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Peripapillary choroidal thickness assessed using automated choroidal segmentation software in an Asian population
  1. Preeti Gupta1,2,
  2. Tian Jing3,
  3. Pina Marziliano3,
  4. Mani Baskaran1,2,4,
  5. Gemmy C M Cheung1,4,
  6. Ecosse L Lamoureux1,4,
  7. Carol Y Cheung1,3,
  8. Tien Yin Wong1,2,4,
  9. Tin Aung1,2,4,
  10. Ching-Yu Cheng1,2,4
  1. 1Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
  2. 2Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
  3. 3School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
  4. 4Duke-NUS Graduate Medical School, Singapore, Singapore
  1. Correspondence to Dr Cheng-Yu Cheng, Ocular Epidemiology Research Group & Statistics Unit, Singapore Eye Research Institute, 20 College Road, The Academia, Level 6, Discovery Tower, Singapore 169856, Singapore; ching-yu_cheng{at}


Aims To objectively quantify the thickness of peripapillary choroid using spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) followed by a novel automated choroidal segmentation software in Asian eyes and to evaluate its systemic and ocular determinants.

Methods We recruited 520 subjects (1040 eyes) from the Singapore Malay Eye Study, a cross-sectional population-based study. Subjects underwent standardised detailed ophthalmic examination including SD-OCT (Spectralis) with EDI for measurement of peripapillary choroidal thickness (PPCT).

Results The mean age of the subjects was 66.7±10.4 years (range 47–88 years) and the mean spherical equivalent was −0.01±2.28 D (range −18.50 to +7.00 D). The intra-session repeatability of PPCT measurements at four quadrants using automated choroidal segmentation software was excellent (intraclass correlation coefficient 0.9998–0.9999). The overall mean PPCT was 136.2±56.8 µm. Peripapillary choroid showed geographical differences among the four quadrants, being thickest in the superior quadrant (150.5±59.6 µm), followed by the nasal (143.5±58.4 µm) and temporal quadrants (139.4±68.9 µm), and thinnest in the inferior quadrant (111.3±51.7 µm). Among the range of ocular and systemic factors studied, shorter axial length (p=0.002), younger age (p=0.018), lower triglyceride level (p=0.015) and the presence of diabetes (p=0.036) were the only significant predictors of thicker peripapillary choroid.

Conclusions Using novel automated choroidal segmentation software, we provide reliable objective measurements of PPCT in a population-based setting. Shorter axial length, younger age, lower triglyceride levels and the presence of diabetes are the factors independently associated with thicker PPCT. These factors should be taken into consideration when interpreting Spectralis EDI SD-OCT-based PPCT measurements in clinics.

  • Epidemiology
  • Imaging

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