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Cláudia Farinha, Alda Baltar, Sandrina Nunes, Ana Rita Santos, Maria da Luz Cachulo, Isabel Pires, João Figueira, Rufino Silva; CHOROIDAL THICKNESS IN PATHOLOGIC MYOPIA. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3864. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate macular choroidal thickness (CT) in pathologic myopic eyes without CNV and with CNV treated with photodynamic therapy (PDT), intravitreal ranibizumab (IVR), or both (PDT + IVR).
The medical records of patients with high myopia treated with PDT and/or IVR in our Department were reviewed. All eyes with history of CNV that met the inclusion criteria were assigned to three groups according to treatment received: PDT, IVR and PDT+IVR. A fourth group - “dry myopic maculopathy group” - included the contralateral highly myopic eyes that never developed CNV. All patients underwent complete ophthalmologic examination with best-corrected visual acuity (BCVA), measurement of axial length, color fundus photography and enhanced depth imaging optical coherence tomography (EDI OCT). Both the horizontal and vertical sections passing through the center of the fovea were used for the choroidal thickness measurements on EDI OCT. Type of myopic maculopathy found in each point measured was recorded, using the classification system proposed by Hayashi et al.
Forty-two eyes (21 patients) were included: 11 eyes (26,2%) in PDT group, 8 (19,0%) in IVR group, 9 (21,4%) in PDT+IVR group, and 14 (33,3%) in dry maculopathy group. Mean age was not statistically different between groups. Mean subfoveal CT was 69,4±33,6 μm in PDT group, 80,9±50,5 μm in IVR group, 106,2±52,0 μm in PDT+IVR group, and 119,4±81,4 μm in dry maculopathy group, without significant differences between groups (p>0.05). A positive but weak correlation was found between BCVA and macular CT (r=+0.293, p<0.001). The tessellated fundus lesion had the thickest choroids (194,3±57,0 μm) followed by macular atrophy (82,0±55,8 μm), diffuse chorioretinal atrophy (70,3±49,1 μm), and patchy chorioretinal atrophy (62,5±9,2 μm). Regression analysis showed that age (p<0.001), axial length (p<0.001), gender (p=0.001), and myopic lesions such as tessellated fundus (p=0.046) and patchy atrophy (p=0.008) were predictive of choroidal thickness. Type of treatment used for myopic CNV was not predictive of choroidal thickness.
Older age and greater axial length are the major factors associated with macular choroidal thinning. No significant differences in subfoveal CT between treatment groups were found, and type of treatment used for myopic CNV showed no predictive value for choroidal thickness.
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