Macular and choroidal thickness in Down syndrome by swept-source optical coherence tomography (SS-OCT) | Archivos de la Sociedad Española de Oftalmología (English Edition)

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Esteban, C. Marcuello, M. Martinez, L. Lavilla, S. Marco, F.J. Ascaso" "autores" => array:6 [ 0 => array:4 [ "nombre" => "O." "apellidos" => "Esteban" "email" => array:1 [ 0 => "oliviaestebanfloria@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Marcuello" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Martinez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Lavilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 4 => array:3 [ "nombre" => "S." 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"apellidos" => "Ascaso" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Hospital San Pedro, Logroño, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Espesor macular y coroideo en el síndrome de Down mediante swept-source tomografía de coherencia óptica (SS-OCT)" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2440 "Ancho" => 1508 "Tamanyo" => 359552 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Swept-source OCT images from the right eye of a 40-year-old DS subject (above) and control (below). Thickness maps were overlapped to the EDTRS grid (6 × 6 mm) to get values for each sector from choroid." ] ] ] "textoCompleto" => "IntroductionDS is associated with certain structural and functional disorders in the whole visual system like significant refractive errors, amblyopia, strabismus, nystagmus, glaucoma, keratoconus, cataract, and retinal abnormalities.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> However, a poor visual function was also found in absence of ocular pathology and the cause of this decreased visual performance in some Down syndrome (DS) subjects cannot be attributed to individual selection, attention, or motivational factors.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>Although optical coherence tomography (OCT) offers an objective tool to evaluate retinal and choroidal structural features, very few studies have used it in DS subjects. Swept-source OCT (SS-OCT) provides better visualization, deeper penetration below retinal pigment epithelium (RPE), improves our knowledge of choroidal structures and performs automated segmentation of the choroidal boundaries. The purpose of this study was to explore retinal and choroidal thickness in DS subjects using SS-OCT.Materials and methodsA hundred eyes from 52 participants with DS were enrolled under this cross-sectional study. Control group was formed by 78 eyes from 39 subjects with age and axial length-matched with cases. All individuals were recruited between October and November 2019 based on cytogenetic analysis. Inclusion criteria included any DS subjects with a legal guardian able to give an informed consent. Exclusion criteria were retinal pathology such as macular degeneration, retinal vein occlusion or diabetic retinopathy; media opacities such as cataract or vitreous haemorrhage, which difficult eye examination. The research protocol adhered to Declaration of Helsinki and the study obtained the approbation of the local ethics committee (CEICA). An informed consent was obtained from all subjects and their parents or the legally-authorized representative. DS subjects and controls were referred between 3:00 p.m. and 6:00 p.m to minimize choroidal variation to the Department of Ophthalmology at Hospital Clínico Universitario Lozano Blesa in Zaragoza, Spain. An ophthalmological examination including: general medical history and use of prescription drugs, best corrected visual acuity (BCVA) using an ETDRS chart; refractometry examination, ocular motility, slit lamp biomicroscopy examination and intraocular pressure measurement by Goldmann applanation tonometry. OCT was performed with the SS-OCT (DRI OCT Triton, Topcon, Japan). We repeated the acquisition until high-quality images (signal strength ≥ 7) were obtained. Each participant underwent a 3D raster scan protocol with 3 µm axial resolution and a speed of 100,000 A-scans per second was performed to obtain the retinal and choroidal thickness map focused on the macula (12 × 9 mm). Thickness maps were overlapped to the EDTRS grid (6 × 6 mm) to get values for each sector. Built-in software was used to automatically calculate thickness values in the EDTRS grid; the inner and outer rings, with semidiameters of 1500 µm and 3000 µm, respectively, were segmented into four quadrants (superior, inferior, nasal, and temporal). The central sector was defined as being within 1000 µm from the foveal center. Mean thicknesses of ganglion cell layer, retina and choroid in macular region of subjects with DS were automatically acquired and compared with those in controls to assess for macular change. It included retinal foveal thickness (rFT), ganglion foveal thickness (gFT) and choroidal foveal thickness (cFT). Besides that, the inner and outer retinal ring thickness were analyzed in four quadrants using the segmentation software of the equipment. Statistical analysis data was completed using SPSS software version 19.0 (IBM-SPSS, Inc, Chicago, Illinois, USA). Qualitative differences were compared by using Pearson’s chi-squared test. A normal distribution test was conducted by a Kolmogorov–Smirnov test. As data showed a non-parametric distribution, a Mann–Whitney U test was employed to compare both groups. Spearman Rank correlation coefficient was used for evaluating bivariate correlations. A p value < 0.05 was considered statistically significant.ResultsNinety-one subjects were added in the analysis: one hundred eyes from 52 DS subjects (F/M 38.5%/61.5%, mean age of 26.2 ± 11.8 years) and seventy-eight eyes from 39 controls (F/M 25.6%/74.4% mean age of 28.1 ± 14.4 years). Age (p = 0.072, Mann–Whitney U test) and spherical equivalent (SEQ) (p = 0.167) showed no statistically significant difference between both groups however BCVA was lower in DS group than in control group (p = 0.015) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). All subjects in the DS group demonstrated identifiable macular structure, including a foveal pit. