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Su-Na Lee, Giulio Barteselli, Sharif El-Emam, Huiyuan Hou, Dirk-Uwe Bartsch, Lingyun Cheng, William Freeman; Manual segmentation of choroidal volume in emmetropic and high myopic eyes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1916.
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© ARVO (1962-2015); The Authors (2016-present)
To compare choroidal volume between emmetropic and high myopic eyes and to assess the variations of choroidal volume among eyes with non-pathologic high myopia, pathologic high myopia with vitreoretinal pathology and choroidal neovascularization (CNV)
We retrospectively reviewed imaging studies of 137 eyes of 86 patients who underwent choroidal volume measurement using enhanced depth imaging (EDI)-OCT. Forty four eyes were emmetropic (axial length: ≥ 23.5 mm and < 24.5 mm) and 93 eyes were high myopic (axial length: > 26.5 mm). High myopic eyes were divided into high myopia without pathology (51 eyes), high myopia with vitreoretinal pathology (30 eyes), and high myopia with CNV (12 eyes). The EDI-OCT protocol used to assess the choroidal volume consisted in 31 high-resolution B-scans centered on the fovea. The choroid was segmented manually from the hyper-reflective line of the retinal pigment epithelium to the chorio-scleral junction on SD-OCT by two retina specialists. Choroidal volume map and measurements were obtained applying the 6-mm diameter grid used by the Early Treatment Diabetic Retinopathy Study (ETDRS).
Mean subfoveal and total choroidal volume were 0.24 ± 0.07 mm3 and 7.67 ± 2.15 mm3 in emmetropic eyes, 0.16 ± 0.06 mm3 and 5.60 ± 1.77 mm3 in high myopic eyes without pathology, 0.08 ± 0.04 mm3 and 3.01 ± 1.26 mm3 in high myopic eyes with vitreoretinal pathology, 0.09 ± 0.05 mm3 and 3.29 ± 1.41 mm3 in high myopic eyes with CNV. After adjusting for age and sex, subfoveal and total choroidal volume were lower in high myopic eyes without pathology than emmetropic eyes (both P<0.0001). Subfoveal and total choroidal volume were lower in high myopia with vitreoretinal pathology and high myopia with CNV than high myopia without pathology (both P<0.01) after adjusting for age, sex, and axial length. Among the 4 ETDRS quadrants, superior quadrant had the greatest choroidal volume in emmetropia (2.07 ± 0.71 mm3) and high myopia without pathology (1.54 ± 0.62 mm3), while the nasal quadrant had the lowest choroidal volume in emmetropia (1.62 ± 0.69 mm3) and high myopia without pathology (1.08 ± 0.59 mm3).
We concluded that the choroid is thinner in high myopic eyes than emmetropic eyes, but eyes with coexisting myopic pathology have more severe thinning.
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