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PurposeTo determine the relationship between the peripapillary choroidal thickness (ppCT) and the degree and distribution of the tessellation in the fundus of normal eyes.MethodsThis was a prospective, observational cross-sectional study of 118 right eyes of young healthy volunteers. The ppCT was measured from the optical coherence tomography (OCT) circle scans manually at eight sectors: the nasal, supranasal superior, supratemporal, temporal, infratemporal, inferior, and infranasal sectors. The subjective degree of the tessellation in the color fundus photographs (CFPs) was classified into three categories: non-tessellated (NT), weakly tessellated (WT), and strongly tessellated (ST) in same sectors. The objective degree of tessellation designated by the tessellation fundus index (TFI) which was calculated as TFI = (R − G)/(R + G + B) using the mean value of the red-green-blue intensities of the CFPs. The differences in the ppCT and TFI for the three tessellation groups were analyzed. The correlations between the TFI and the ppCT were also determined.ResultsThe mean age of the subjects was 25.8 years and the mean axial length of the eye was 25.5 mm. The inter-rater agreement of the subjective classifications was high with a Fleiss kappa of 0.71. The ppCT was significantly thinner in eyes with higher degrees of tessellation (P < 0.05) in all sectors. The TFIs were significantly and negatively correlated with the ppCTs in all sectors (r = − 0.44 to − 0.24, P < 0.05) except the nasal and the supranasal sectors.ConclusionThe degree of peripapillary tessellation is significantly correlated with the ppCT in young healthy eyes, and it has large individual and geographic variations.

This study was conducted to investigate the size and shape of the foveal avascular zone (FAZ) determined by optical coherence tomography angiography (OCTA) and the relationship of the size and shape to the clinical findings in normal subjects. This was a cross-sectional study with seventy eyes of 70 volunteers. The size of the superficial FAZs were assessed by its area, length of perimeter, and Feret’s diameter, and the shape by the circularity, axial ratio, roundness, and solidity. The correlations between each parameter and the clinical findings were statistically determined. The coefficients of variation (CV) of the parameters of FAZ size were higher than that of the parameters of FAZ shape. The refractive error and axial length were significantly correlated with area-related factors. The central macular thickness (CMT) was significantly correlated with all parameters. Although the CMT was a critical factor that was significantly correlated with the size and shape characteristics of the FAZ, the shape might be a better factor for characterizing the FAZ than the size because of the low CV of shape-related factors and the characteristics are less affected by the other ocular factors.

To explore the effect of photodynamic therapy (PDT) on the choroid of medial area from optic disc and factors correlated with treatment outcomes, we evaluated choroidal changes using ultra-widefield optical coherence tomography (UWF-OCT) after PDT for central serous chorioretinopathy (CSC). In this retrospective case-series, we included CSC patients who received a standard-dose of full-fluence PDT. UWF-OCT were examined at baseline and 3 months after treatment. We measured choroidal thickness (CT), classified into central, middle, and peripheral sectors. We examined CT changes after PDT by sectors and treatment outcome. Twenty-two eyes of 21 patients (20 males; mean age 58.7 ± 12.3 years) were included. CT reduction after PDT was significant in all sectors, including peripheral areas: supratemporal, 330.5 ± 90.6 μm vs. 237.0 ± 53.2 μm; infratemporal, 240.0 ± 89.4 μm vs. 209.9 ± 55.1 μm; supranasal, 237.7 ± 59.8 vs 209.3 ± 69.3 μm; infranasal, 172.6 ± 47.2 μm vs. 155.1 ± 38.2 μm (P < 0.001, for all). In patients with retinal fluid resolution, despite no apparent difference in baseline CT, there was more significant reduction after PDT in supratemporal and supranasal peripheral sectors, compared with patients without resolution: supratemporal, 41.9 ± 30.3 μm vs. -1.6 ± 22.7 μm; supranasal, 24.7 ± 15.3 μm vs. 8.5 ± 3.6 μm (P < 0.019, for both). Whole CT decreased after PDT, including in medial areas from optic disc. This may be associated with the treatment response of PDT for CSC.

