Increased Choroidal Thickness May Indicate Systemic Venous Disease

Increased choroidal thickness may share the same vascular wall pathology as dilated venous diseases, which include varicose veins, varicocele, pelvic obstruction syndrome, and hemorrhoids, according to research published in Journal Français D’Ophtalmologie.

Researchers conducted a prospective, cross-sectional assessment including 56 patients with lower extremity venous insufficiency (LEVI; mean age, 45.21 years; 43 women) and 50 age- and sex-matched control group participants (mean age, 46.04; 34 women). The team captured choroidal thickness measurements from 5 different points using optical coherence tomography (OCT) and 2 investigators blinded to LEVI status evaluated average CT values.

Participants with LEVI demonstrated increased choroidal thicknesses at all 5 points where measurements were obtained. Mean subfoveal choroidal thickness (363.04 vs 320.30 µm; P =.013) and choroidal thicknesses obtained temporally at 3 mm (265.91 vs 238.84 µm; P =.035), temporally at 1 mm (326.82 vs 294.06 µm; P =.028), nasally at 1 mm (320.93 vs 285.02 µm; P =.038), and nasally at 3 mm from the fovea (203.04 vs 177.06 µm; P =.043) were all significantly thicker in patients with LEVI compared with control group participants.

While there was no correlation between increased choroidal thickness and diameter of the great and small saphenous vein in the LEVI cohort, patients with choroidal thickness thicker than 400 um had wider great and small saphenous veins (P =.027 and P =.007, respectively).

“Varicose veins and increased CT can be part of a systemic venous disease that may result from subclinical inflammation and dilatation of vascular structures,” according to the study authors. “We suggest a clinical examination and USG evaluation in terms of systemic weakness of the vein walls, particularly LEVI, in patients with higher CT. With early diagnosis, the progression of these diseases can be slowed down.”

Study limitations include a small sample size and a failure to qualitatively assess choroidal morphology.