Abstract
Purpose :
Pachychoroid disorders, such as central serous chorioretinopathy, are associated with high psychological stress and a "type-A" personality. We used a prospective, cross-sectional study to examine if there is an association between high self-reported stress levels and choroidal thickness and vascularity.
Methods :
The Perceived Stress Scale (PSS-10) questionnaire was used to quantify psychological stress. All subjects underwent Enhanced Depth Imaging Optical Coherence Tomography (EDI-OCT). Subfoveal choroidal thickness (SFCT) was measured from horizontal EDI-OCT images bisecting the fovea. Subfoveal choroid vascularity was described as the choroid vascularity index (CVI), the ratio of vascular area (hyporeflective densities on EDI-OCT) to total choroid area (hyperreflective densities on EDI-OCT). General estimating equation (GEE) analysis was used for statistical modelling.
Results :
128 eyes of 64 subjects were included. Mean age was 42 years (range 23-79 years, SD 14.7 years). 61% of subjects were female. Based on the PSS-10, 23 subjects (36%) reported low stress, 34 (53%) reported moderate stress, and 7 (11%) reported high stress. Among those with low stress, SFCT was 297 um (range 181-448 um, SD 71 um). Among moderate stress individuals, SFCT was 310 um (range 129-675 um, SD 102 um). Among high stress individuals, SFCT was 461 um (range 218-1036, SD 274 um) (P=0.32). CVI was similar among all three groups, with low stress individuals’ CVI at 64.8% (range 55.7-73.5%, SD 4.3%), moderate stress individuals' CVI at 65.5% (range 57.7-76.1%, SD 4.9%), and high stress individuals’ CVI at 65.5% (47.6-75.2%, SD 8%) (P = 0.82). Older age was significantly associated with lower SFCT (P=0.03) and higher CVI (P=0.009). There was no significant association between history of diabetes, hypertension, peptic ulcer disease, sleep apnea, steroid use, or psychiatric medication and SFCT or CVI.
Conclusions :
Though not statistically significant, we report a trend toward higher SFCT among individuals with high self-reported levels of stress. CVI remains similar among subjects regardless of stress level. As others have reported, we find age is negatively correlated with SFCT. Due to small sample size and high variability of SFCT among high stress individuals, further recruitment and study of individuals in this group is necessary to establish the association between stress and SFCT.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.