Integrity of the Hyperreflective Layer in the Inner Choroid in Eyes with Drusen

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Abstract

Introduction

This study aimed to compare the integrity of the hyperreflective layer of the inner choroid in eyes with and without drusen.

Methods

Swept-source optical coherence tomography images of patients with drusen and normal controls were reviewed. Using a line plot of ImageJ, choroidal reflectivity was measured at the subfovea, and the integrity of the hyperreflective layer of the inner choroid was determined.

Results

In total, 63 eyes with drusen and 30 control eyes without drusen were included. The integrity of the hyperreflective layer of the inner choroid was preserved in 81.0% of eyes with drusen and 93.3% of normal controls. The proportion of eyes with the hyperreflective layer did not differ between eyes with and without drusen. Of the 63 subjects with drusen, this hyperreflective layer was observed in all 28 eyes (100%) with pachydrusen but only in 68.6% of the 35 eyes with soft drusen, and its prevalence was significantly different ( P = 0.001).

Conclusion

The prevalence of the hyperreflective layer between the choriocapillaris and medium or large choroidal vessels in eyes with soft drusen differed from that in eyes with pachydrusen. These findings support the suggestion that changes within the choroidal stroma may be involved in the pathogenesis of age-related macular degeneration.

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Most cited references 35

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A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

Ron Margolis, Richard Spaide (2009)

To measure macular choroidal thickness in normal eyes at different points using enhanced depth imaging (EDI) optical coherence tomography (OCT) and to evaluate the association of choroidal thickness and age. Retrospective, observational case series. EDI OCT images were obtained in patients without significant retinal or choroidal pathologic features. The images were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. Seven sections were obtained within a 5 x 30-degree area centered at the fovea, with 100 scans averaged for each section. The choroid was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 500-microm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate variations of choroidal thickness at each location and to correlate choroidal thickness and patient age. The mean age of the 30 patients (54 eyes) was 50.4 years (range, 19 to 85 years), and 14 patients (46.7%) were female. The choroid was thickest underneath the fovea (mean, 287 microm; standard deviation, +/- 76 microm). Choroidal thickness decreased rapidly in the nasal direction and averaged 145 microm (+/- 57 microm) at 3 mm nasal to the fovea. Increasing age was correlated significantly with decreasing choroidal thickness at all points measured. Regression analysis suggested that the subfoveal choroidal thickness decreased by 15.6 microm for each decade of life. Choroidal thickness seems to vary topographically within the posterior pole. The thickness of the choroid showed a negative correlation with age. The decrease in the thickness of the choroid may play a role in the pathophysiologic features of various age-related ocular conditions.

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Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography.

Varsha Manjunath, Mohammad Taha, James Fujimoto … (2010)

To examine choroidal thickness and area in healthy eyes using spectral-domain optical coherence tomography (SD-OCT). Retrospective, observational case series. Thirty-four eyes (34 subjects), with no retinal or choroidal disease, underwent high-definition raster scanning using SD-OCT with frame enhancement software. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-microm intervals up to 2500 microm temporal and nasal to the fovea. The central 1-mm area of the choroid was also measured, along with foveal thickness of the retina. All measurements were performed by 2 independent observers. Statistical analysis was used to correlate inter-observer findings, choroidal thickness and area measurements with age, and choroidal thickness with retinal foveal thickness. The 34 subjects had a mean age of 51.1 years. Reliable measurements of choroidal thickness were obtainable in 74% of eyes examined. Choroidal thickness and area measurements had strong inter-observer correlation (r = 0.92, P < .0001 and r = 0.93, P < .0001 respectively). Area had a moderate negative correlation with age (r = -0.62, P < .0001) that was comparable to the correlation between mean subfoveal choroidal thickness and age (r = -0.61, P < .0001). Retinal and choroidal thickness were found to be poorly correlated (r = -0.23, P = .18). Mean choroidal thickness showed a pattern of thinnest choroid nasally, thickening in the subfoveal region, and then thinning again temporally. Mean subfoveal choroidal thickness was found to be 272 microm (SD, +/- 81 microm). Choroidal thickness can be measured using SD-OCT high-definition raster scans in the majority of eyes. Choroidal thickness across the macula demonstrates a thin choroid nasally, thickest subfoveally, and again thinner temporally, and a trend toward decreasing choroidal thickness with age. Copyright (c) 2010 Elsevier Inc. All rights reserved.

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Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography.

