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Ophthalmol SciJuly 20242 citations

The Association between the Pulsatile Choroidal Volume Change and Ocular Rigidity.

Sayah Diane N, Descovich Denise, Costantino Santiago, Lesk Mark R


AI Summary

This study found that more rigid eyes have less pulsatile choroidal expansion, suggesting ocular biomechanics resist choroidal blood flow. This interaction is crucial for understanding eye disease pathophysiology.

Abstract

Purpose

To assess the relationship between the pulsatile choroidal volume change (ΔV) and ocular rigidity (OR), an important biomechanical property of the eye.

Design

This is a prospective cross-sectional study.

Subjects

Two hundred seventeen participants (235 eyes) were included in this study. Of those, 18 eyes (18 participants) had exudative retinal disease, and 217 eyes (199 participants) had open-angle glaucoma (39.2%), suspect discs (12.4%), ocular hypertension (14.3%), or healthy eyes (34.1%).

Methods

Pulsatile choroidal volume change was measured using dynamic OCT, which detects the change in choroidal thickness during the cardiac cycle. Ocular rigidity was measured using an invasive procedure as well as using a validated optical method. Correlations between ΔV and OR were assessed in subjects with healthy eyes, eyes with glaucoma, or eyes with exudative retinal disease.

Main outcome measures

Ocular rigidity and pulsatile ocular volume change.

Results

In 18 eyes where OR was obtained invasively and ΔV was obtained noninvasively, a significant correlation was found between ΔV and OR (r s  = -0.664, P  = 0.003). Similarly, a strong inverse correlation was found between the noninvasive measurements of both ΔV and OR (r s  = -0.748, P  < 0.001) in a large cohort and maintained its significance across diagnostic groups (a more compliant eye is associated with greater ΔV). No correlation was found between ΔV and age, blood pressure, intraocular pressure, axial length, or diagnosis ( P  ≥ 0.05). Mean ΔV was 7.3 ± 3.4 μL for all groups combined with a range of 3.0 to 20.8 μL.

Conclusions

These results suggest an association between the biomechanics of the corneoscleral shell and pulsatile ocular blood flow, which may indicate that a more rigid eye exerts more resistance to pulsatile choroidal expansion. This highlights the dynamic nature of both blood flow and biomechanics in the eye, as well as how they may interact, leading to a greater understanding of the pathophysiology of ocular disease.

Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.


Key Concepts6

In 18 eyes where ocular rigidity (OR) was obtained invasively and pulsatile choroidal volume change (ΔV) was obtained noninvasively, a significant correlation was found between ΔV and OR (r_s = -0.664, P = 0.003).

MechanismCross-sectionalProspective Cross-sectional Studyn=18 eyes from 18 participantsCh3Ch5

A strong inverse correlation was found between the noninvasive measurements of both pulsatile choroidal volume change (ΔV) and ocular rigidity (OR) (r_s = -0.748, P < 0.001) in a large cohort of 217 eyes (199 participants) and this correlation maintained its significance across diagnostic groups (healthy eyes, open-angle glaucoma, suspect discs, ocular hypertension, and exudative retinal disease).

MechanismCross-sectionalProspective Cross-sectional Studyn=217 eyes from 199 participantsCh3Ch5

No correlation was found between pulsatile choroidal volume change (ΔV) and age, blood pressure, intraocular pressure, axial length, or diagnosis (P ≥ 0.05) in a study of 217 eyes (199 participants) including healthy eyes, eyes with glaucoma, or eyes with exudative retinal disease.

MechanismCross-sectionalProspective Cross-sectional Studyn=217 eyes from 199 participantsCh3Ch5

The mean pulsatile choroidal volume change (ΔV) was 7.3 ± 3.4 µL for all groups combined (217 eyes from 199 participants) with a range of 3.0 to 20.8 µL.

PrognosisCross-sectionalProspective Cross-sectional Studyn=217 eyes from 199 participantsCh5

This prospective cross-sectional study included 217 participants (235 eyes), of whom 18 eyes (18 participants) had exudative retinal disease, and 217 eyes (199 participants) had open-angle glaucoma (39.2%), suspect discs (12.4%), ocular hypertension (14.3%), or healthy eyes (34.1%).

MethodologyCross-sectionalProspective Cross-sectional Studyn=235 eyes from 217 participantsCh10

Pulsatile choroidal volume change was measured using dynamic OCT, which detects the change in choroidal thickness during the cardiac cycle, and ocular rigidity was measured using an invasive procedure as well as a validated optical method in a prospective cross-sectional study.

MethodologyCross-sectionalProspective Cross-sectional Studyn=Not specified for this statement, but…Ch3Ch5

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