Distribution and Determinants of Choroidal Thickness and Volume Using Automated Segmentation Software in a Population-Based Study

PURPOSE: To objectively quantify choroidal thickness and choroidal volume using fully automated choroidal segmentation software applied to images obtained from enhanced depth imaging spectral-domain optical coherence tomography (EDI SD OCT) in a population-based study; and evaluate the ocular and systemic determinants of choroidal thickness and choroidal volume. DESIGN: Prospective cross-sectional study. METHODS: Participants ranging in age from 45 to 85 years were recruited from the Singapore Malay Eye Study-2 (SiMES-2), a follow-up population-based study. All participants (n = 540) underwent a detailed ophthalmic examination, including EDI SD OCT for measurements of thickness and volume of the choroid. RESULTS: The intrasession repeatability of choroidal thickness at 5 measured horizontal locations and macular choroidal volume using automated choroidal segmentation software was excellent (intraclass correlation coefficient; 0.97-0.99). Choroid was significantly thicker under the fovea (242.28 +/- 97.58 mu m), followed by 3 mm temporal (207.65 +/- 80.98 mu m), and was thinnest at 3 mm nasal (142.44 +/- 79.19 mu m) location. The mean choroidal volume. at central macular region (within a circle of 1 mm diameter) was 0.185 +/- 0.69 mm(3). Among the range of ocular and systemic factors studied, age, sex, and axial length were the only significant predictors of choroidal thickness and choroidal volume (all P < .05). CONCLUSIONS: Using a new automated choroidal segmentation software, we provide fast, reliable, and objective measurements of choroidal thickness and volume in a population-based sample. Male sex, younger age, and shorter axial length are the factors independently associated with thicker choroid and larger choroidal volume. These factors should be taken into consideration when interpreting EDI SD OCT-based choroidal thickness measurements in clinics. (C) 2015 by Elsevier Inc. All rights reserved.