Abstract PurposeTo analyze the choroidal morphological changes in central serous chorioretinopathy (CSC) using ultra-widefield (UWF)-optical coherence tomography (OCT).MethodsThis single-center, case–control study included 65 CSC eyes (52 males; age, 55.6 ± 13.0 years) and 65 healthy eyes (50 males; age, 57.1 ± 17.9 years). UWF-OCT (viewing angle, 200°) with real-shape correction was used to create an automated choroidal thickness (CT) map. The CT map had three sub-areas: the central (0–30°), middle (30–60°), and peripheral areas (60–100°), and was divided by vertical and horizontal lines. Differences in the CT and the CT change rate (CTCR) from the central to peripheral areas were examined between the CSC and control groups after adjusting for subjects’ demographic and clinical factors. Furthermore, we assessed the vortex veins dilation patterns (VVDP) in the macula and examined the CT and the CTCR differences between CSC patients and controls for each VVDP.ResultsCSC patients had greater CT than those of the controls in all sectors (CSC vs. controls, the peripheral area: supratemporal 284.4 ± 71.2 μm vs. 220.4 ± 71.2 μm, infratemporal 263.3 ± 69.2 μm vs. 195.3 ± 52.3 μm, supranasal 251.9 ± 70.3 μm vs. 189.5 ± 58.1 μm, infranasal 193.6 ± 71.2 μm vs. 146.3 ± 48.9 μm, P < 0.0001 for all sectors). The CTCR was apparently larger in CSC eyes than controls only for the upper-dominant type of VVDP (CSC patients vs. controls, supratemporal 32.1 ± 9.9% vs. 4.6 ± 23.1%, infratemporal 44.0 ± 11.2% vs. 25.6 ± 16.8%, supranasal 42.6 ± 9.8% vs. 22.2 ± 19.4%, infranasal 57.6 ± 41.2% vs. 41.2 ± 13.9%, P < 0.0001 for all sectors).ConclusionsCSC has a thicker choroid, even in the peripheral areas, and the macular choroidal thickening was more severe in the upper-dominant type of VVDP. VVDP may affect the location of excessive fluid.

This study compared the retinal structure between the eyes of children with a history of treated retinopathy of prematurity (ROP), spontaneously regressed ROP and full-term children using widefield optical coherence tomography angiography (OCTA) and swept-source OCT (SSOCT). We identified patients who were diagnosed with ROP and followed up. Age-matched full-term controls were also recruited. We reviewed the medical records of 34 ROP eyes (34 patients) treated with laser photocoagulation, 5 spontaneously regressed ROP eyes (5 patients), and 15 age-matched full-term controls (15 control eyes). The thickness of the foveal retina and choroid, the foveal avascular zone (FAZ), and ocular shape were assessed using OCTA and SSOCT (Xephilio OCT-S1) images. The mean foveal thickness of the treated ROP eyes was significantly thicker than that of the control eyes. The FAZ of the treated ROP eyes was significantly smaller than that of the control eyes. SSOCT images revealed that 5 of 34 eyes in the treated ROP group had a dome-shaped macula, while 18 had an elongated barrel shape. Understanding these structural changes is crucial for developing targeted treatments and optimizing visual function in this population.

The purpose of this study was to compare the incidences of macular irregularities of elementary school (ES) and junior high school (JHS) students. This was a prospective cross-sectional observational study of 122 right eyes of 122 ES students (8–9 years) and 173 right eyes of 173 JHS students (12–13 years). Vertical cross-sectional images of the macula were obtained by optical coherence tomography. The eyes were classified based on the vertical symmetry of the posterior pole, and then sub-classified as convex-, flat-, concave-, or dome-shaped based on the direction of the curvature of the retinal pigment epithelium. One hundred and two eyes (83.6%) were placed in the symmetrical group in the ES students and 149 eyes (86.1%) in the JHS students. Twenty eyes (16.4%) were placed in the asymmetric groups in the ES students and 24 eyes (13.9%) in the JHS students. In symmetrical group, 78 and 118 eyes had a convex-shape (76.4 and 79.2%), followed by 22 and 29 eyes of dome-shaped group (21.6 and 19.4%) in ES and JHS students respectively. Because the incidences of the posterior pole shapes were not significantly different between the groups, it is likely that the macular irregularities develop before the age of ES.

Although the underlying mechanism of macular curvature remains unclear, it has been linked to various ocular diseases. However, changes in macular curvature during growth have not been thoroughly investigated. This study aimed to investigate macular curvature in children of different ages and its association with axial length. A total of 122 right eyes of healthy elementary school students (Group E; 8–9 years old; 61 males and 61 females) and 173 right eyes of healthy junior high school students (Group J; 12–13 years old; 83 males and 90 females) were included. Axial length, color fundus photographs, and optical coherence tomographic vertical cross-sectional images of the macula were obtained and used for analysis. The macular curvature was plotted as the retinal pigment epithelium and fitted to a second-degree polynomial equation using ImageJ software, to calculate the macular curvature. The Mann-Whitney U test compared macular curvature and axial length between the E and J Groups. The association between the macular curvature and axial length was determined using Spearman’s correlation analysis. Group J’s axial length and macular curvature were significantly greater than Group E’s ( p  < 0.001). Macular curvature was significantly positively correlated with axial length in Group J ( r  = 0.40, P  < 0.001) but not in Group E ( r  = 0.08, P  = 0.40). These findings suggest a possible increase in macular steepness during this period. Further longitudinal cohort studies are needed to confirm these results.

