Elsevier

American Journal of Ophthalmology

Volume 156, Issue 6, December 2013, Pages 1277-1284.e1
American Journal of Ophthalmology

Original article
Peripapillary Choroidal Thickness in Both Eyes of Glaucoma Patients With Unilateral Visual Field Loss

https://doi.org/10.1016/j.ajo.2013.07.011Get rights and content

Purpose

To investigate whether peripapillary choroidal thickness in perimetrically affected eyes of primary open-angle glaucoma (POAG) patients differs from that in perimetrically unaffected fellow eyes and eyes of healthy controls.

Design

Retrospective, comparative, cross-sectional study.

Methods

Thirty-one POAG patients with unilateral visual field loss and 31 healthy controls were included. Eyes were divided into 3 groups: 31 eyes in group A (eyes with visual field loss), 31 eyes in group B (perimetrically unaffected fellow eyes), and 31 eyes in group C (age- and sex-matched controls). A 360-degree 3.4-mm diameter peripapillary circle scan was performed for retinal nerve fiber layer (RNFL) assessment using enhanced depth imaging optical coherence tomography. The observer used the manual segmentation function to delineate the posterior edge of the retinal pigment epithelium and the sclerochoroidal interface. The RNFL thickness algorithm function was used to generate the choroidal thickness automatically in corresponding sectors. Statistical analysis was conducted to compare mean choroidal thickness and RNFL thickness among 3 groups and to correlate choroidal thickness with age, RNFL thickness, and visual field mean deviation.

Results

The global mean RNFL and choroidal thickness measurements were 62.3 ± 16.7 μm and 154.3 ± 69.7 μm in group A, 90.4 ± 12.2 μm and 154.7 ± 68.9 μm in group B, and 106.6 ± 9.2 μm and 154.2 ± 60.9 μm in group C. The RNFL thickness was significantly thinner in group A than in groups B and C globally and at all peripapillary locations (all P = .000). The RNFL thickness also was significantly thinner in group B than in group C (P = .000 to .021). However, choroidal thickness measurements did not differ among 3 groups globally or at any peripapillary location (P = .273 to .934, P = .757 to .994, and P = .808 to .975, respectively). Age was the only significant factor associated with peripapillary choroidal thickness in each group (r = −0.418 to −0.641, r = −0.569 to −0.690, and r = −0.689 to −0.827, respectively; all P < .05).

Conclusions

There was no significant difference in peripapillary choroidal thickness of POAG eyes with visual field loss compared with that of perimetrically unaffected fellow eyes and eyes of healthy controls, which does not support using peripapillary choroidal thickness as a clinical parameter in POAG diagnosis or management.

Section snippets

Subjects

This was a retrospective, comparative cross-sectional study. The study was approved by the Institutional Review Board at Peking Union Medical College Hospital and adhered to the tenets of the Declaration of Helsinki. We reviewed data from 31 POAG patients with unilateral VF loss who were referred to the Department of Ophthalmology, Peking Union Medical College Hospital, between June 2012 and December 2012. POAG was diagnosed in the presence of open iridocorneal angles accompanied by

Demographic and Clinical Characteristics of Subjects

The mean age of the POAG patients and the healthy subjects was 57.2 ± 14.7 years (range, 27 to 80 years) and 57.9 ± 14.6 years (range, 27 to 78 years), respectively. In each group, 17 (54.8%) of the 31 subjects were male. Mean spherical equivalent was −1.17 ± 1.85 D in group A, −0.99 ± 1.79 D in group B, and −0.43 ± 1.15 D in group C. The IOP at imaging was 16.4 ± 3.0 mm Hg in group A, 16.6 ± 2.4 mm Hg in group B, and 15.8 ± 2.3 mm Hg in group C. The horizontal and vertical diameters of the

Discussion

The role of the choroid in the pathogenesis of GON is understood incompletely as yet, although several reports have demonstrated an association between GON and impaired choroidal circulation or blood flow to the optic nerve head.4, 22, 23 Thus, evaluation of choroidal thickness in glaucomatous eyes would contribute further to the understanding of the relationship between the choroid and glaucoma. Nonetheless, the results presented herein show that the peripapillary choroidal thickness in POAG

Lüe Li, MD, graduated from Zhejiang University School of Medicine, Zhejiang Province, China in 2000. He completed his ophthalmology residency program in Peking Union Medical College Hospital, Beijing, China. Currently he is working in Peking Union Medical College Hospital, and his major research interest is imaging in glaucoma and retinal diseases.

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    Lüe Li, MD, graduated from Zhejiang University School of Medicine, Zhejiang Province, China in 2000. He completed his ophthalmology residency program in Peking Union Medical College Hospital, Beijing, China. Currently he is working in Peking Union Medical College Hospital, and his major research interest is imaging in glaucoma and retinal diseases.

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