The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes

Xuemin Zhang, Emily Cole, Angelique Pillar, Mark Lane, Nadia Waheed, Mehreen Adhi, Laurence Magder, Harry A Quigley, Osamah Saeedi

Research output: Contribution to journalArticle

Abstract

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.

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.

Results: Mean choroidal vessel thickness increases 1.5 μm 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 μm 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).

Conclusions: The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.

Original languageEnglish (US)
Pages (from-to)3278-3285
Number of pages8
JournalInvestigative ophthalmology & visual science
Volume58
Issue number7
DOIs
StatePublished - Jun 1 2017

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Intraocular Pressure
Optical Coherence Tomography
Regression Analysis
Confidence Intervals
Light
Glaucoma
Linear Models

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes. / Zhang, Xuemin; Cole, Emily; Pillar, Angelique; Lane, Mark; Waheed, Nadia; Adhi, Mehreen; Magder, Laurence; Quigley, Harry A; Saeedi, Osamah.

In: Investigative ophthalmology & visual science, Vol. 58, No. 7, 01.06.2017, p. 3278-3285.

Research output: Contribution to journalArticle

Zhang, X, Cole, E, Pillar, A, Lane, M, Waheed, N, Adhi, M, Magder, L, Quigley, HA & Saeedi, O 2017, 'The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes', Investigative ophthalmology & visual science, vol. 58, no. 7, pp. 3278-3285. https://doi.org/10.1167/iovs.17-21598
Zhang, Xuemin ; Cole, Emily ; Pillar, Angelique ; Lane, Mark ; Waheed, Nadia ; Adhi, Mehreen ; Magder, Laurence ; Quigley, Harry A ; Saeedi, Osamah. / The Effect of Change in Intraocular Pressure on Choroidal Structure in Glaucomatous Eyes. In: Investigative ophthalmology & visual science. 2017 ; Vol. 58, No. 7. pp. 3278-3285.
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AU - Zhang, Xuemin

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AU - Pillar, Angelique

AU - Lane, Mark

AU - Waheed, Nadia

AU - Adhi, Mehreen

AU - Magder, Laurence

AU - Quigley, Harry A

AU - Saeedi, Osamah

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N2 - 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.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.Results: Mean choroidal vessel thickness increases 1.5 μm 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 μm 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).Conclusions: The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.

AB - 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.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.Results: Mean choroidal vessel thickness increases 1.5 μm 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 μm 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).Conclusions: The increase in choroidal thickness at lower IOP is associated with approximately equal increases in its intravascular and extravascular compartments.

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