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows demographic and clinical data between both groups. The inner and outer ring thicknesses showed no significant differences between DS and control group either in ganglion cell layer or in retina (Mann–Whitney U test, all p > 0.05). Nevertheless, rFT and gFT were significantly higher in DS subjects than in controls (p < 0.05). Regarding choroidal layer, cFT and choroidal thickness in temporal and inferior quadrants (inner and outer retinal rings) were significantly lower in DS subjects than in age and axial lenght-matched control group (Mann–Whitney U test, all p < 0.05) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). BCVA in the DS group showed no correlation with retinal or choroidal thickness (p > 0.05) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>We found thicker rFT in DS group (p < 0.05) which is a consistent finding with the data obtained in other studies with DS children<a class="elsevierStyleCrossRefs" href="#bib0015">3,4</a> and DS adults<a class="elsevierStyleCrossRef" href="#bib0025">5</a> related to a different macular development without differences in inner or outer rings around fovea.It has been suggested that peripapillary RNFL thickness is a biomarker of axonal loss, which would reflect central nervous system axonal loss. Whereas measurement of RNFL thickness reflects axons and would allow quantification of axonal loss, measurement of macular thickness would reflect neuronal cell bodies, allowing quantification of neuronal loss. This is because the macular region contains mostly ganglion cell bodies, as the nerve fibers are around the macula to avoid obscuring the most sensitive area for vision. Therefore, macular thickness measurement may be a noninvasive way to assess whether neuronal degeneration is occurring in addition to axonal loss.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> We decided to study ganglion cell layer in macular area by SS-OCT. Our results show thicker gFT in DS group than in controls. Walpert et al. found similar results in ganglion cell layer in DS (N = 49) population.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> These researchers, unlike to their hypothesis, also found increased thickness in global RNFL and RNFL (temporal, superior and inferior) quadrants in DS group compared with age-matched controls (n = 36) (p < 0.01). However, they pointed out that these findings were not present in a small group of DS participants in their 50 s. Recently, Ugurlu et al. also has found thicker RNFL quadrants in children compared with controls.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> These results are consistent with our gFT findings because of only two DS subjects were more than 50 s. This fact suggests the hypothesis of thicker RNFL in the 40 s and thinner RNFL when cerebral beta-amyloid protein (AßP) appear in the 50 s in DS subjects. The AßP gene is inheritd in triplicate in DS subjects. Overproduction of AßP generate brain’s senile plaques. They are observed in about 100% of DS individuals over the age of 40 years. These plaques are also seen in mild cognitive impairment (MCI) before dementia and in dementia like Alzheimer’s disease (AD).A vascular role in cognitive impairment or dementia has also been recognised. Cerebral amyloid angiopathy (CAA) is a factor of vascular dysfunction in AD. Head et al. studied the presence of CAA in biopsies of AD, DS and controls. They found an increased probability of severe CAA in DS than in the rest of groups.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> In this sense, a study has recently found choroidal thinning in a sample of AD and MCI in comparaison with age-matched controls.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> They related these findings with the role of cerebreal vascular involvement in the pathogenesis of the disease. These authors also conclude that choroidal thickness is correlated with cognitive impairment and could be a new biomarker for early diagnosis of MCI. Other authors afirm that choroidal thinning in AD may be associated with hypoperfusion of choroid and could be related to those observed in AD brain.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> Even, it has been hypothesized that choroidal thinning could depend on AßP toxicity which matchs with the mecanism of choroidal damage in age-related macular degeneraion (AMD) where accumulation of AßP has been also found.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> In contrast with other studies which analyzes choroidal thickness by SD-OCT in DS children,<a class="elsevierStyleCrossRef" href="#bib0020">4</a> we found thinner cFT and thinner choroid in temporal and inferior quadrants (inner and outer retinal rings around fovea) by SS-OCT than in aged and axial length match controls (p < 0.05). We suggest that our population is older compared with these studies with children and it may be consistent with the hypothesis of vascular role. Studies with larger adult DS groups that include choridal thickness by SS-OCT would be needed to validate the findings seen in this study.It is prudent to analyze the limitations of measuring choroidal thickness. Some ocular and systemic factors are believed to affect it. Exclusion criteria avoid main ocular disorders. Prescribed drugs and systemic diseases which could influcence were dicarded by medical history. However, participants were not fully controlled for smoking or caffeine. Blood pressure as another confounding factor was not specifically ruled out either.This is the first cross-sectional study with larger number of DS participants that evaluate choroidal features by Swept Source-OCT compared with age and axial length matched control group. We hypothesize a possible vascular role in DS visual system. The choroid is one of the most vascularized tissues of the body and provides oxygen and nutrition to the external retinal tissue. Thinning of choroidal tissue in DS individuals may be related to hypoperfusion and changes in retina and neuronal evolution, along with the thinning associated with premature aging. It is possible that greater severity in DS may cause greater choroidal thinning. Nevertheless, further studies should analyze the progression and correlation between ocular features and age-associated development in DS people. Changes in SS-OCT parameters observed in DS group may be a useful tool to understand the unexplained worst visual function observed in some DS patients in absence of ocular pathology.Compliance with ethical standardsEthical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.The study obtained the approbation of the local ethics committee in Aragon (Spain): Research Ethics Committee of the Autonomous Community of Aragon (Comité de Ética de la Investigación de la Comunidad Autónoma de Aragón: CEICA). Reference number of the study: PI16/00030An informed consent was obtained from all subjects and their parents or the legally-authorized representative.FundingAny of the authors received any grant or fund for this study.This study wasn’t performed any grant or fund in support.This paper wasn’t presented at any national or international meeting.Conflict of interestsThe authors declare that they have no conflict of interests.AcknowledgementsThanks to all the people who have participated in the elaboration of this work and to their families for their willingness to collaborate." 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The purpose was to compare retinal and choroidal thickness using swept-source optical coherence tomography (SS-OCT) in DS subjects with controls. This cross-sectional study included 100 eyes of 52 DS subjects and 78 eyes of 39 matching age and axial length controls. Our results showed that inner or outer retinal and ganglionar thickness showed no significant differences between DS and control group (p > 0.05). However, retinal foveal thickness (rFT), ganglion foveal thickness (gFT) were significantly higher in DS group than in controls, whereas choroidal foveal thickness (cFT) and some choroidal quadrants of inner and outer rings were significantly lower (p < 0.05). This the first pilot study to provide information about macular and choroidal thicknesses in SD using SS-OCT compared to controls. Further analyses with larger numbers of subjects are needed to confirm our results." