Elsevier

Ophthalmology

Volume 119, Issue 12, December 2012, Pages 2572-2578
Ophthalmology

Original article
Choroidal Volume Variations with Age, Axial Length, and Sex in Healthy Subjects: A Three-Dimensional Analysis

https://doi.org/10.1016/j.ophtha.2012.06.065Get rights and content

Purpose

To demonstrate the 3-dimensional choroidal volume distribution in healthy subjects using enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT) and to evaluate its association with age, sex, and axial length.

Design

Retrospective case series.

Participants

A total of 176 eyes from 114 subjects with no retinal or choroidal disease.

Methods

The EDI SD-OCT imaging studies of healthy patients who had undergone a 31-raster scanning protocol on a commercial SD-OCT device were reviewed. Manual segmentation of the choroid was performed by 2 retinal specialists. A macular choroidal volume map and 3-dimensional topography were automatically created by the built-in software of the device. Mean choroidal volume was calculated for each Early Treatment Diabetic Retinopathy Study (ETDRS) subfield. Regression analyses were used to evaluate the correlation between macular choroidal volume and age, sex, and axial length.

Main Outcome Measures

Three-dimensional topography and ETDRS-style volume map of the choroid.

Results

Three-dimensional topography of the choroid and volume map was obtained in all cases. The mean choroidal volume was 0.228±0.077 mm3 for the center ring and 7.374±2.181 mm3 for the total ETDRS grid. The nasal quadrant showed the lowest choroidal volume, and the superior quadrant showed the highest choroidal volume. The temporal and inferior quadrants did not show different choroidal volume values. Choroidal volume in all the EDTRS rings was significantly correlated with axial length after adjustment for age (P < 0.0001), age after adjustment for axial length (P < 0.0001), and sex after adjustment for axial length (P < 0.05). Choroidal volume decreases by 0.54 mm3 (7.32%) for every decade and by 0.56 mm3 (7.59%) for every millimeter of axial length. Male subjects have a 7.37% greater choroidal volume compared with that of female subjects.

Conclusions

Enhanced depth imaging SD-OCT is a noninvasive and well-tolerated procedure with an excellent ability to visualize 3-dimensional topography of the choroid and to measure choroidal volume at the posterior pole using manual segmentation. Age and axial length are inversely correlated with choroidal volume, most likely leading to changes in retinal metabolic support in elderly, highly myopic patients. Sexual differences should be considered when interpreting an EDI SD-OCT scan of the choroid.

Financial Disclosure(s)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Section snippets

Study Population

Starting in July 2011, all patients undergoing SD-OCT scans at the Jacobs Retina Center at Shiley Eye Center, University of California San Diego (La Jolla, CA) underwent choroidal imaging as part of their evaluation. A raster scan of the macula using an SD-OCT device in EDI mode (Heidelberg Spectralis HRA2; Heidelberg Engineering, Carlsbad, CA) was used to study the choroid. The raster scan required approximately 30 seconds of additional time and was therefore incorporated into the standard

Results

A total of 176 eyes of 114 healthy subjects (51 men and 63 women), with a mean age of 50 years (range, 14–89 years), were included in the study. Ethnic distribution included 75 Caucasian subjects, 20 Asian subjects, 18 Hispanic subjects, and 1 black subject. A total of 160 eyes were phakic, and 16 eyes were pseudophakic. The best-corrected visual acuity ranged from 20/63 to 20/20 (Snellen equivalent). Axial length measurement was available for 146 of 176 eyes (83%). The mean axial length was

Discussion

In this study, 3-dimensional visualization of the choroid of the macular area in a large sample of healthy eyes was performed using EDI SD-OCT and allowed a comprehensive analysis of the choroidal anatomy. Manual segmentation of the choroidal borders was performed following a well-reproducible method described in a previous report by our group.34 The volume of the analyzed choroid was automatically calculated by the built-in software of the SD-OCT.

So far, no previous report has provided in vivo

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    Manuscript no. 2012-378.

    Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    Supported by National Institutes of Health Grants R01EY007366 and R01EY018589 (W.R.F.), R01EY016323 (D.U.B.), and R01EY020617 (L.C.). RPB Incorporated and unrestricted funds from Jacobs Retina Center. The funding organizations had no role in the design or conduct of this research.

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