Assessment of choroidal thickness before and after steep Trendelenburg position using swept-source optical coherence tomography

Br J Ophthalmol. 2015 Apr;99(4):493-9. doi: 10.1136/bjophthalmol-2014-305525. Epub 2014 Oct 21.

Abstract

Background: To evaluate changes in choroidal thickness before and after steep Trendelenburg position (STP, 40° head-down) using automated segmentation software to analyse swept-source optical coherence tomography (SS-OCT) data.

Methods: The eyes of 20 healthy volunteers underwent a three-dimensional wide scanning protocol with SS-OCT (Topcon, Tokyo, Japan) at baseline, immediately after STP was initiated, and 5, 10 and 15 min after STP; blood pressure and heart rate were measured concurrently. The predictive mean difference was calculated using a generalised linear mixed model that adjusted for potential confounders.

Results: Mean choroidal thickness significantly and transiently increased immediately (268.18±9.24 μm, p<0.01) and 5 min (264.25±9.30 μm, p=0.03) after STP, relative to baseline (256.51±9.20 μm). However, choroidal thickness decreased by 10 min (262.51±9.34 μm, p=0.15) and 15 min (261.38±9.40 μm, p=0.37) after STP. Mean arterial pressure also transiently increased from baseline (78.2±1.2 mm Hg) immediately after STP (79.9±1.1 mm Hg, p=0.01), but normalised by 5 min after STP (p>0.05 for all comparisons ≥5 min).

Conclusions: Choroidal thickness significantly but transiently increases after adopting STP, as evaluated by automated layer segmentation analysis of SS-OCT data.

Keywords: Anatomy; Choroid; Imaging.

MeSH terms

  • Adult
  • Blood Pressure / physiology
  • Choroid / anatomy & histology*
  • Female
  • Head-Down Tilt / physiology*
  • Healthy Volunteers
  • Heart Rate / physiology
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Organ Size
  • Prospective Studies
  • Tomography, Optical Coherence*