included iNPH patients, 6 had undergone VP shunting with beneficial outcome. Parameters studied with EDI SD-OCT were macular retinal thickness (MT), subfoveal choroidal thickness (SFChT), retinal nerve fiber layer thickness (RNFL), and PPChT. Results were compared with 13 healthy, age-matched controls. Results Macular thickness and RNFL and MT values of iNPH patients did not reflect atrophy. Non-shunted iNPH patients showed significantly lowered median PPChT and SFChT values compared to healthy controls. Shunted iNPH patients displayed a significantly higher median PPChT and SFChT compared to non-shunted iNPH patients. SFChT and PPChT values in shunted patients were not significantly different to values in healthy controls. Conclusion Although limited by small sample size, SD-OCT measures in this study reveal significant changes of choroidal thickness and support the hypothesis of choroidal susceptibility to hemodynamic alterations in iNPH. Non-shunted iNPH patients in this study show choroidal thinning in combination with normal RNFL and MT values. In addition to neurological and neuroradiological exams, this pattern may aid in the challenging diagnosis of iNPH.

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Choroidal Thickness and Open-Angle Glaucoma: A Meta-Analysis and Systematic Review

Cited by 46 publications

References 53 publications

Retinal and choroidal oxygen saturation of the optic nerve head in open-angle glaucoma subjects by multispectral imaging

Retinal and choroidal oxygen saturation of the optic nerve head in open-angle glaucoma subjects by multispectral imaging

Choroidal area assessment in various fundus sectors of patients at different stages of primary open-angle glaucoma by using enhanced depth imaging optical coherence tomography

Spectral Domain-Optical Coherence Tomography As a New Diagnostic Marker for Idiopathic Normal Pressure Hydrocephalus

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