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Paula Borba, Vitor Gomes Prado, Igor Matsubara, Augusto Paranhos, Roberto M Vessani, Tiago S Prata; Correlation Between Peripapillary Choroidal Thickness Measurements and Visual Field Status in Glaucomatous Patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):948.
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To correlate choroidal thickness measurements obtained by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) with visual field indices in glaucomatous patients.
We prospectively enrolled glaucomatous patients (glaucomatous optic neuropathy and reproducible visual field defect), suspects (based on the presence of ocular hypertension or disc appearance) and healthy controls. Exclusion criteria were significant media opacity or any ocular disease besides glaucoma. Participants underwent EDI-OCT (SD-OCT; Spectralis®, Wavelength: 870nm; Heidelberg Engineering Co., Heidelberg, Germany) and visual field assessment using the Humphrey Visual Field Analyzer (24-2; SITA-Standard). Peripapillary choroidal thickness was measured 500µm away from the margin of the Bruch’s membrane opening. Two independent examiners assessed all EDI-OCT images (poor quality images were not included in the analysis). Choroidal thickness values were compared among groups using analysis of covariance (accounting for age differences). Multiple regression analysis (accounting for age effect) investigated the correlation between choroidal thickness and visual field indices [mean deviation (MD) and visual field index (VFI)]. When both eyes were eligible, one was randomly selected for analysis.
25 eyes of 25 patients were included. Glaucomatous patients were older than glaucomatous suspects and controls (p=0.013; Table 1). Peripapillary choroid was thinner in glaucomatous patients (mean, 157.3 μm) compared to suspects (mean, 185.4 μm) and controls (mean, 202.3 μm), but the differences did not reach statistical significance (p≥0.123) due to the small sample size and large standard deviation values (Figure 1). Although univariable analysis showed significant correlations between peripapillary choroidal thickness and visual field indices (MD, R2=0.20, p=0.035; VFI, R2=0.21, p=0.033; Figures 2 and 3), the correlations lost significance after accounting for age effect in the multivariable analysis. Older patients, regardless of visual field status, had thinner peripapillary choroid (R2=0.47, p<0.01).
Our data suggest a trend for reduced peripapillary choroidalthickness values in glaucomatous patients. Choroidal thickness seemed to be associated with visual field status, but this association was mitigated by age effect.
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