Abstract
Purpose :
Changes in choroidal thickness measured on Optical Coherence Tomography (OCT) have been associated with cardiovascular, autoimmune, inflammatory diseases, hypertension, diabetes and dyslipidemia. We performed the first retrospective cross-sectional study investigating an association between subfoveal choroidal thickness (SFCT) and history of stroke and/or transient ischemic attack (TIA). Findings could stimulate further discussion on the potential role of OCT imaging in the screening for early cerebrovascular changes, or detection of subclinical infarcts.
Methods :
We measured the subfoveal SFCTs of 353 eyes from 204 patients with a history of stroke and/or Transient Ischemia Attack (TIA), and 379 eyes from 220 age-and-gender matched controls. The median participant age was 70 (SD=14.24). Images were previously acquired on spectral-domain OCT during routine ophthalmological visits. Images where poor quality or pathology obscured measurement were excluded. For consistency, a single grader measured all SFCTs according to a predetermined protocol. Ocular and systemic conditions were recorded from charts
Results :
A linear mixed effects model was initially fit including nearly all of the ocular/systemic condition variables, with subsequent variable selection (using F tests) to produce the final model. Some interaction effects were included based on the results of the exploratory analysis. The results of a linear mixed effects model, with choroidal thickness as the outcome, indicate that the coefficient estimate for the presence of stroke or TIA history was non-significant (p=0.315). However, variables such as age (p<0.001), myopia (p=0.005) and lattice degeneration (p=0.022) were significantly associated with decreased choroidal thickness, although their corresponding confidence intervals were quite wide due to high standard errors. Dry AMD was nearly significant (p=0.083). Other effects within the model were not statistically significant
Conclusions :
A thinner SFCT is not associated with stroke/TIA history. Given SFCT is associated with various ocular conditions, further investigation excluding subjects with other ocular in particular retinal pathologies is warranted to determine physiologic differences that protect choroid vasculature from the degeneration affecting cerebrovasculature, and whether pharmacologics can mimic these differences.
This is a 2020 ARVO Annual Meeting abstract.