Peripapillary and macular choroidal thickness before and after phenylephrine instillation

Casado, Alfonso; López-de-Eguileta, Alicia; Gaitán, Jorge; Fonseca, Soraya; Gordo-Vega, Miguel Angel

doi:10.1038/s41433-019-0478-z

Cited by 10 publications

(24 citation statements)

References 32 publications

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“…Also, the OCT was performed without pupil dilation in this study. Since pupil dilation using phenylephrine drops is reported to thin the choroidal tissue 25 , our study is free from the measurement error which could be induced by pupil. Lastly, the reproducibility of manual choroidal segmentation was very high in our study (0.988-0.995) and was comparable to the previous reports 21,26 .…”

Section: Discussionmentioning

confidence: 99%

Choroidal spatial distribution indexes as novel parameters for topographic features of the choroid

Hwang

Kong

Song

et al. 2020

Sci Rep

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Song 4* & Don-Il Ham 1* the purpose of the study is to propose choroidal spatial distribution indexes (cSDis) to represent choroidal topographic features, establish a normative database for CSDIs, and identify factors associated with CSDIs in healthy eyes. Retrospective data analysis of 363 healthy eyes from a singlecenter, prospective, cross-sectional, non-interventional study. Subjects were evaluated using spectral domain oct with enhanced depth imaging. choroidal volume and average thickness were measured with OCT in nine macular subfields defined by the Early Treatment Diabetic Retinopathy Study. Vertical CSDI was defined as the natural logarithm of superior choroidal volume divided by inferior choroidal volume. Horizontal CSDI was defined as the natural logarithm of temporal choroidal volume divided by nasal choroidal volume. the overall distributions of vertical and horizontal cSDis was analyzed. Linear regression analyses were used to identify ocular and systemic factors associated with vertical and horizontal CSDIs. The average vertical CSDI was 0.062 ± 0.206, and average horizontal CSDI was 0.138 ± 0.226. Both vertical and horizontal CSDIs followed normal distribution. Increasing age was significantly associated with greater vertical CSDI (choroidal volume distribution tilted toward the superior region), and longer axial length and thinner subfoveal choroidal thickness were significantly associated with greater horizontal cSDi (choroidal volume distribution tilted toward the temporal region). The choroid is the vascular layer of the eye with the highest blood flow of any tissue in the human body 1. As a major vascular layer, the choroid plays an important role in ocular health and is involved in a number of ocular diseases such as central serous chorioretinopathy, age-related macular degeneration, polypoidal choroidal vasculopathy, and myopic macular degeneration 2-6. Thus, there needs to be an emphasis on gaining a better understanding of choroidal structure. Recently, the advent of enhanced depth imaging optical coherence tomography (OCT) and swept-source OCT has provided more precise and detailed assessment of the choroid 7-9. Along with the advancement of imaging technology, choroid assessment in the literature has shifted from merely measuring subfoveal choroidal thickness 2,5,6 to calculating the entire choroidal volume. The latter is done by using the Early Treatment Diabetic Retinopathy Study (ETDRS) grid 10-12 as measuring choroidal thickness from a single or few sampling points can be easily influenced by local changes in choroidal thickness or irregularities in the choroidoscleral border 4,5,13,14. Volume scanning of the choroid has led to deeper understanding of topographical features of the choroid. The spatial distribution of the choroid was found to be more complex and varied compared to that of the retina. Choroidal distribution is not necessarily centered at the fovea; it can be displaced in either direction of the macula, and the amount and direction of displacement varies between indiv...

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Section: Discussionmentioning

confidence: 99%

Choroidal spatial distribution indexes as novel parameters for topographic features of the choroid

Hwang

Kong

Song

et al. 2020

Sci Rep

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“…However, a different number of CT locations were measured in each study, within 7 [ 30 ], 9 [ 26 – 28 ] and 13 [ 29 ] measurements. In order to solve this discrepancy, we analyzed CT at 14 locations, 2 of subfoveal thickness in 2 different scans and 12 more separated 1500, 1000 and 500 μm from these subfoveal locations [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, they did not mention if OCT analysis was performed before or after pupil dilatation nor did specify which kind of drop was used. This may be of crucial importance, as we have proved that phenylephrine 2.5%, a common drop for pupil dilatation, might cause a significant choroidal thinning thirty minutes after its instillation [37]. Thus, mentioning the use of dilatation drops should be important to reach a conclusion in CT changes, because if they used phenylephrine differently in AD patients and controls, this might be a source of bias.…”