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "El síndrome de Down (SD) se asocia a diversos trastornos estructurales y funcionales en la totalidad del sistema visual. El propósito del estudio fue comparar el grosor retiniano y coroideo utilizando tomografía de coherencia óptica swept-source (SS-OCT) en sujetos con SD y controles. Este estudio transversal incluye 100 ojos de 52 sujetos SD y 78 ojos de 39 controles de edad y longitud axial concordantes. Los resultados mostraron que el grosor retiniano interno o externo y el grosor ganglionar no presentaron diferencias significativas entre los sujetos con SD y el grupo de control (p > 0,05). Sin embargo, el grosor retiniano foveal (rFT) y el grosor ganglionar foveal (gFT) fueron significativamente superiores en el grupo SD que en los controles, mientras que el grosor foveal coroideo (cFT) y algunos cuadrantes coroideos de los anillos interno y externo fueron significativamente inferiores (p < 0,05). Este es el primer estudio piloto que proporciona información sobre los grosores macular y coroideo en SD utilizando SS-OCT comparado con controles. Es necesario realizar análisis adicionales con grupos mayores de sujetos para confirmar estos resultados." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Esteban O, Marcuello C, Martinez M, Lavilla L, Marco S, Ascaso FJ. Espesor macular y coroideo en el síndrome de Down mediante swept-source tomografía de coherencia óptica (SS-OCT). Arch Soc Esp Oftalmol. 2021;96:618–622." ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2440 "Ancho" => 1508 "Tamanyo" => 359552 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Swept-source OCT images from the right eye of a 40-year-old DS subject (above) and control (below). Thickness maps were overlapped to the EDTRS grid (6 × 6 mm) to get values for each sector from choroid." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Abbreviations. BCVA (Best Corrected Visual Acuity). Spherical equivalent (SE). Retinal foveal thickness (rFT). Choroidal foveal thickness (cFT). Ganglion foveal thickness (gFT)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Down syndrome group \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Control group \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Value of p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">(N = 52) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">(N = 39) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.2 ± 11.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.8 ± 14.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.072 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(15–47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(16–57) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BCVA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.49 ±  0.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 ± 0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.015 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(0.2 D 0.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(1.0 D 1.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean SEQ (dioptres) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">D1.16 ± 4.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">D0.81 ± 1.77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.167 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(D11.00 to +1.25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(D9.50 to +1.00) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Retina \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">rFT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">253.9 ± 28.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">229.4 ± 28.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inner layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">288.8 ± 33.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">293.2 ± 28.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.846 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">302.7 ± 37.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">312.8 ± 15.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.429 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">300.6 ± 38.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">308.8 ± 22.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.341 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">301.1 ± 37.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">310.2 ± 20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.336 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Outer layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">264.6 ± 29.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">261 ± 16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.182 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">281.8 ± 29.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">275.9 ± 25.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.063 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">291.9 ± 32.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">294.7 ± 15.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.710 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">271.2 ± 27.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">267.6 ± 18.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.182 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Choroids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">cFT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">287.1 ± 112.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">311.9 ± 78.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inner layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">286.4 ± 104 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">310 ± 73 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.012 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">288.9 ± 106.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">313.7 ± 75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.072 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">270 ± 108 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">288.4 ± 75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.173 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">279.4 ± 100.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">305.5 ± 79.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.021 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Outer layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">278.7 ± 90.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">298.8 ± 70.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.018 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">292.3 ± 99.