Purpose: To evaluate the subfoveal choroidal thickness in Vogt-Koyanagi-Harada (VKH) disease using enhanced depth imaging optical coherence tomography. Methods: Retrospective observational study. Subfoveal choroidal thickness was measured using enhanced depth imaging optical coherence tomography, in which the optical coherence tomography instrument was placed close enough to the eye to obtain an inverted image, which was averaged for 100 scans. All patients were diagnosed as having the ocular findings of VKH disease with or without extraocular disorders. The patients were followed during their initial treatment with corticosteroids. Results: All 8 patients (16 eyes) with acute phase VKH disease presented with thickening of the choroid. The serous retinal detachment disappeared in 1 month after corticosteroid treatment. The mean choroidal thickness in 16 eyes decreased from 805 ± 173 μm at the first visit to 524 ± 151 μm at 3 days (P < 0.001) and 341 ± 70 μm by 2 weeks (P < 0.001). Conclusion: Patients with active VKH disease have markedly thickened choroids, possibly related not only to inflammatory infiltration but also to increased exudation. Both the choroidal thickness and the exudative retinal detachment decreased quickly with corticosteroid treatment. Enhanced depth imaging optical coherence tomography can be used to evaluate the choroidal involvement in VKH disease in the acute stages and may prove useful in the diagnosis and management of this disease noninvasively.

Purpose To investigate circadian changes in subfoveal choroidal thickness (SFCT) and the relation to systemic factors in healthy subjects. Methods Thirty-eight eyes of 19 healthy volunteers were enrolled. SFCT was measured by using prototype high-penetration optical coherence tomography. Intraocular pressure (IOP), systolic blood pressure (SBP), diastolic blood pressures (DBP), and heart rate (HR) were measured every 3 hours over a 24-hour period. Circadian changes in the mean arterial pressure (MAP) and mean ocular perfusion pressure (MOPP) were calculated. The difference between the maximal and minimal SFCTs was analyzed, and correlations between the SFCT and other systemic factors were evaluated. Results There was a significant circadian variation in SFCT (P < 0.0001). The total mean SFCT was 280.3 ± 106.1 μm. At 6 PM, the mean SFCT (271.9 ± 103.5 μm) was the thinnest and at 3 AM it was the thickest (290.8 ± 110.8 μm). The SFCTs in 32 of 38 eyes were thickest between 3 and 9 AM and in 27 of 38 eyes, thinnest between 3 and 9 PM. The mean SFCT was significantly negatively correlated with the mean SBP (R² = 0.59, P = 0.02) in all eyes. There were no significant correlations between the mean SFCT and the mean DBP, MAP, HR, IOP, and MOPP in all eyes. Conclusions We investigated the circadian change of choroidal thickness using high-penetration optical coherence tomography in healthy volunteers. The significant diurnal change was found and the choroid was thicker at night and thinner in daytime. Fluctuations in the choroidal thickness may be related to SBP.

Purpose: To evaluate the subfoveal choroidal thickness in the fellow eyes of patients with CSC, a disease often associated with choroidal vascular hyperpermeability even in eyes without subretinal fluid. Methods: In this observational cross-sectional study, we measured the bilateral subfoveal choroidal thickness in patients with unilateral CSC using enhanced depth imaging spectral-domain optical coherence tomography. Areas of choroidal vascular hyperpermeability were visualized with indocyanine green angiography. Results: Sixty-six consecutive Japanese patients (50 men, 16 women; mean age, 52.8 years) with unilateral CSC were examined. The subfoveal choroid in symptomatic eyes was significantly thicker than that in fellow eye (414 ± 109 μm vs. 350 ± 116 μm, P < 0.001, respectively). The subfoveal choroid of eyes with choroidal vascular hyperpermeability was 410 ± 92 μm, which differed significantly (P < 0.001) from the choroid (239 ± 59 μm) of fellow eyes without choroidal vascular hyperpermeability. Conclusion: The subfoveal choroid in the fellow eyes of patients with CSC was thicker in the eyes with choroidal vascular hyperpermeability. Enhanced depth imaging spectral-domain optical coherence tomography can assess the effects of choroidal vascular hyperpermeability by measuring the choroidal thickness noninvasively.

Purpose.: Two optical coherence tomography (OCT) modalities can visualize the choroid: high-penetration OCT (HP-OCT) using a long wavelength, and enhanced depth imaging technique using Heidelberg OCT (EDI-OCT). The purpose of this study was to compare and investigate the agreement among the retinal/choroidal thickness parameters. Methods.: Twenty-four eyes of 12 healthy volunteers were examined simultaneously using the prototype swept-source HP-OCT and EDI-OCT. Six independent examiners measured the central retinal/choroidal thicknesses on horizontal B-scan images. The reliability was evaluated by intraclass correlation coefficient (ICC). Intervisit reproducibility was assessed by examining 10 of the volunteers 4 months later. Results.: Using HP-OCT, the average of all measurements was 209.1 ± 12.9 μm in the retina and 292.7 ± 77.3 μm in the choroid, and using EDI-OCT, 212.5 ± 13.3 μm in the retina and 283.7 ± 84.1 μm in the choroid. An intersystem comparison showed that the ICCs were 0.661 (95% confidence interval [CI], 0.535–0.754) for the retina and 0.921 (95% CI, 0.875–0.948) for the choroid. Using HP-OCT, the interexaminer ICC reproducibility values were 0.630 (95% CI, 0.447–0.791) for the retinal thickness and 0.912 (95% CI, 0.835–0.958) for the choroidal thickness; using EDI-OCT, the values for the retinal and choroidal thicknesses were 0.788 (95% CI, 0.607–0.898) and 0.970 (95% CI, 0.948–0.985), respectively. The intervisit ICC values for the retinal and choroidal thicknesses were 0.504 (95% CI, 0.376–0.609) and 0.893 (95% CI, 0.864–0.916). Conclusions.: The retinal and choroidal thicknesses were well-correlated between the instruments. Higher reliability and reproducibility are expected for the choroidal thickness measurements despite with higher morphologic interindividual variations.