Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Choroidal Thickness in Primary Open Angle Glaucoma and Pseudoexfoliative Glaucoma: An EDI-OCT Approach
Primer Açık Açılı Glokom ve Psödoeksfolyatif Glokomda Koroid Kalınlığı: Bir EDI-OCT Yaklaşımı
Müberra AKDOĞANa, Merve ŞİMŞEKa, Hamidu Hamisi GOBEKAb, A. Yeşim ORALa
aDepartment of Ophthalmology, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, TURKEY
bDepartment of Ophthalmology, Ağrı İbrahim Çeçen University Faculty of Medicine, Ağrı, TURKEY
Turkiye Klinikleri J Ophthalmol. 2021;30(2):123-9
doi: 10.5336/ophthal.2020-79626
Article Language: EN
Full Text
ABSTRACT
 Objective: To investigate choroidal changes in pseudoexfoliative glaucoma and primary open angle glaucoma using enhanced depth imaging optical coherence tomography (EDI-OCT). Material and Methods: Ninety eyes of 90 participants, 30 of whom had pseudoexfoliative glaucoma (Group 1), 30 had primary open angle glaucoma (Group 2) and 30 were healthy subjects (Group 3) were investigated between June and September 2019. Pseudoexfoliative glaucoma and primary open angle glaucoma patients received only brimonidine tartrate and/or brinzolamide/dorzolamide and timolol maleate combination therapy during the study. Peripapillary retinal nerve fibre layer and subfoveal choroidal thickness with and without EDI mode of SD-OCT, central corneal thickness and intraocular pressure were compared among groups. Results: Mean age for each group was 56.12±11, 53.89±7 and 52.86±6 (±standard deviation) years in Groups 1, 2 and 3, respectively (p=0.110). Although Group 1 had retinal nerve fibre layer value of 72.9±20 µm, this was as high as 92±14 µm and 97.3±13 µm in Groups 2 and 3, respectively (p=0.001). Choroidal thickness measured using SD-OCT with and without EDI mode was 192±49/193±48 µm in Group 1. However, Group 2 and Group 3 had roughly identical choroidal thickness of 289±40/294±39 µm and 292±47/297±47 µm, respectively (p=0.001). Mean intraocular pressure was 14.8±3, 14.4±2.7, and 11.7±1.4 mmHg in Groups 1, 2 and 3, respectively (p=0.072). Group 1 was associated with marginally thinner cornea of 522±34 µm compared to 560±24 µm and 575±18 µm in Groups 2 and 3, respectively (p=0.001). Conclusion: Glaucoma, especially pseudoexfoliative glaucoma, influences choroidal microcirculation and thus physiological and morphological alteration of the choroidal layer.

Keywords: Choroidal thickness; pseudoexfoliative glaucoma; retinal nerve fibre layer; spectral-domain optical coherence tomography; enhanced depth imaging
ÖZET
 Amaç: Psödoeksfolyatif glokom ve primer açık açılı glokomlu gözlerde, geliştirilmiş derinlik görüntüleme optik koherens tomografi [enhanced depth imaging optical coherence tomography (EDI-OCT)] ile koroid değişikliklerini incelemek. Gereç ve Yöntemler: Haziran ve Eylül 2019 tarihleri arasında 30'u psödoeksfolyatif glokom (Grup 1), 30'u primer açık açılı glokom (Grup 2) ve 30'u sağlıklı (Grup 3) olmak üzere 90 katılımcının 90 gözü incelendi. Psödoeksfolyatif glokom ve primer açık açılı glokom hastaları, çalışma sırasında sadece brimonidin tartar ve/veya brinzolamid/dorzolamid ve timolol maleat kombinasyon tedavisi almıştır. Peripapiller retina sinir lifi tabakası ve EDI modu olan ve olmayan subfoveal koroid kalınlığı, santral kornea kalınlığı ve göz içi basıncı gruplar arasında karşılaştırıldı. Bulgular: Grup 1, 2 ve 3'te her grup için ortalama yaş sırasıyla 56,12±11; 53,89±7 ve 52,86±6 (±standart sapma) yıldı (p=0,110). Grup 1'in retina sinir lifi tabakası değeri 72,9±2 µm olmasına rağmen bu değer sırasıyla Grup 2 ve 3'te 92±14 µm ve 97,3±13 µm idi (p=0,001). Grup 1'de EDI modu olan ve olmayan spektral-domain OCT kullanılarak ölçülen koroid kalınlığı 192±49 µm/193±48 µm idi. Bununla birlikte Grup 2 ve 3, sırasıyla 289±40/294±39 µm ve 292±47/297±47 µm'lik kabaca özdeş koroid kalınlığına sahipti (p=0,001). Grup 1, 2 ve 3'te ortalama göz içi basıncı sırasıyla 14,8±3; 14,4±2,7 ve 11,7±1,4 mmHg idi (p=0,072). Grup 2 ve 3'te sırasıyla 560±24 µm ve 575±18 µm olan korneal kalınlıklarına göre Grup 1'de 522±34 µm'lik marjinal olarak daha ince kornea ile ilişkili idi (p=0,001). Sonuç: Psödoeksfolyatif glokom başta olmak üzere glokom koroidal mikrovasküler kan dolaşımını etkileyerek, koroidal tabakanın fizyolojik ve morfolojik değişimine yol açar.

Anahtar Kelimeler: Koroid kalınlığı; psödoeksfolyatif glokom; retina sinir lifi tabakası; spektral-domain optik koherens tomografi; geliştirilmiş derinlik görüntüleme
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