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">307.4 ± 76.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.297 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">226.3 ± 99.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">236.3 ± 76.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.444 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">267.8 ± 101.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">286.7 ± 69.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.040 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ganglion cell layers \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">gFT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.7 ± 17.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.9 ± 11.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inner layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.2 ± 15.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.1 ± 12.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.062 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.7 ± 18.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.7 ± 12.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.828 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.1 ± 19.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.2 ± 14.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.678 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.9 ± 17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.3 ± 12.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.131 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Outer layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.5 ± 13.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24.9 ± 10.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.243 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.2 ± 15.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.9 ± 10.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.782 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.6 ± 15.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49.1 ± 14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.966 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2733463.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Demographic and clinical data: mean retinal, choroidal and ganglion thickness (μm) and in sections." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Abbreviations. *Spearman’s rank correlation coefficient (rho); retinal foveal thickness (rFT); choroidal foveal thickness (cFT)." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Rho* \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">rFT retinal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.006 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.961 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inner layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.205 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.730 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.267 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.060 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.213 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.064 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.240 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.076 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Outer layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.131 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.255 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.432 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.098 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.350 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.089 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.135 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.240 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">cFT choroidal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.887 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inner layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.984 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.999 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.549 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.515 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Outer layer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Temporal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.010 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.930 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.011 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.926 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.138 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.231 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">@0.022 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.849 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2733464.png" ] ] ] ] "descripcion" => array:1 [ "en" => "BCVA and correlation of retinal and choroidal cell layer thicknesses (μm) in sections for the Down syndrome group." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular findings in Down’s syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.P. Da Cunha" 1 => "J.B. Moreira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0002-9394(14)72015-x" "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "1996" "volumen" => "122" "paginaInicial" => "236" "paginaFinal" => "244" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8694092" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Visual acuity in infants and children with Down syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.L. Courage" 1 => "R.J. Adams" 2 => "S. Reyno" 3 => "P.G. Kwa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1469-8749.1994.tb11895.x" "Revista" => array:6 [ "tituloSerie" => "Dev Med Child Neurol" "fecha" => "1994" "volumen" => "36" "paginaInicial" => "586" "paginaFinal" => "593" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8034120" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Macular structural characteristics in children with Down syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. O’Brien" 1 => "J. Wang" 2 => "H.A. Smith" 3 => "D.L. Donaldson" 4 => "K.M. Haider" 5 => "G.J. 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Altinkurt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "J Ophthalmol" "fecha" => "2020" "volumen" => "2020" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Age-related retinal thickness in Down’s syndrome: a high-risk population for dementia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.J. Walpert" 1 => "E.M. Normando" 2 => "T. Annus" 3 => "S.R. Jennings" 4 => "L.R. Wilson" 5 => "P. 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Macular and choroidal thickness in Down syndrome by swept-source optical coherence tomography (SS-OCT)

Espesor macular y coroideo en el síndrome de Down mediante swept-source tomografía de coherencia óptica (SS-OCT)

O. Estebana,b,

Corresponding author

oliviaestebanfloria@hotmail.com

Corresponding author.

