Peripapillary and Subfoveal Choroidal Vascular Index in Postmenopausal Women

Abstract

Purpose: To evaluate changes in choroidal vascularity in postmenopausal women and to compare these parameters with those of healthy women of reproductive age. Materials and Methods: This prospective, observational, cross-sectional study included 51 healthy postmenopausal women and 51 healthy women of reproductive age. Choroidal images were obtained using extended depth imaging (EDI) mode on spectral-domain optical coherence tomography (SD-OCT). Using a binarization method, luminal choroidal area (LCA), stromal choroidal area (SCA), total choroidal area (TCA), and choroidal vascularity index (CVI) were calculated in both subfoveal and peripapillary regions. Age-adjusted analyses were performed using analysis of covariance (ANCOVA) and quantile regression, as appropriate. Results: The mean age was 55.4 ± 5.5 years in the postmenopausal group and 43.9 ± 2.5 years in the control group (p < 0.001). In unadjusted analyses, there were no significant differences between the groups in subfoveal LCA, SCA, TCA, subfoveal CVI, or subfoveal choroidal thickness (SFCT) (p > 0.05). Peripapillary LCA, SCA, TCA, and CVI were significantly lower in postmenopausal women compared with controls (p = 0.022, 0.012, 0.016, and 0.037, respectively). However, after adjustment for age, these peripapillary differences were no longer statistically significant. Conclusion: Postmenopausal women exhibited lower peripapillary CVI compared with premenopausal women; however, this difference was no longer present after age adjustment, indicating that the observed reduction was driven by age rather than menopausal status.