Comparison of Choroidal Thicknesses in Patients with Coronary Artery Disease and Patients at Risk of Coronary Artery Disease

Purpose: The study aimed to compare choroidal thicknesses (CTh) in patients with coronary artery disease (CAD) and patients at risk of coronary artery disease and investigate whether thinning of the choroid can be used as a biomarker for development of coronary artery disease in patients at risk.

Materials and methods: The study group was composed of 103 eyes of 53 patients with coronary artery disease, and the control group was composed of 62 eyes of 32 patients with diabetes mellitus, hypertension and/or hyperlipidemia without coronary artery disease. CAD was diagnosed in patients with one of the following: myocardial infarction with/without ST segment elevation, clinically proven history of cardiac catheterization testifying greater than 50% obstruction in at least one coronary artery, revascularization operations. The control group consisted of clinically proven patients with normal coronary arteries. The choroidal thickness was measured with enhanced depth imaging optical coherence tomography under the fovea and at six other points, located at 500 micron, 1000 micron and 1500 micron nasal to the fovea and 500 micron, 1000 micron, 1500 micron temporal to the fovea.

Results: The subfoveal choroidal thickness was significantly thinner in the coronary artery disease group compared to the control group (244 µm vs. 289 µm; p < 0,001). In all other measured regions (nasal 500, nasal 1000, nasal 1500, temporal 500, temporal 1000, and temporal 1500 micron), CTh was statistically significant thinner in the CAD group. A negative significant linear relationship (low level) between CAD duration and choroidal thickness in the subfoveal, nasal 1000, nasal 1500, temporal 500, temporal 1000 micron regions was detected.

Conclusion: Patients with CAD have a decreased choroidal thickness compared to patients at risk of CAD. Detection of CTh thinning in a patient with diseases, such as diabetes, hypertension and/or hypercholesterolemia, which pose a risk for CAD may be a predictor of development of coronary artery disease.