Re: Choroidal thickness change after water drinking is greater in angle closure than in open-angle eyes

摘要

We thank De Moraes et al.1 for the opportunity to emphasize the findings of our study and how they differ from their publication.2 We reported, for the first time, the response of angle closure (AC) patients to the water-drinking test (WDT), including changes in IOP, blood pressure (BP), and choroidal thickness.3 The most important finding was that AC eyes significantly increase choroidal thickness in the WDT, whereas open angle glaucoma (OAG) eyes do not. In addition, a shallowing of the anterior chamber was observed in AC but not in OAG eyes, illustrating how thickening of the choroid can hypothetically intensify pupil block and make AC more likely. Our findings further support the concept4 that dynamic choroidal thickness change is a contributing feature to AC disease. AC eyes not only have greater choroidal expansion than other eyes, but their resting choroidal thickness is greater than that of OAG or control eyes,5 including in the anterior choroid,6 after adjusting for relevant variables like age, axial length, and IOP. The references that the letter by De Moraes et al.1 cites from Lowe7 and from Kirsch8 neither suggested nor documented with data any study of choroidal thickness, and neither mentioned choroidal participation in AC.