Journal article
Comparison of retinal and choriocapillaris thicknesses following sitting to supine transition in healthy individuals and patients with age-related macular degeneration
JAMA ophthalmology, Vol.133(3), pp.297-303
03/2015
DOI: 10.1001/jamaophthalmol.2014.5168
PMCID: PMC5777152
PMID: 25521616
Abstract
The effects of position on retinal and choroidal structure are absent from the literature yet may provide insights into disease states such as age-related macular degeneration (AMD). To evaluate the effect of postural change on retinal and choroidal structures in healthy volunteers and patients with non-neovascular AMD. Prospective observational case series at an academic tertiary care retina service from September 2013 to April 2014 involving 4 unaffected volunteers (8 eyes) and 7 patients (8 eyes) with intermediate AMD. Healthy volunteers selected for the study had no evidence of ocular disease. Patients with AMD were required to have at least 10 intermediate-sized drusen. Spectral-domain optical coherence tomography with enhanced depth imaging in upright (sitting) and supine positions. Stable imaging was achieved using a rotating adjustable mechanical arm that we constructed to allow the optical coherence tomography transducer to rotate 90°. The Iowa Reference Algorithms were used to quantify choroid and choriocapillaris thicknesses. Changes in sitting and supine position central macular thickness (in micrometers), total macular volume (in cubic millimeters), choroidal thickness (in micrometers), and choriocapillaris-equivalent thickness (CCET, in micrometers). Choriocapillaris-equivalent thickness was thinner in healthy participants (9.89 μm; range, 7.15-12.5 μm) compared with patients with intermediate AMD (16.73 μm; range, 10.31-27.38 μm) (P = .02); there was no difference in overall choroidal thickness between the 2 groups (P = .38). There was a 15% CCET reduction among healthy participants when transitioning from a sitting (9.89 μm) to supine (8.4 μm; range, 6.92-10.7 μm) position (P = .02) vs a CCET reduction of 11.1% from sitting (16.73 μm) to supine (14.88 μm; range, 8.76-20.8 μm) positioning (P = .10) in patients with intermediate AMD. Intermediate AMD appears to be associated with an increase in CCET and with a lack of positional responses that are observed in the CCET of normal eyes. Our results suggest that although outer portions of the choroid do not appear to be responsive to modest positional or hydrostatic pressure, the choriocapillaris capacity is, and this is measurable in vivo. Whether this physiologic deviation that occurs in AMD is related to atrophy, inflammation, or changes in autoregulatory factors or growth factors remains to be determined.
Details
- Title: Subtitle
- Comparison of retinal and choriocapillaris thicknesses following sitting to supine transition in healthy individuals and patients with age-related macular degeneration
- Creators
- David R P Almeida - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa CityLi Zhang - The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa CityEric K Chin - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa CityRobert F Mullins - The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa CityMurat Kucukevcilioglu - The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa CityD Brice Critser - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa CityMilan Sonka - The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa CityEdwin M Stone - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City2The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa CityJames C Folk - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa CityMichael D Abràmoff - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City2The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa City3Iowa Institute for Biomedical Imaging, Iowa City4VStephen R Russell - Vitreoretinal Service, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City2The Stephen A. Wynn Institute for Vision Research, University of Iowa, Iowa City
- Resource Type
- Journal article
- Publication Details
- JAMA ophthalmology, Vol.133(3), pp.297-303
- DOI
- 10.1001/jamaophthalmol.2014.5168
- PMID
- 25521616
- PMCID
- PMC5777152
- NLM abbreviation
- JAMA Ophthalmol
- ISSN
- 2168-6165
- eISSN
- 2168-6173
- Publisher
- United States
- Grant note
- R01 EY019112 / NEI NIH HHS R01 EB004640 / NIBIB NIH HHS R01 EY018853 / NEI NIH HHS
- Language
- English
- Date published
- 03/2015
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Electrical and Computer Engineering; The University of Iowa Institute for Vision Research; Iowa Neuroscience Institute; Radiation Oncology; Injury Prevention Research Center; Ophthalmology and Visual Sciences
- Record Identifier
- 9983806284002771
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