Upside-down position leads to choroidal expansion and anterior chamber shallowing: OCT study

To determine whether dynamic changes in choroidal thickness (CT) cause shallowing of the anterior chamber.

34 healthy volunteers were enrolled. The participants in our study adopted the upside-down position for 1.5 min, which was the model we used to study the dynamic changes in CT. Intraocular pressure (IOP) elevation, optical coherence tomography images of the choroid and anterior chamber were obtained at baseline, after being in an upside-down position in an inversion machine and after 15 min of rest. The changes in IOP, anterior chamber and choroidal blood flow between the baseline and the upside-down position were compared.

Sixty-eight eyes from 34 subjects were analysed. After being in upside-down position for 1.5 min, there was a significant increase in CT from 226.39±52.44 µm to 238.34±54.84 µm (p<0.001). Choroidal flow index decreased from 0.3357±0.0251 to 0.3004±0.0190 in upside-down position, and there was a decrease in anterior chamber depth (3.21±0.22 mm to 3.13±0.21 mm, p<0.001) and angle opening distance at 500 µm from the scleral spur (0.65±0.24 mm to 0.58±0.20 mm, p=0.007). Pearson correlation analysis showed that the increase in CT was positively related with CT at baseline CT (p=0.001).

When the body position changed from sitting to upside-down position, there was choroidal thickening, anterior chamber shallowing and IOP elevation with reduced choroidal blood flow. The data provide evidence about the relationship between choroid expansion and shallowing of the anterior chamber, which may be of relevance for the pathogenesis of angle closure.