, C. Marcuelloc, M. Martinezd, L. Lavillae, S. Marcoa, F.J. Ascasoa,b

a Departamento de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain

b Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain

c Departamento de Psicología y Sociología, Universidad de Zaragoza, Zaragoza, Spain

d Hospital San Pedro, Logroño, Spain

e Hospital Universitario Miguel Servet, Zaragoza, Spain

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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Swept-source OCT images from the right eye of a 40-year-old DS subject &#40;above&#41; and control &#40;below&#41;&#46; Thickness maps were overlapped to the EDTRS grid &#40;6&#160;&#215;&#160;6&#160;mm&#41; to get values for each sector from choroid&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">DS is associated with certain structural and functional disorders in the whole visual system like significant refractive errors&#44; amblyopia&#44; strabismus&#44; nystagmus&#44; glaucoma&#44; keratoconus&#44; cataract&#44; and retinal abnormalities&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However&#44; a poor visual function was also found in absence of ocular pathology and the cause of this decreased visual performance in some Down syndrome &#40;DS&#41; subjects cannot be attributed to individual selection&#44; attention&#44; or motivational factors&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Although optical coherence tomography &#40;OCT&#41; offers an objective tool to evaluate retinal and choroidal structural features&#44; very few studies have used it in DS subjects&#46; Swept-source OCT &#40;SS-OCT&#41; provides better visualization&#44; deeper penetration below retinal pigment epithelium &#40;RPE&#41;&#44; improves our knowledge of choroidal structures and performs automated segmentation of the choroidal boundaries&#46; The purpose of this study was to explore retinal and choroidal thickness in DS subjects using SS-OCT&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Materials and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">A hundred eyes from 52 participants with DS were enrolled under this cross-sectional study&#46; Control group was formed by 78 eyes from 39 subjects with age and axial length-matched with cases&#46; All individuals were recruited between October and November 2019 based on cytogenetic analysis&#46; Inclusion criteria included any DS subjects with a legal guardian able to give an informed consent&#46; Exclusion criteria were retinal pathology such as macular degeneration&#44; retinal vein occlusion or diabetic retinopathy&#59; media opacities such as cataract or vitreous haemorrhage&#44; which difficult eye examination&#46; The research protocol adhered to Declaration of Helsinki and the study obtained the approbation of the local ethics committee &#40;CEICA&#41;&#46; An informed consent was obtained from all subjects and their parents or the legally-authorized representative&#46; DS subjects and controls were referred between 3&#58;00 p&#46;m&#46; and 6&#58;00 p&#46;m to minimize choroidal variation to the Department of Ophthalmology at Hospital Cl&#237;nico Universitario Lozano Blesa in Zaragoza&#44; Spain&#46; An ophthalmological examination including&#58; general medical history and use of prescription drugs&#44; best corrected visual acuity &#40;BCVA&#41; using an ETDRS chart&#59; refractometry examination&#44; ocular motility&#44; slit lamp biomicroscopy examination and intraocular pressure measurement by Goldmann applanation tonometry&#46; OCT was performed with the SS-OCT &#40;DRI OCT Triton&#44; Topcon&#44; Japan&#41;&#46; We repeated the acquisition until high-quality images &#40;signal strength&#160;&#8805;&#160;7&#41; were obtained&#46; Each participant underwent a 3D raster scan protocol with 3&#160;&#181;m axial resolution and a speed of 100&#44;000 A-scans per second was performed to obtain the retinal and choroidal thickness map focused on the macula &#40;12&#160;&#215;&#160;9&#160;mm&#41;&#46; Thickness maps were overlapped to the EDTRS grid &#40;6&#160;&#215;&#160;6&#160;mm&#41; to get values for each sector&#46; Built-in software was used to automatically calculate thickness values in the EDTRS grid&#59; the inner and outer rings&#44; with semidiameters of 1500&#160;&#181;m and 3000&#160;&#181;m&#44; respectively&#44; were segmented into four quadrants &#40;superior&#44; inferior&#44; nasal&#44; and temporal&#41;&#46; The central sector was defined as being within 1000&#160;&#181;m from the foveal center&#46; Mean thicknesses of ganglion cell layer&#44; retina and choroid in macular region of subjects with DS were automatically acquired and compared with those in controls to assess for macular change&#46; It included retinal foveal thickness &#40;rFT&#41;&#44; ganglion foveal thickness &#40;gFT&#41; and choroidal foveal thickness &#40;cFT&#41;&#46; Besides that&#44; the inner and outer retinal ring thickness were analyzed in four quadrants using the segmentation software of the equipment&#46; Statistical analysis data was completed using SPSS software version 19&#46;0 &#40;IBM-SPSS&#44; Inc&#44; Chicago&#44; Illinois&#44; USA&#41;&#46; Qualitative differences were compared by using Pearson&#8217;s chi-squared test&#46; A normal distribution test was conducted by a Kolmogorov&#8211;Smirnov test&#46; As data showed a non-parametric distribution&#44; a Mann&#8211;Whitney U test was employed to compare both groups&#46; Spearman Rank correlation coefficient was used for evaluating bivariate correlations&#46; A p value&#160;&#60;&#160;0&#46;05 was considered statistically significant&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0020" class="elsevierStylePara elsevierViewall">Ninety-one subjects were added in the analysis&#58; one hundred eyes from 52 DS subjects &#40;F&#47;M 38&#46;5&#37;&#47;61&#46;5&#37;&#44; mean