M Branchini, Mehreen Adhi, Caio Regatieri … (2013)

To analyze the morphologic features and vasculature of the choroid in healthy eyes using spectral-domain (SD) optical coherence tomography (OCT). Cross-sectional retrospective review. Forty-two healthy subjects (42 eyes) with no ocular disease who underwent high-definition scanning with Cirrus high-definition OCT (Carl Zeiss Meditec, Inc., Dublin, CA) at the New England Eye Center, Boston, Massachusetts, between November 2009 and September 2010. The SD OCT images were evaluated for morphologic features of the choroid, including the shape of the choroid-scleral border, location of the thickest point of choroid, and regions of focal choroidal thinning. Total choroidal thickness and large choroidal vessel layer thickness were measured by 2 independent observers experienced in analyzing OCT images using the Cirrus linear measurement tool at the fovea, 750 μm nasal and temporal to the fovea. Custom software was used to calculate the ratio of choroidal stroma to the choroidal vessel lumen. Qualitative assessment of the choroidal morphologic features, quantitative analysis of choroidal vasculature, and use of novel automated software to determine the ratio of choroidal stromal area to the area of choroidal vessel lumen. The 42 subjects had a mean age of 51.6 years. All subjects (100%) had a so-called bowl or convex shape to the choroid-sclera junction, and the thickest point of the choroid was under the fovea in 88.0% of the subjects. The mean choroidal thickness was 256.8 ± 75.8 μm, mean thickness of the large choroidal vessel layer was 204.3 ± 65.9 μm, and that of the medium choroidal vessel layer-choriocapillaris layer was 52.9 ± 20.6 μm beneath the fovea. The ratio of large choroidal vessel layer thickness to the total choroidal thickness beneath the fovea was 0.7 ± 0.06. The software-generated ratio of choroidal stromal area to the choroidal vessel lumen area was 0.27 ± 0.08, suggesting that choroidal vessel lumen forms a greater proportion of the choroid than the choroidal stroma in healthy eyes. This is the first study to describe the morphologic features and vasculature of the choroid in healthy eyes from 1-line raster scans obtained using SD OCT. The method described holds promise and has immediate clinical usefulness in recognizing subtle changes in choroidal morphologic features and the role of choroidal angiopathy in various disease states that, in the future, may inform new treatment methods. Proprietary or commercial disclosure may be found after the references. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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Author and article information

Contributors

Jaeryung Oh:

ORCID: http://orcid.org/0000-0002-1036-6562

ojr4991@korea.ac.kr

Journal

Journal ID (nlm-ta): Ophthalmol Ther

Journal ID (iso-abbrev): Ophthalmol Ther

Title: Ophthalmology and Therapy

Publisher: Springer Healthcare (Cheshire )

ISSN (Print): 2193-8245

ISSN (Electronic): 2193-6528

Publication date (Electronic): 19 December 2023

Publication date PMC-release: 19 December 2023

Publication date (Print): February 2024

Volume: 13

Issue: 2

Pages: 529-540

Affiliations

GRID grid.222754.4, ISNI 0000 0001 0840 2678, Department of Ophthalmology, , Korea University College of Medicine, ; 73 Goryeodae-ro Sungbuk-ku, Seoul, 02841 Korea

Author information

Young Ho Kim http://orcid.org/0000-0002-5281-1185

Cheolmin Yun http://orcid.org/0000-0002-7438-3660

Jaeryung Oh http://orcid.org/0000-0002-1036-6562

Article

Publisher ID: 865

DOI: 10.1007/s40123-023-00865-z

PMC ID: 10787704

PubMed ID: 38113024

SO-VID: 2cb3d5fb-d364-4255-bebf-15786fb01689

License:

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 19 October 2023

Date accepted : 23 November 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100019266, Korea Medical Device Development Fund;

Award ID: KMDF_PR_20200901_0026

Award ID: RS-2020-KD000026

Award Recipient : Jaeryung Oh

Custom metadata

Keywords: age-related macular degeneration,choroid,drusen, hyperreflective layer of the inner choroid,optical coherence tomography,pachydrusen

Data availability:

Keywords: age-related macular degeneration, choroid, drusen, hyperreflective layer of the inner choroid, optical coherence tomography, pachydrusen

Integrity of the Hyperreflective Layer in the Inner Choroid in Eyes with Drusen

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Abstract

Introduction

Methods

Results

Conclusion

Related collections

Karger: Ophthalmology

Most cited references 35

A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes.

Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography.

Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography.

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