This study aims to develop a method to quantify choroidal vessels in normal eyes using wide-field optical coherence tomography (OCT) en-face images. The study included participants with normal eyes in whom wide-angle OCT images were acquired to generate planarized choroidal en-face and thickness map images. The images were segmented into central, midperipheral, and peripheral areas, and the midperipheral and peripheral areas were further segmented into supratemporal, infratemporal, supranasal, and infranasal sectors. The mean planarized choroidal-vessel density (p-CVD), planarized choroidal-vessel size (p-CVS), and choroidal thickness (CT) were calculated in each sector. Sex differences were analyzed using the Mann–Whitney U test. The study included 162 participants comprising 84 female (mean age, 43.5 years; axial length, 24.0 mm) and 78 male (mean age, 44.4 years; axial length, 24.2 mm) participants with no significant differences in demographics (P ≥ 0.107). Men had a higher mean p-CVD in all regions (P < 0.001). The mean p-CVS was greater in men in all regions except for the supratemporal sector (P < 0.001). No significant differences in sex in the mean CT were observed in all regions (P ≥ 0.106). The p-CVD and p-CVS in normal eyes differ between sexes. This finding may contribute to the understanding of the pathophysiology of choroidal diseases.

In a previous cross-sectional study, we reported that the sexes can be distinguished using known factors obtained from color fundus photography (CFP). However, it is not clear how sex differences in fundus parameters appear across the human lifespan. Therefore, we conducted a cohort study to investigate sex determination based on fundus parameters in elementary school students. This prospective observational longitudinal study investigated 109 right eyes of elementary school students over 4 years (age, 8.5 to 11.5 years). From each CFP, the tessellation fundus index was calculated as red/red + green + blue (R/[R+G+B]) using the mean value of red-green-blue intensity in eight locations around the optic disc and macular region. Optic disc area, ovality ratio, papillomacular angle, and retinal vessel angles and distances were quantified according to the data in our previous report. Using 54 fundus parameters, sex was predicted by L2 regularized binomial logistic regression for each grade. The right eyes of 53 boys and 56 girls were analyzed. The discrimination accuracy rate significantly increased with age: 56.3% at 8.5 years, 46.1% at 9.5 years, 65.5% at 10.5 years and 73.1% at 11.5 years. The accuracy of sex discrimination by fundus photography improved during a 3-year cohort study of elementary school students.

This study was performed to compare the area of the foveal avascular zone (FAZ-area) obtained by three optical coherence tomography angiography (OCTA) instruments. This was a cross-sectional, non-interventional study of twenty-seven healthy right eyes. The superficial and deep FAZ-area was measured manually with three OCTA instruments: Triton (Topcon), RS3000 (Nidek), and CIRRUS (Zeiss). The intra-rater, inter-rater, and inter-instrument correlation coefficients (CC) were assessed. The intra-rater and inter-rater CC were significantly high for the superficial and deep FAZ-areas ( P  < 0.001). The inter-instrument CC (95% confidence interval) for the superficial FAZ-area was 0.920 (0.803–0.965) for Triton vs RS3000, 0.899 (0.575–0.965) for RS3000 vs CIRRUS, and was 0.963 (0.913–0.983) for CIRRUS vs Triton ( P  < 0.001). For the deep FAZ-area, the inter-instrument CC was 0.813 (0.633–0.910) for Triton vs RS3000, 0.694 (0.369–0.857) for RS3000 vs CIRRUS, and 0.679 (0.153–0.872) for CIRRUS vs Triton ( P  < 0.001). The superficial FAZ-area (mm 2 ) was 0.264 ± 0.071 with Triton, 0.278 ± 0.072 with RS3000 and 0.257 ± 0.066 with CIRRUS. For deep FAZ-area, it was 0.617 ± 0.175 with Triton, 0.646 ± 0.178 with RS3000 and 0.719 ± 0.175 with CIRRUS. The FAZ-area from these instruments was clinically interchangeable. However, the absolute values of FAZ-area are significantly different among them. These differences must be considered in comparing the FAZ-areas from different OCTA instruments.