Elsevier

American Journal of Ophthalmology

Volume 158, Issue 6, December 2014, Pages 1342-1347.e1
American Journal of Ophthalmology

Original article
Choroidal Thickness in Nonarteritic Anterior Ischemic Optic Neuropathy

https://doi.org/10.1016/j.ajo.2014.09.008Get rights and content

Purpose

To examine choroidal thickness in nonarteritic anterior ischemic optic neuropathy (AION).

Design

Retrospective case control study.

Methods

In the eye clinic of the University Medical Center in Mannheim, Germany, we studied a group that consisted of patients with nonarteritic AION and a control group that consisted of individuals with normal fundus. Choroidal thickness was measured by the enhanced-depth imaging of spectral-domain optical coherence tomography. The main outcome measure was choroidal thickness.

Results

The study group consisted of 20 patients: 11 patients with acute nonarteritic AION and an unaffected contralateral eye and 9 patients with acute unilateral nonarteritic AION and previously nonarteritic AION in the contralateral eye. The control group consisted of 58 patients (58 eyes). In multivariate analysis, thinner subfoveal choroidal thickness was associated with the diagnosis of nonarteritic AION (P = 0.001; regression coefficient B, −55.1), after adjusting for age (P < 0.001) and refractive error (P = 0.20). Similarly, unaffected eyes contralateral to eyes with acute nonarteritic AION as compared to control eyes showed thinner subfoveal choroidal thickness (P = 0.037) after adjusting for age (P = 0.001) and refractive error (P = 0.06). In a reverse manner, nonarteritic AION was associated with thinner subfoveal choroidal thickness (P = 0.007) after adjusting for age, optic disc diameter, gender, and refractive error.

Conclusions

Eyes affected by nonarteritic AION and unaffected contralateral eyes showed significantly thinner macular choroids than eyes of a control group after adjusting ocular and systemic parameters. A thin choroid may be added to the diagnostic features of nonarteritic AION. Future studies may examine the pathophysiologic meaning of the finding.

Section snippets

Methods

The hospital-based retrospective observational study analyzed a study group of patients with nonarteritic AION and a control group of patients who attended the hospital for cataract surgery or reasons other than macular or retinal diseases. The ethics committee II of the Medical Faculty Mannheim of the University of Heidelberg approved the study according to the Declaration of Helsinki and all federal laws in Germany.

All study participants underwent a detailed ophthalmologic examination,

Results

The study group included 20 patients (16 men) with unilateral acute nonarteritic AION. The mean age was 66.9 ± 9.8 years (range, 42–80 years), and the mean refractive error was + 1.18 ± 1.93 diopters (range, −1.25 to +5.25 diopters). The study group was differentiated into 11 patients with first manifestations of nonarteritic AION and 9 patients who had attended the hospital with acute nonarteritic AION in the second eye when the first eye had experienced nonarteritic AION several months

Discussion

In our hospital-based study, patients with nonarteritic AION showed significantly thinner macular choroids, after adjusting for age, optic disc diameter, gender, and refractive error, than did the individuals of the control group without fundus or optic nerve disorders. It held true for eyes with acute nonarteritic AION, eyes with previous nonarteritic AION and contralateral eyes (yet) unaffected by nonarteritic AION. Correspondingly, choroidal macular thickness did not differ significantly

Alexander K. Schuster received a Master of Science in Medical Physics from the Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Germany in August 2011 and a medical degree in November 2012. Subsequently, he began his residency in ophthalmology at the University Eye Clinics Mannheim.

References (27)

  • Y. Imamura et al.

    Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy

    Retina

    (2009)
  • S.W. Kim et al.

    Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy

    Retina

    (2011)
  • I. Flores-Moreno et al.

    The relationship between retinal and choroidal thickness and visual acuity in highly myopic eyes

    Br J Ophthalmol

    (2013)
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    Alexander K. Schuster received a Master of Science in Medical Physics from the Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Germany in August 2011 and a medical degree in November 2012. Subsequently, he began his residency in ophthalmology at the University Eye Clinics Mannheim.

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