age of 26&#46;2&#160;&#177;&#160;11&#46;8 years&#41; and seventy-eight eyes from 39 controls &#40;F&#47;M 25&#46;6&#37;&#47;74&#46;4&#37; mean age of 28&#46;1&#160;&#177;&#160;14&#46;4 years&#41;&#46; Age &#40;p&#160;&#61;&#160;0&#46;072&#44; Mann&#8211;Whitney U test&#41; and spherical equivalent &#40;SEQ&#41; &#40;p&#160;&#61;&#160;0&#46;167&#41; showed no statistically significant difference between both groups however BCVA was lower in DS group than in control group &#40;p&#160;&#61;&#160;0&#46;015&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; All subjects in the DS group demonstrated identifiable macular structure&#44; including a foveal pit&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows demographic and clinical data between both groups&#46; The inner and outer ring thicknesses showed no significant differences between DS and control group either in ganglion cell layer or in retina &#40;Mann&#8211;Whitney U test&#44; all p&#160;&#62;&#160;0&#46;05&#41;&#46; Nevertheless&#44; rFT and gFT were significantly higher in DS subjects than in controls &#40;p&#160;&#60;&#160;0&#46;05&#41;&#46; Regarding choroidal layer&#44; cFT and choroidal thickness in temporal and inferior quadrants &#40;inner and outer retinal rings&#41; were significantly lower in DS subjects than in age and axial lenght-matched control group &#40;Mann&#8211;Whitney U test&#44; all p&#160;&#60;&#160;0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; BCVA in the DS group showed no correlation with retinal or choroidal thickness &#40;p&#160;&#62;&#160;0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">We found thicker rFT in DS group &#40;p&#160;&#60;&#160;0&#46;05&#41; which is a consistent finding with the data obtained in other studies with DS children<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> and DS adults<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> related to a different macular development without differences in inner or outer rings around fovea&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">It has been suggested that peripapillary RNFL thickness is a biomarker of axonal loss&#44; which would reflect central nervous system axonal loss&#46; Whereas measurement of RNFL thickness reflects axons and would allow quantification of axonal loss&#44; measurement of macular thickness would reflect neuronal cell bodies&#44; allowing quantification of neuronal loss&#46; This is because the macular region contains mostly ganglion cell bodies&#44; as the nerve fibers are around the macula to avoid obscuring the most sensitive area for vision&#46; Therefore&#44; macular thickness measurement may be a noninvasive way to assess whether neuronal degeneration is occurring in addition to axonal loss&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> We decided to study ganglion cell layer in macular area by SS-OCT&#46; Our results show thicker gFT in DS group than in controls&#46; Walpert et al&#46; found similar results in ganglion cell layer in DS &#40;N&#160;&#61;&#160;49&#41; population&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> These researchers&#44; unlike to their hypothesis&#44; also found increased thickness in global RNFL and RNFL &#40;temporal&#44; superior and inferior&#41; quadrants in DS group compared with age-matched controls &#40;n&#160;&#61;&#160;36&#41; &#40;p&#160;&#60;&#160;0&#46;01&#41;&#46; However&#44; they pointed out that these findings were not present in a small group of DS participants in their 50&#160;s&#46; Recently&#44; Ugurlu et al&#46; also has found thicker RNFL quadrants in children compared with controls&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> These results are consistent with our gFT findings because of only two DS subjects were more than 50&#160;s&#46; This fact suggests the hypothesis of thicker RNFL in the 40&#160;s and thinner RNFL when cerebral beta-amyloid protein &#40;A&#223;P&#41; appear in the 50&#160;s in DS subjects&#46; The A&#223;P gene is inheritd in triplicate in DS subjects&#46; Overproduction of A&#223;P generate brain&#8217;s senile plaques&#46; They are observed in about 100&#37; of DS individuals over the age of 40 years&#46; These plaques are also seen in mild cognitive impairment &#40;MCI&#41; before dementia and in dementia like Alzheimer&#8217;s disease &#40;AD&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">A vascular role in cognitive impairment or dementia has also been recognised&#46; Cerebral amyloid angiopathy &#40;CAA&#41; is a factor of vascular dysfunction in AD&#46; Head et al&#46; studied the presence of CAA in biopsies of AD&#44; DS and controls&#46; They found an increased probability of severe CAA in DS than in the rest of groups&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In this sense&#44; a study has recently found choroidal thinning in a sample of AD and MCI in comparaison with age-matched controls&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> They related these findings with the role of cerebreal vascular involvement in the pathogenesis of the disease&#46; These authors also conclude that choroidal thickness is correlated with cognitive impairment and could be a new biomarker for early diagnosis of MCI&#46; Other authors afirm that choroidal thinning in AD may be associated with hypoperfusion of choroid and could be related to those observed in AD brain&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Even&#44; it has been hypothesized that choroidal thinning could depend on A&#223;P toxicity which matchs with the mecanism of choroidal damage in age-related macular degeneraion &#40;AMD&#41; where accumulation of A&#223;P has been also found&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> In contrast with other studies which analyzes choroidal thickness by SD-OCT in DS