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      Association of macular choroidal thickness with optical coherent tomography morphology in patients with idiopathic epiretinal membrane

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      Author(s): 1 , 2 , * , 1
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      Publication date (Electronic):
      Journal: PLoS ONE
      Publisher: Public Library of Science

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          Abstract

          Purpose

          To compare macular choroidal thickness of idiopathic epiretinal membrane (ERM) and fellow eyes, and before and after vitrectomy in terms of the morphological features on spectral-domain optical coherent tomography (SD-OCT).

          Methods

          Eighty-four patients with unilateral idiopathic ERM were involved. Patients were categorized into: Group 1, ERM without membrane contraction; Group 2, ERM with membrane contraction and retinal folding; and Group 3, ERM with membrane contraction and macular edema. Twenty-two patients received surgical removal of ERM. Choroidal thickness was compared between ERM and fellow eyes, and before and after treatment.

          Results

          Mean choroidal thickness was significantly greater in ERM eyes than in fellow eyes (234.4 ± 22.5 vs 220.6 ± 20.8 μm; P<0.01). Group 1 (n = 20) showed no significant difference in choroidal thickness between ERM and fellow eyes. Eyes in Group 2 (n = 27) and Group 3 (n = 37) showed statistically significant differences in mean choroidal thickness between ERM and fellow eyes (229.6 ± 23.8 vs 220.8 ± 19.6 μm; 242.6 ± 27.8 vs 221.0 ± 21.8 μm, respectively; P<0.05). In Group 2 (n = 8) and Group 3 (n = 16), choroidal thickness in ERM eyes decreased significantly at 1 month and 6 months after surgery, compared with that before surgery (P<0.05 for all comparisons).

          Conclusions

          Membrane contraction contributed to the increase in choroidal thickness in idiopathic ERM patients. This finding may help to elucidate the pathophysiologic features of idiopathic ERM as well as the response to treatment in these patients.

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          Most cited references21

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          Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes.

          Takamitsu Fujiwara, Yutaka Imamura, Ron Margolis … (2009)
          To measure macular choroidal thickness (CT) in highly myopic eyes using enhanced depth imaging optical coherence tomography (OCT). Retrospective, observational case series. Enhanced depth imaging OCT images were obtained in highly myopic eyes (> or =6 diopters [D]). Images of CT were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. CT was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 1000-mum 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 CT at each location and to correlate CT with age and refractive error. The mean age of the 31 patients (55 eyes) was 59.7 years (+/- 17.6 years; range, 24 to 90 years), and the mean refractive error was -11.9 D (+/- 3.7 D). The mean subfoveal CT was 93.2 microm (+/- 62.5 microm) and was correlated negatively with age (P = .006), refractive error (P < .001), and history of choroidal neovascularization (P = .013). Regression analysis suggested that subfoveal CT decreased by 12.7 mum for each decade of life and by 8.7 microm for each D of myopia. The choroid in highly myopic eyes is very thin and undergoes further thinning with increasing age and degree of myopia. Abnormalities of the choroid may play a role in the pathogenesis of myopic degeneration.
          Article 0 comments Cited 192 times – based on 0 reviews     Review now
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            Retinal and choroidal biometry in highly myopic eyes with spectral-domain optical coherence tomography.

            Yasushi Ikuno, Yasuo Tano (2009)
            Morphologic changes in the retina and choroid are closely related with high myopia-related diseases. This study was conducted to evaluate the morphologic characteristics of normal highly myopic eyes. Thirty-one phakic highly myopic eyes with no posterior abnormalities (18 patients; mean +/- SD age, 51.7 +/- 11.4 years) were enrolled. Retinal-choroidal thickness at the fovea 1.5 mm superiorly, inferiorly, nasally, and temporally and the choroidal curvature were measured in the 512 x 128 three-dimensional scan mode with spectral-domain optical coherence tomography. The degree of posterior staphyloma was determined as the sum of the vertical distance from the retinal pigment epithelial line beneath the fovea to the nasal, temporal, superior, and inferior edge of the image, including the fovea. The association of clinical data with these parameters was evaluated. The mean +/- SD central retinal thickness was 200.9 +/- 39.3 microm. The mean choroidal thickness at the fovea (100.5 +/- 56.9 microm) was significantly different from the temporal (125.4 +/- 59.7 microm), nasal (81.9 +/- 35.0 microm), and superior (129.4 +/- 57.5 microm) thicknesses (P < 0.01). Central retinal thickness did not correlate with age, sex, refractive error, axial length, or central choroidal thickness. Central choroidal thickness was significantly associated with refractive error (P < 0.05) and posterior staphyloma height (P < 0.01). Posterior staphyloma height was significantly correlated with refractive error and axial length (P < 0.01). Stepwise analysis indicated that choroidal thickness correlated significantly with age and posterior staphyloma height (P < 0.01). Posterior staphyloma formation was a key factor in choroidal thinning in highly myopic eyes. Choroidal thickness had a greater effect than retinal thickness in highly myopic eyes.
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              Prevalence and associations of epiretinal membranes in the visual impairment project.

