The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes.
Citation: Investigative Ophthalmology & Visual Science. 58(7):3278-3285, 2017 Jun 01PMID: 28666278Institution: MedStar Harbor HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Choroid/pp [Physiopathology] | *Glaucoma/pp [Physiopathology] | *Intraocular Pressure/ph [Physiology] | Aged | Aged, 80 and over | Axial Length, Eye/pa [Pathology] | Female | Glaucoma/su [Surgery] | Humans | Male | Middle Aged | Prospective Studies | Regression Analysis | Tomography, Optical Coherence/mt [Methods] | Tonometry, Ocular | TrabeculectomyYear: 2017Local holdings: Available online from MWHC library: 1962 - present (after 1 year), Available in print through MWHC library: 1999 - 2006ISSN:- 0146-0404
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 28666278 | Available | 28666278 |
Available online from MWHC library: 1962 - present (after 1 year), Available in print through MWHC library: 1999 - 2006
Conclusions: The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.
Methods: Thirty eyes of twenty-nine patients were examined pre- and postoperatively for up to 6 months with standard clinical assessment, enhanced depth imaging spectral-domain optical coherence tomography (OCT), and axial length measurement. Each enhanced depth imaging spectral-domain OCT image was analyzed using three separate methods to determine the choroidal thickness, choroidal vessel thickness, choroidal interstitial thickness, large choroidal vessel layer thickness, medium choroidal vessel layer thickness, and light-dark ratio. Bivariate linear regression analysis was completed with largest change in IOP as the independent variable. The dependent variables included choroidal thickness, choroidal vessel thickness, and choroidal interstitial thickness, at the largest change in IOP. Multivariable regression analysis using a generalized estimating equation to account for multiple measurements per eye was also completed.
Purpose: Choroidal thickness increases linearly with intraocular pressure (IOP) lowering. We studied the relationship between the change in size of the choroidal vasculature and IOP lowering after glaucoma procedures.
Results: Mean choroidal vessel thickness increases 1.5 mum for every 1 mm Hg decrease in IOP (P < 0.0001; 95% confidence interval [CI], 0.8, 2.1) and choroidal interstitial thickness increases 1.3 mum for every 1 mm Hg change in IOP (P < 0.0001; 95% CI, 0.8, 1.8). There was no significant association between change in IOP and change in large choroidal vessel layer temporally (P = 0.13), nasally (P = 0.20), or subfoveally (P = 0.18). There was also no association between IOP and the light-dark ratio (P = 0.16).
English