September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A Longitudinal Analysis of Choroidal Thinning in Healthy and Glaucoma Subjects
Author Affiliations & Notes
  • Rusdeep S Mundae
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
    Saint Louis University School of Medicine, St. Louis, Missouri, United States
  • Linda M Zangwill
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Sami W. Kabbara
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
    The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, United States
  • Naama Hammel
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Christopher Bowd
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Christopher A Girkin
    School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Jeffrey M Liebmann
    Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Felipe A Medeiros
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Robert N Weinreb
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Akram Belghith
    Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Rusdeep Mundae, None; Linda Zangwill, Carl Zeiss Meditec Inc. (F), Carl Zeiss Meditec Inc. (R), Heidelberg Engineering GmbH (F), Optovue Inc. (F), Optovue Inc. (R), Quark (F), Topcon Medical Systems Inc. (F); Sami Kabbara, None; Naama Hammel, None; Christopher Bowd, None; Christopher Girkin, Carl Zeiss Meditech, Inc. (F), EyeSight Foundation of Alabama (F), Heidelberg Engineering, GmbH (F), National Eye Institute (F), Research to Prevent Blindness (F); Jeffrey Liebmann, Alcon, Inc (C), Allergan, Inc. (C), Bausch & Lomb, Inc. (C), Bausch & Lomb, Inc. (F), Carl Zeiss Meditech, Inc (C), Carl Zeiss Meditech, Inc (F), Diopysis, inc. (C), Diopysis, inc. (E), Diopysis, inc. (F), Heidelberg Engineering, GmbH (C), Heidelberg Engineering, GmbH (F), Merz Phamaceuticals, Inc (C), National Eye Institute (F), New York Glaucoma Research Institute (F), Optovue, inc (F), Quark Pharmaceuticals, Inc. (C), Reichert, Inc (C), Reichert, Inc (F), Sensimed, Inc. (C), Topcon, Inc. (F); Felipe Medeiros, Alcon (C), Allergan (F), Allergan (C), Ametek (F), Ametek (C), Bausch+Lomb (F), Carl-Zeiss Meditec (F), Carl Zeiss Meditec Inc (R), Carl Zeiss Meditec Inc (C), Heidelberg Engineering (F), Heidelberg Engineering, GmbH (C), Topcon (F); Robert Weinreb, Alcon, Inc (C), Allergan, Inc. (C), Bausch & Lomb, Inc. (C), Carl Zeiss Meditech, Inc. (C), Carl Zeiss Meditec Inc (F), Carl Zeiss Meditec Inc (R), Genentech (F), Heidelberg Engineering (F), Optovue (F), Topcon (C), Topcon (F); Akram Belghith, None
  • Footnotes
    Support  NIH Grants P30EY022589, EY11008, EY019869, EY021818, EY025056, EY022039 Eyesight Foundation of Alabama; Alcon Laboratories Inc.; Allergan Inc.; Pfizer Inc.; Merck Inc.; Santen Inc.; and the Edith C. Blum Research Fund of the New York Glaucoma Research Institute, New York, NY, Unrestricted grant from Research to Prevent Blindness, New York, New York.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 876. doi:
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    • Get Citation

      Rusdeep S Mundae, Linda M Zangwill, Sami W. Kabbara, Naama Hammel, Christopher Bowd, Christopher A Girkin, Jeffrey M Liebmann, Felipe A Medeiros, Robert N Weinreb, Akram Belghith; A Longitudinal Analysis of Choroidal Thinning in Healthy and Glaucoma Subjects. Invest. Ophthalmol. Vis. Sci. 2016;57(12):876.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We performed a longitudinal observational study to evaluate the rate of peripapillary choroidal thinning in glaucomatous subjects and healthy controls using spectral domain optical coherence tomography (SD-OCT).

Methods : One hundred thirty-two eyes from 68 healthy subjects and 165 eyes from 115 glaucomatous subjects were selected from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Innovations in Glaucoma Study (DIGS). Subjects were imaged using Spectralis SD-OCT. Peripapillary choroidal thickness (PCT) was assessed from a 3.4-mm diameter circular scan centered on the optic nerve head. The San Diego Automated Segmentation Algorithm (SALSA) was used to automatically segment and measure the PCT from the posterior edge of Bruch’s Membrane (BM) to the choroid-scleral interface. The rate of PCT thinning over time was calculated using a mixed effects model.

Results : The participants in the healthy group (mean ±SD, 56±14 years) were significantly younger than in the glaucoma group (68±11 years) (P<0.001). In comparison to the healthy group, the glaucoma group had longer mean axial length (24.0±1.0 vs 23.7±0.9, respectively; P=0.02), worse baseline MD (-0.31±1.2 dB vs -5.3±7.2, respectively; P<0.001), more Spectralis visits (median[IQR], 7 visits[5-8] vs 5 visits[4-7], respectively; P<0.001), and longer follow up periods (median 3.0 years [IQR 2.6-3.4] vs 1.6 years [1.2-2.5], respectively; P<0.001). At baseline, the global mean PCT was significantly thinner in glaucoma subjects compared to healthy controls (141.74±66.3 µm vs 155.66 ±64.8 µm, respectively; P<0.001). However, when the age was included in the model, this difference was no longer significant (P = 0.38). No significant difference was found between glaucoma and healthy controls in rate of PCT change (-1.88 µm/year vs -2.18 µm/year, respectively; P=0.28) or PCT percentage change over time (2.85%/year vs -3.32%/year, respectively; P=0.23).

Conclusions : Although the choroid was significantly thinner in glaucoma eyes compared to healthy eyes at baseline, the rate of PCT change was not significantly different in the 2 groups during this relatively short follow-up period. Longer follow-up is needed to determine whether monitoring the rate of PCT change has a role in glaucoma management.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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