Objective: To measure the macular and peripapillary choroidal thickness in the primary open-angle glaucoma (POAG), and to investigate the association between the visual field loss and choroidal thickness. Material and Methods: The study enrolled 90 eyes of 50 patients diagnosed with POAG, and 30 eyes of 19 patients as the control group (Group 0). Patients with POAG were divided into 3 groups as mild (Group 1), moderate (Group 2), and severe (Group 3) according to Hodapp, Anderson, Parrish criteria and 30 eyes were included in each group. The macular and peripapillary choroidal thicknesses were compared between the groups through enhanced depth imaging spectral-domain optic coherence tomography. Visual fields were measured by automated perimetry. Results: The peripapillary choroidal thickness in Group 3 with severe glaucomatous injury was significantly thinner when compared with the control group at all peripapillary locations except nasal location. Furthermore, the peripapillary choroidal thickness in Group 3 was significantly thinner than Group 1 at the mean, temporal, superior, superonasal, and inferonasal locations. Macular choroidal thickness did not differ between the groups. The age was inversely correlated with macular and peripapillary choroidal thickness. Conclusion: The peripapillary choroidal thickness was thinner in eyes with severe glaucomatous damage compared to normal and mildly glaucomatous damaged eyes. Treatments that support choroidal circulation may be beneficial in cases with severe POAG.
Keywords: Choroidal thickness; primary open-angle glaucoma; visual field; enhanced depth imaging optical coherence tomography; mean deviation
Amaç: Bu çalışmanın amacı, primer açık açılı glokomda (PAAG) makular ve peripapiller koroid kalınlığının ölçülerek görme alanı kaybı ile koroid kalınlığı arasındaki ilişkinin araştırılmasıdır. Gereç ve Yöntemler: Çalışmaya her grupta toplam 30 göz olacak şekilde PAAG tanılı 50 hastanın 90 gözü ve kontrol grubu (Grup 0) olarak 19 hastanın 30 gözü dâhil edildi. PAAG'li hastalar Hodapp, Anderson, Parrish kriterlerine göre hafif (Grup 1), orta (Grup 2) ve ağır (Grup 3) görme alanı kaybı olmak üzere 3 gruba ayrıldı ve her gruba 30 göz dâhil edildi. Gruplar arasında ve kontrol grubunda makular ve peripapiller koroid kalınlığı geliştirilmiş derinlik görüntüleme spektral domain optik koherens tomografi ile ölçülerek karşılaştırıldı. Görme alanları otomatik perimetri ile ölçüldü. Bulgular: Ağır glokomatöz hasar olan Grup 3'te peripapiller koroid kalınlığı kontrol grubuna göre nazal lokalizasyon haricindeki tüm peripapiller lokalizasyonlarda anlamlı derecede ince bulundu. Yine Grup 3'te peripapiller koroid kalınlığı Grup 1'e göre ortalama, temporal, superior, superonazal ve inferonazal lokalizasyonlarda anlamlı derecede ince bulundu. Makular bölgeden yapılan koroid kalınlık ölçümlerinde gruplar arasında anlamlı farklılık bulunmadı. Yaşın makular ve peripapiller koroid kalınlığı ile negatif korele olduğu görüldü. Sonuç: Peripapiller koroid kalınlığı ağır glokomatöz hasar olan gözlerde normal ve hafif glokomatöz hasarlı gözlere göre incelmektedir. Şiddetli PAAG'li olgularda koroid dolaşımını destekleyen tedaviler faydalı olabilir.
Anahtar Kelimeler: Koroid kalınlığı; primer açık açılı glokom; görme alanı; geliştirilmiş derinlik görüntüleme optik koherens tomografi; ortalama deviasyon
- Quigley HA. Open-angle glaucoma. N Engl J Med. 1993;328(15):1097-106. [Crossref] [PubMed]
- Mantravadi AV, Vadhar N. Glaucoma. Prim Care. 2015;42(3):437-49. [Crossref] [PubMed]
- Anderson DR; Normal Tension Glaucoma Study. Collaborative normal tension glaucoma study. Curr Opin Ophthalmol. 2003;14(2):86-90. [Crossref] [PubMed]
- Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-11. [Crossref] [PubMed] [PMC]
- Cristini G, Cennamo G, Daponte P. Choroidal thickness in primary glaucoma. Ophthalmologica. 1991;202(2):81-5. [Crossref] [PubMed]
- De Moraes CG, Reis AS, Cavalcante AF, Sano ME, Susanna R Jr. Choroidal expansion during the water drinking test. Graefes Arch Clin Exp Ophthalmol. 2009;247(3):385-9. [Crossref] [PubMed]
- Grunwald JE, Piltz J, Hariprasad SM, DuPont J. Optic nerve and choroidal circulation in glaucoma. Invest Ophthalmol Vis Sci. 1998;39(12):2329-36. [PubMed]
- Galassi F, Sodi A, Ucci F, Renieri G, Pieri B, Baccini M. Ocular hemodynamics and glaucoma prognosis: a color Doppler imaging study. Arch Ophthalmol. 2003;121(12):1711-5. [Crossref] [PubMed]