Section: Plos Onementioning

confidence: 95%

“…All participants underwent a thorough ophthalmic examination on the day of OCT imaging, by order of eye assessments: best-corrected visual acuity (Snellen charts), anterior segment biomicroscopy, refraction, OCT measurements, axial length (AL) assessment, IOP quantification with Goldmann applanation tonometer (GAT) and dilated fundus examination. Participants received one drop of tropicamide 1% and phenylephrine per eye for pupil dilation after IOP measurement to avoid modifications in choroidal thickness due to phenylephrine instillation as it has been previously reported [37]. The refractive error was recorded using an auto refractometer Canon RK-F1 (Canon USA Inc., Lake Success, NY, USA).…”

Section: Patient/subject Groupsmentioning

confidence: 99%

“…The border of CT was defined as extending from the outer portion of the hyperreflective line (corresponding to the RPE) to the inner surface of the sclera. CT was measured at 14 different locations (Fig 2): at the fovea (with horizontal and vertical scan: F H and F V , respectively), and at 500, 1000 and 1500 μm from the fovea in the nasal (N 500μm , N 1000μm and N 1500μm , respectively), temporal (T 500μm , T 1000μm and T 1500μm , respectively), superior (S 500μm , S 1000μm and S 1500μm , respectively), and inferior (I 500μm , I 1000μm and I 1500μm , respectively) quadrants, as published previously [37].…”

Section: Optical Coherence Tomography Assessmentmentioning

confidence: 99%

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Evaluation of choroidal thickness in prodromal Alzheimer’s disease defined by amyloid PET

et al. 2020

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Objective To assess and compare the involvement of choroidal thickness (CT) in patients with mild cognitive impairment (MCI) and dementia due to Alzheimer's disease (AD) defined by amyloid PET and healthy controls (HC). Methods Sixty-three eyes from 34 AD patients [12 eyes (19.0%) with dementia and 51 eyes (80.9%) with MCI], positive to 11 C-labelled Pittsburgh Compound-B with positron emission tomography (11 C-PiB PET/CT), and the same number of sex-and age-paired HC were recruited. All participants underwent enhanced depth imaging optical coherence tomography (EDI-OCT) assessing CT at 14 measurements from 2 B-scans. Paired Student t-test was used to compare CT measurements between MCI, dementia and sex-and age-paired HC. A univariate generalized estimating equations model (GEE) test was performed to compare MCI and dementia individually with all HC included. Results Compared with HC, eyes from patients with positive 11 C-PiB PET/CT showed a significant CT thinning in 5 selected locations (in foveal thickness in vertical scan, in temporal scan at 1500μm, in superior scan at 500μm and in inferior scan at 1000μm and 1500μm, p = 0.020-0.045) whilst few significant CT reduction data was reported in MCI or dementia individually versus HC. However, the GEE test identified significant CT thinning in AD compared with all HC included (p = 0.015-0.046).

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Effects of different mydriatics on the choroidal vascularity in healthy subjects

Iovino

Chhablani

Rasheed

et al. 2020

Eye

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Purpose To evaluate choroidal vasculature changes after the instillation of mydriatic parasympatholytic and sympathomimetic agents in healthy subjects. Methods A total of 95 healthy subjects were enrolled in this prospective, randomized comparative study. Study participants were divided into three different groups depending on the drug to be administered: tropicamide (1%) group (n = 31), tropicamide (0.5%) + phenylephrine (10%) group (n = 30) and control group receiving artificial tears (n = 34). All participants underwent a complete ophthalmological examination including best corrected visual acuity, refractive status and axial length. Subfoveal choroidal thickness (CT), total choroidal area (TCA), luminal and stromal choroidal area (LCA and SCA) and choroidal vascularity index (CVI) were measured before and after eye drops instillation. Results All the baseline characteristics were matched between the three groups (all P > 0.05). Before the mydriatic instillation, there were no significant differences of CT, TCA, LA, SCA, and CVI among the three groups (all P > 0.05). After drug administration, CT, TCA, LCA, SCA, and CVI did not show any significant change as well (respectively, P = 0.265; P = 0.483; 0.573; P = 0.405 and P = 0.708). Conclusions Instillation of mydriatic eye drops did not induce significant changes of the choroidal vasculature, suggesting that their use do not alter CT and CVI evaluation.

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Peripapillary and macular choroidal thickness before and after phenylephrine instillation

Cited by 10 publications

References 32 publications

Choroidal spatial distribution indexes as novel parameters for topographic features of the choroid

Choroidal spatial distribution indexes as novel parameters for topographic features of the choroid

Evaluation of choroidal thickness in prodromal Alzheimer’s disease defined by amyloid PET

Effects of different mydriatics on the choroidal vascularity in healthy subjects

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