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. 2024 May;262(5):1475-1487.
doi: 10.1007/s00417-023-06342-4. Epub 2023 Dec 22.

Macular choroidal thickness, volume, and vascularity index in patients with systemic sclerosis

Barbara Pieklarz  1 , Ewa Gińdzieńska-Sieśkiewicz  2 , Izabela Zawadzka  3 , Magdalena Bagrowska  2 , Joanna Daniluk  2 , Marcin Palewski  3 , Agnieszka Zonenberg  3 , Otylia Kowal-Bielecka  2 , Joanna Konopińska  3 , Diana Anna Dmuchowska  4
Affiliations

Macular choroidal thickness, volume, and vascularity index in patients with systemic sclerosis

Barbara Pieklarz et al. Graefes Arch Clin Exp Ophthalmol. 2024 May.

Abstract

Purpose: The aim of this study was to investigate choroidal parameters in patients with systemic sclerosis (SSc) using enhanced depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT) and to determine their relationships with clinical variables and ocular features.

Methods: Thirty-three patients with SSc and 40 controls were enrolled. The groups did not differ with regard to age, sex, and axial length. The mean choroidal thickness and volume were obtained in each conventional Early Treatment of Diabetic Retinopathy Study grid subfield. The choroidal vascularity index (CVI), which provides a quantitative analysis of vasculature by calculating the proportion of the luminal area (LA) to the total choroidal area (TCA), was determined.

Results: Lower choroidal thickness and volume were observed in the SSc group. The CVI was significantly higher in SSc patients, whereas the TCA, LA, and stromal area were significantly lower in the SSc group; however, the significant difference of the stromal component was more pronounced than that of the luminal component. Regression analyses did not identify any clinical factors associated with the CVI (except Ca-blocker use), central macular thickness, or volume. No significant differences in choroidal parameters were found within the SSc subtypes (diffuse cutaneous systemic sclerosis (dcSSc) vs. limited cutaneous systemic sclerosis (lcSSc)), or between eyes stratified according to SSc pattern (early, active, or late) using nailfold capillaroscopy (p > 0.05 for all).

Conclusion: Our results, with notably higher CVI values, may shed new light on choroidal impairment in patients with SSc. Stromal involvement appeared to dominate the vascular component.

Keywords: Choroidal microcirculation; Choroidal thickness; Choroidal vascularity index; Systemic sclerosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Examined choroidal and retinal area overlaid on fundus image
Fig. 2
Fig. 2
Image binarization of choroid: luminal area (vertical arrows) and stromal area (horizontal arrows). a Total choroidal area marked on original enhanced depth imaging (EDI) SD-OCT scan. Measurement area was defined as 1000 μm in width. b Niblack auto local threshold tool applied. c Highlighted luminal area using color threshold tool. d Overlay of luminal area on original OCT scan
See this image and copyright information in PMC

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