Peripapillary Choroidal Thickness in Healthy Controls and Patients With Focal, Diffuse, and Sclerotic Glaucomatous Optic Disc Damage

Objective: To examine peripapillary choroidal thickness in healthy controls and in patients with glaucoma who have focal, diffuse, and sclerotic optic disc damage. Methods: Healthy controls (n=92) and patients with glaucoma who have focal (n=34), diffuse (n=35), and sclerotic (n=34) optic disc damage were imaged with spectral-domain optical coherence tomography (12 circular scan protocol centered on optic nerve head). Peripapillary choroidal thickness was measured as the distance between the automatically segmented retinal pigment epithelium/Bruch's membrane and the manually outlined interface between the posterior choroid and the anterior border of the sclera in eyes in which the anterior scleral border was visible over more than 85% of the scan circumference. Results: The anterior scleral border was visible in 76 controls (83%) and 89 patients (86%). Peripapillary choroidal thickness in healthy controls decreased linearly with age (-11 mu m/decade; P < .001; r(2)=0.16), with a predicted value of 137 mu m at age 70 years (95% prediction interval, 62-212 mu m). While this value was similar in patients with focal and diffuse optic disc damage (126 and 130 mu m, respectively; P=.22 compared with controls), it was approximately 30% lower in patients with sclerotic optic disc damage (96 mu m; P<.001 compared with controls). Conclusions: The peripapillary choroid of patients with glaucoma who have sclerotic optic disc damage was approximately 25% to 30% thinner compared with that in patients with focal and diffuse optic disc damage and with that in healthy controls. The role of the choroid in the pathophysiology of sclerotic glaucomatous optic disc damage needs further investigation.