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D. Y. Kim, J. R. Ehrlich, J. Peterson, G. J. Parlitsis, K. Y. Kay, S. Kiss, N. M. Radcliffe; Relationship Between Peripapillary Atrophy and Peripapillary Choroidal Thickness in Glaucoma as Measured by Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2746.
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As choroidal atrophy has been described in glaucoma and in peripapillary atrophy (PPA), we examined peripapillary choroidal thickness (CT) in normal and glaucomatous eyes with varying degrees of PPA.1
Measurements were collected from 50 eyes of 50 patients with and without glaucoma using spectral-domain optical coherence tomography (Heidelberg Spectralis®). In 40 patients, a 360 degree peripapillary scan was performed for retinal nerve fiber layer (RNFL) assessment. An additional 10 patients with PPA were assessed using 3-dimensional volume scans of the optic disc and parapapillary structures. CT circle scans were manually segmented (outer retinal pigment epithelial border to inner scleral wall) by two independent investigators. The presence of β-PPA for each optic nerve quadrant was determined from photographs by a single masked observer.
Independent measurements of CT by two observers in 238 locations of 36 eyes from 22 patients were highly correlated (r=0.913, p<0.001). Measurements of CT but not RNFL thickness decreased significantly with age (Kruskal-Wallis test; p<0.001 and p=0.326). Normal and glaucomatous eyes differed significantly in visual field mean deviation (-0.39 vs. -8.8 dB, Wilcoxon rank test; p<0.001) and global RNFL thickness (93.1 vs. 73.0 microns; p<0.001), but not age (58.3 vs. 62.0 years, p=0.365) or sectoral or global CT (141.2 vs. 144.0 microns; p=0.69). CT was not correlated with RNFL thickness for any location (r≤0.078; p>0.6) and did not vary based on presence of PPA (global CT=156 vs. 147 microns; p=0.7). The choroid underlying regions of PPA was demonstrated using OCT volumetric data (Figure 1).
We have presented a repeatable assessment of CT that replicates prior reports of age dependent choroidal atrophy but did not confirm suggested CT-PPA or CT-glaucoma associations.1,2
1.Yin ZQ, et al. Widespread choroidal insufficiency in primary open-angle glaucoma. J Glaucoma. 1997 Feb;6(1):23-32.2.Spaide RF. Age-related choroidal atrophy. Am. J. Ophthalmol. 2009;147(5):801-810.
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