- Nicolela MT, Hnik P, Drance SM. Scanning laser Doppler flowmeter study of retinal and optic disk blood flow in glaucomatous patients. Am J Ophthalmol. 1996;122(6):775-83. Erratum in: Am J Ophthalmol 1997;123(4):575. [Crossref] [PubMed]
- Yin ZQ, Vaegan, Millar TJ, Beaumont P, Sarks S. Widespread choroidal insufficiency in primary open-angle glaucoma. J Glaucoma. 1997;6(1):23-32. [Crossref] [PubMed]
- Spraul CW, Lang GE, Lang GK, Grossniklaus HE. Morphometric changes of the choriocapillaris and the choroidal vasculature in eyes with advanced glaucomatous changes. Vision Res. 2002;42(7):923-32. [Crossref] [PubMed]
- Tane S, Kohno J, Horikoshi J, Kondo K, Ohashi K, Komatsu A, et al. [The study on the microscopic biometry of the thickness of the human retina, choroid and sclera by ultrasound]. Nippon Ganka Gakkai Zasshi. 1984;88(11):1412-7. Japanese. [PubMed]
- Mwanza JC, Hochberg JT, Banitt MR, Feuer WJ, Budenz DL. Lack of association between glaucoma and macular choroidal thickness measured with enhanced depth-imaging optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;52(6):3430-5. [Crossref] [PubMed] [PMC]
- Mwanza JC, Sayyad FE, Budenz DL. Choroidal thickness in unilateral advanced glaucoma. Invest Ophthalmol Vis Sci. 2012;53(10):6695-701. [Crossref] [PubMed]
- Cennamo G, Finelli M, Iaccarino G, de Crecchio G, Cennamo G. Choroidal thickness in open-angle glaucoma measured by spectral-domain scanning laser ophthalmoscopy/optical coherence tomography. Ophthalmologica. 2012;228(1):47-52. [Crossref] [PubMed]
- Hirooka K, Tenkumo K, Fujiwara A, Baba T, Sato S, Shiraga F. Evaluation of peripapillary choroidal thickness in patients with normal-tension glaucoma. BMC Ophthalmol. 2012;12:29. [Crossref] [PubMed] [PMC]
- Usui S, Ikuno Y, Miki A, Matsushita K, Yasuno Y, Nishida K. Evaluation of the choroidal thickness using high-penetration optical coherence tomography with long wavelength in highly myopic normal-tension glaucoma. Am J Ophthalmol. 2012;153(1):10-6.e1. [Crossref] [PubMed]
- Li L, Bian A, Zhou Q, Mao J. Peripapillary choroidal thickness in both eyes of glaucoma patients with unilateral visual field loss. Am J Ophthalmol. 2013;156(6):1277-84.e1. [Crossref] [PubMed]
- Lin Z, Huang S, Huang P, Guo L, Shen X, Zhong Y. The diagnostic use of choroidal thickness analysis and its correlation with visual field indices in glaucoma using spectral domain optical coherence tomography. PLoS One. 2017;12(12):e0189376. [Crossref] [PubMed] [PMC]
- Park HY, Lee NY, Shin HY, Park CK. Analysis of macular and peripapillary choroidal thickness in glaucoma patients by enhanced depth imaging optical coherence tomography. J Glaucoma. 2014;23(4):225-31. [Crossref] [PubMed]
- Sogawa K, Nagaoka T, Takahashi A, Tanano I, Tani T, Ishibazawa A, et al. Relationship between choroidal thickness and choroidal circulation in healthy young subjects. Am J Ophthalmol. 2012;153(6):1129-32.e1. [Crossref] [PubMed]
- Vance SK, Imamura Y, Freund KB. The effects of sildenafil citrate on choroidal thickness as determined by enhanced depth imaging optical coherence tomography. Retina. 2011;31(2):332-5. [Crossref] [PubMed]
- Ho J, Branchini L, Regatieri C, Krishnan C, Fujimoto JG, Duker JS. Analysis of normal peripapillary choroidal thickness via spectral domain optical coherence tomography. Ophthalmology. 2011;118(10):2001-7. [Crossref] [PubMed] [PMC]
- Schwartz B, Harris A, Takamoto T, Kagemann L, Evans D, Chung HS. Regional differences in optic disc and retinal circulation. Acta Ophthalmol Scand. 2000;78(6):627-31. [Crossref] [PubMed]
- Maul EA, Friedman DS, Chang DS, Boland MV, Ramulu PY, Jampel HD, et al. Choroidal thickness measured by spectral domain optical coherence tomography: factors affecting thickness in glaucoma patients. Ophthalmology. 2011;118(8):1571-9. [Crossref] [PubMed] [PMC]
- Li XQ, Larsen M, Munch IC. Subfoveal choroidal thickness in relation to sex and axial length in 93 Danish university students. Invest Ophthalmol Vis Sci. 2011;52(11):8438-41. [Crossref] [PubMed]
- Tan CS, Ouyang Y, Ruiz H, Sadda SR. Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2012;53(1):261-6. [Crossref] [PubMed]
- Ikuno Y, Tano Y. Retinal and choroidal biometry in highly myopic eyes with spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2009;50(8):3876-80. [Crossref] [PubMed]
.: Process List