The choroid in glaucoma

PURPOSE OF REVIEW: Prior studies have not conclusively established a relationship between the choroid and glaucoma. The development of an enhanced imaging technique for spectral domain optical coherence tomography (SD-OCT) has allowed for measurements of choroidal thickness that are more accurate than previously possible. Therefore, the SD-OCT may be capable of documenting the changes in the choroid as they relate to glaucoma. RECENT FINDINGS: When applied to the SD-OCT, the technique of enhanced depth imaging allows for reproducible measurements of choroidal thickness. Nine reports have been published about choroidal thickness within the macula, as measured by OCT, in eyes with glaucoma. In six publications, there was no significant difference between the macular choroidal thicknesses of patients with glaucoma compared with those without glaucoma. Additional five studies have reported on peripapillary choroidal thickness in glaucoma patients. Although three of the studies determined that the peripapillary choroid is thinner in glaucoma patients, two others failed to establish this relationship. SUMMARY: The SD-OCT is capable of reproducibly measuring choroidal thickness in the peripapillary and macular areas. In those with glaucoma, choroidal thickness does not change within the macula. In a few subsets of glaucoma, the peripapillary choroid is thinner when compared with normals.