First Author: R.Kamal Salah UK
Co Author(s): T. Hidalgo Diaz M. Morillo Sanchez
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The purpose of the study was to analyze macular choroidal thickness (MCT) in patients with Pseudoxanthoma elasticum (PXE) by enhanced-depth imaging optical coherence tomography (EDI-OCT).
Hospital Virgen de la Victoria de Malaga. Spain
Sixty-eight (68) eyes of thirty-three (34) patients with pseudoxhantoma elasticum and 68 eyes of 34 age-matched and sex-matched control subjects were analysed using EDI-OCT to measure choroidal thickness (CT) in different locations: subfoveal, nasal, temporal, superior and inferior. Eyes with pseudoxanthoma elasticum were classified in 3 groups: those without choroidal neovascularization (CNV) or chorioretinal macular atrophy macular (Group 1); those with active CNV (Group 2), those with macular atrophy (Group 3) and control eyes (Group 0).
Mean subfoveal CT was 266.70±46.93 µm in control group, 304.24±65.52 µm in group 1, 198.55±66.33 µm in group 2, and 119.45±63.89 µm in group 3 (p=0.00). Comparison between PXE subgroups showed that subfoveal CT was significantly decreased in group 2 and 3 compared to group 1 (p˂0.0001 for both groups). The CT in the different quadrants (superior, inferior, temporal and nasal) was significantly thinner in group 3, followed by group 2 and 1 in ascendant order. Group 1 showed significant increased thickness compared to the other groups.
Significant changes in the choroidal thickness in eyes with PXE were found. Initial changes in Bruch membrane (MB) and choroid, in addition to the increased oxidative stress, would lead to hyperpermeability of the choroid and alterations of the barrier BM-RPE causing a thick choroid in early stages. Persistent damage would cause secondary choroidal thinning; in association with angioid streaks, CNV could develop or progressive macular atrophy could occur.