children&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> we found thinner cFT and thinner choroid in temporal and inferior quadrants &#40;inner and outer retinal rings around fovea&#41; by SS-OCT than in aged and axial length match controls &#40;p&#160;&#60;&#160;0&#46;05&#41;&#46; We suggest that our population is older compared with these studies with children and it may be consistent with the hypothesis of vascular role&#46; Studies with larger adult DS groups that include choridal thickness by SS-OCT would be needed to validate the findings seen in this study&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">It is prudent to analyze the limitations of measuring choroidal thickness&#46; Some ocular and systemic factors are believed to affect it&#46; Exclusion criteria avoid main ocular disorders&#46; Prescribed drugs and systemic diseases which could influcence were dicarded by medical history&#46; However&#44; participants were not fully controlled for smoking or caffeine&#46; Blood pressure as another confounding factor was not specifically ruled out either&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">This is the first cross-sectional study with larger number of DS participants that evaluate choroidal features by Swept Source-OCT compared with age and axial length matched control group&#46; We hypothesize a possible vascular role in DS visual system&#46; The choroid is one of the most vascularized tissues of the body and provides oxygen and nutrition to the external retinal tissue&#46; Thinning of choroidal tissue in DS individuals may be related to hypoperfusion and changes in retina and neuronal evolution&#44; along with the thinning associated with premature aging&#46; It is possible that greater severity in DS may cause greater choroidal thinning&#46; Nevertheless&#44; further studies should analyze the progression and correlation between ocular features and age-associated development in DS people&#46; Changes in SS-OCT parameters observed in DS group may be a useful tool to understand the unexplained worst visual function observed in some DS patients in absence of ocular pathology&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Compliance with ethical standards</span><p id="par0050" class="elsevierStylePara elsevierViewall">Ethical approval&#58; All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and&#47;or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The study obtained the approbation of the local ethics committee in Aragon &#40;Spain&#41;&#58; <span class="elsevierStyleItalic">Research Ethics Committee of the Autonomous Community of Aragon</span> &#40;Comit&#233; de &#201;tica de la Investigaci&#243;n de la Comunidad Aut&#243;noma de Arag&#243;n&#58; CEICA&#41;&#46; Reference number of the study&#58; PI16&#47;00030</p><p id="par0060" class="elsevierStylePara elsevierViewall">An informed consent was obtained from all subjects and their parents or the legally-authorized representative&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Funding</span><p id="par0065" class="elsevierStylePara elsevierViewall">Any of the authors received any grant or fund for this study&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">This study wasn&#8217;t performed any grant or fund in support&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">This paper wasn&#8217;t presented at any national or international meeting&#46;</p></span><span id="sec0021" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0041">Conflict of interests</span><p id="par0061" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interests&#46;</p></span><span id="sec0022" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0042">Acknowledgements</span><p id="par0062" class="elsevierStylePara elsevierViewall">Thanks to all the people who have participated in the elaboration of this work and to their families for their willingness to collaborate&#46;</p></span></span>"
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            0 => "Grosor macular"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Down syndrome &#40;DS&#41; is associated with certain structural and functional disorders in the whole visual system&#46; The purpose was to compare retinal and choroidal thickness using swept-source optical coherence tomography &#40;SS-OCT&#41; in DS subjects with controls&#46; This cross-sectional study included 100 eyes of 52 DS subjects and 78 eyes of 39 matching age and axial length controls&#46; Our results showed that inner or outer retinal and ganglionar thickness showed no significant differences between DS and control group &#40;p&#160;&#62;&#160;0&#46;05&#41;&#46; However&#44; retinal foveal thickness &#40;rFT&#41;&#44; ganglion foveal thickness &#40;gFT&#41; were significantly higher in DS group than in controls&#44; whereas choroidal foveal thickness &#40;cFT&#41; and some choroidal quadrants of inner and outer rings were significantly lower &#40;p&#160;&#60;&#160;0&#46;05&#41;&#46; This the first pilot study to provide information about macular and choroidal thicknesses in SD using SS-OCT compared to controls&#46; Further analyses with larger numbers of subjects are needed to confirm our results&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El s&#237;ndrome de Down &#40;SD&#41; se asocia a diversos trastornos estructurales y funcionales en la totalidad del sistema visual&#46; El prop&#243;sito del estudio fue comparar el grosor retiniano y coroideo utilizando tomograf&#237;a de coherencia &#243;ptica <span class="elsevierStyleItalic">swept-source</span> &#40;SS-OCT&#41; en sujetos con SD y controles&#46; Este estudio transversal incluye 100 ojos de 52 sujetos SD y 78 ojos de 39 controles de edad y longitud axial concordantes&#46; Los resultados mostraron que el grosor retiniano interno o externo y el grosor ganglionar no presentaron diferencias significativas