              Daniel J. McCarty, Bickol Mukesh, Vatsal Chikani … (2005)
              To determine the prevalence and factors associated with epiretinal membranes in a random sample of the population aged 40 years and older in Victoria, Australia. Population-based cross-sectional study. Detailed eye examinations, including retinal photographs, were conducted in 1992 and 1997 in 3271 people (83% of the eligible) in Melbourne and 1473 (92% of the eligible) in rural Victoria. Eyes present with either cellophane macular reflex (CMR) or preretinal macular fibrosis (PMF) were classified as having epiretinal membranes. Eyes with both CMR and PMF present were classified as having PMF. Age-standardized prevalence rates and 95% confidence limits were calculated by the direct methods using Segi's world population. Epiretinal membranes were observed in 253 of 4313 participants (6.0%; 95% confidence interval [CI] 5.2 to 6.7), bilaterally in 19%. Prevalence increased significantly by age group (0.5% for 40 to 49 years, 2.6% for 50 to 59 years, 9.4% for 60 to 69 years, 15.1% for 70 to 79 years, and 11.3% for 80 years and older). Prevalence was similar in males and females after adjusting for age. The overall age- and gender-standardized prevalence of CMR was 4.8% (95% CI 4.0 to 5.6) and PMF was 1.7% (95% CI 1.2 to 2.3). A decrease in visual acuity (<6/6) was significantly associated with idiopathic PMF (odds ratio [OR] 1.9; 95% CI 1.0 to 3.6) and CMR (OR 1.5; 95% CI 1.1 to 2.0) after adjusting for age. The prevalence of epiretinal membranes was similar to that reported in other population-based studies. Population shifts in the age distribution to older ages could lead to an increase in mild visual impairment caused by epiretinal membranes.
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                Author and article information

                Contributors
                I-Mo Fang:
                ORCID: http://orcid.org/0000-0001-6360-7588
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draft
                Li-Li Chen: Role: ResourcesRole: Visualization
                Alon Harris: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 29 September 2020
                Publication date Collection: 2020
                Volume: 15
                Issue: 9
                Electronic Location Identifier: e0239992
                Affiliations
                [1 ] Department of Ophthalmology, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan
                [2 ] Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
                Icahn School of Medicine at Mount Sinai, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-6360-7588
                Article
                Publisher ID: PONE-D-20-12131
                DOI: 10.1371/journal.pone.0239992
                PMC ID: 7523999
                PubMed ID: 32991629
                SO-VID: a08a9463-c87e-4de3-a15b-735b300afcc5
                Copyright © © 2020 Fang, Chen
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 26 April 2020
                Date accepted : 16 September 2020
                Page count
                Figures: 3, Tables: 1, Pages: 10
                Funding
                The author(s) received no specific funding for this work
                Categories
                Subject: Research Article
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Head
                Subject: Eyes
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Head
                Subject: Eyes
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Eyes
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Eyes
                Subject: Medicine and Health Sciences
                Subject: Surgical and Invasive Medical Procedures
                Subject: Medicine and Health Sciences
                Subject: Clinical Medicine
                Subject: Signs and Symptoms
                Subject: Edema
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Choroid
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Choroid
                Subject: Medicine and Health Sciences
                Subject: Diagnostic Medicine
                Subject: Diagnostic Radiology
                Subject: Tomography
                Subject: Research and Analysis Methods
                Subject: Imaging Techniques
                Subject: Diagnostic Radiology
                Subject: Tomography
                Subject: Medicine and Health Sciences
                Subject: Radiology and Imaging
                Subject: Diagnostic Radiology
                Subject: Tomography
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Cognitive Science
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Vision
                Subject: Visual Acuity
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Vision
                Subject: Visual Acuity
                Subject: Social Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Vision
                Subject: Visual Acuity
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Sensory Perception
                Subject: Vision
                Subject: Visual Acuity
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Cognitive Science
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Vision
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Vision
                Subject: Social Sciences
                Subject: Psychology
                Subject: Cognitive Psychology
                Subject: Perception
                Subject: Sensory Perception
                Subject: Vision
                Subject: Biology and Life Sciences
                Subject: Neuroscience
                Subject: Sensory Perception
                Subject: Vision
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Fovea Centralis
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Fovea Centralis
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                Data Availability All relevant data are within the manuscript.

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