The effect of menopause on choroidal thickness and vascularity index.

Objective: Our study aimed to compare premenopausal and postmenopausal women in terms of choroidal thickness and choroidal vascularity index.

Methods: This cross-sectional study included 96 eyes of 96 participants, comprising 48 premenopausal and 48 postmenopausal women. Enhanced depth image optical coherence tomography (EDI-OCT) was used to visualize the choroid. Choroidal thickness measurements were performed at three points, including the subfoveal region (subfoveal choroidal thickness [SFCT]), 1500 μm nasal to the fovea (nasal choroidal thickness [NCT]), and 1500 μm temporal to the fovea (temporal choroidal thickness [TCT]) from EDI-OCT images. The choroidal vascularity index (CVI), total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured in the subfoveal 3000 μm area by the binarization technique via ImageJ software. Measurements of premenopausal and postmenopausal women were compared after adjusting for age.

Results: The comparison of axial length, spherical equivalent, and body mass index values revealed no significant differences (P>0.05 for all). SCFT, NCT, TCT, LA, and TCA values were statistically significantly lower after adjusting for age in the postmenopausal group compared with the premenopausal group (P=0.002, 0.020, 0.004, 0.020, 0.043) respectively. There was no statistically significant difference in SA and CVI values (P>0.05 for all).

Conclusion: The decreased choroidal thickness in postmenopausal women likely resulted from the reduction in the vascular component of the choroid, while the stromal component remained unchanged. Further prospective long-term studies are needed to evaluate women before and during menopause to investigate the relationship between choroidal vascular structure and the risk of ischemic vascular diseases.