entre los sujetos con SD y el grupo de control &#40;p&#160;&#62;&#160;0&#44;05&#41;&#46; Sin embargo&#44; el grosor retiniano foveal &#40;rFT&#41; y el grosor ganglionar foveal &#40;gFT&#41; fueron significativamente superiores en el grupo SD que en los controles&#44; mientras que el grosor foveal coroideo &#40;cFT&#41; y algunos cuadrantes coroideos de los anillos interno y externo fueron significativamente inferiores &#40;p&#160;&#60;&#160;0&#44;05&#41;&#46; Este es el primer estudio piloto que proporciona informaci&#243;n sobre los grosores macular y coroideo en SD utilizando SS-OCT comparado con controles&#46; Es necesario realizar an&#225;lisis adicionales con grupos mayores de sujetos para confirmar estos resultados&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Esteban O&#44; Marcuello C&#44; Martinez M&#44; Lavilla L&#44; Marco S&#44; Ascaso FJ&#46; Espesor macular y coroideo en el s&#237;ndrome de Down mediante <span class="elsevierStyleItalic">swept-source</span> tomograf&#237;a de coherencia &#243;ptica &#40;SS-OCT&#41;&#46; Arch Soc Esp Oftalmol&#46; 2021&#59;96&#58;618&#8211;622&#46;</p>"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#46; BCVA &#40;<span class="elsevierStyleItalic">Best Corrected Visual Acuity</span>&#41;&#46; <span class="elsevierStyleItalic">Spherical equivalent</span> &#40;<span class="elsevierStyleItalic">SE</span>&#41;&#46; Retinal foveal thickness &#40;rFT&#41;&#46; Choroidal foveal thickness &#40;cFT&#41;&#46; Ganglion foveal thickness &#40;gFT&#41;&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Age &#40;years&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;15&#8211;47&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;16&#8211;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">BCVA</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#46;2 D 0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;1&#46;0 D 1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Mean SEQ &#40;dioptres&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">D1&#46;16&#160;&#177;&#160;4&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">D0&#46;81&#160;&#177;&#160;1&#46;77&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;D11&#46;00 to &#43;1&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;D9&#46;50 to &#43;1&#46;00&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Retina</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">rFT</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">253&#46;9&#160;&#177;&#160;28&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">229&#46;4&#160;&#177;&#160;28&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Inner layer</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Temporal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">288&#46;8&#160;&#177;&#160;33&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Superior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">302&#46;7&#160;&#177;&#160;37&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">312&#46;8&#160;&#177;&#160;15&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nasal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">300&#46;6&#160;&#177;&#160;38&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">308&#46;8&#160;&#177;&#160;22&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;341&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">301&#46;1&#160;&#177;&#160;37&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">310&#46;2&#160;&#177;&#160;20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;336&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Outer layer</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Temporal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">264&#46;6&#160;&#177;&#160;29&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">261&#160;&#177;&#160;16&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;182&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Superior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">281&#46;8&#160;&#177;&#160;29&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">275&#46;9&#160;&#177;&#160;25&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;063&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nasal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">291&#46;9&#160;&#177;&#160;32&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">279&#46;4&#160;&#177;&#160;100&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Temporal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">278&#46;7&#160;&#177;&#160;90&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">298&#46;8&#160;&#177;&#160;70&#46;4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">292&#46;3&#160;&#177;&#160;99&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nasal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">226&#46;3&#160;&#177;&#160;99&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">236&#46;3&#160;&#177;&#160;76&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Inferior&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">267&#46;8&#160;&#177;&#160;101&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">286&#46;7&#160;&#177;&#160;69&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Ganglion cell layers</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>gFT</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15&#46;7&#160;&#177;&#160;17&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#46;9&#160;&#177;&#160;11&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic"><span class="elsevierStyleHsp" style=""></span>Inner layer</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Temporal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&#46;2&#160;&#177;&#160;15&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  """
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