{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T14:25:21Z","timestamp":1777559121700,"version":"3.51.4"},"reference-count":53,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T00:00:00Z","timestamp":1707523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The use of choroidal vascularization to diagnose and follow-up ocular and systemic pathologies has been consolidated in recent research. Unfortunately, the choroidal parameters can be different depending on the lighting settings of optical coherence tomography (OCT) images. The purpose of this study was to examine whether the brightness of OCT images could influence the measurements of choroidal parameters obtained by processing and analyzing scientific images with the ImageJ program. In this observational, prospective, non-randomized study, 148 eyes of 74 patients with a mean age of 30.7 \u00b1 8.5 years (ranging from 23 to 61 years) were assessed. All patients underwent a complete ophthalmological examination including slit lamp, fundus oculi, ocular biometry, corneal tomography and spectral domain (SD) OCT evaluations of the foveal region in the enhanced depth imaging (EDI) mode. OCT images at two different brightness levels were obtained. The total choroidal area (TCA), choroidal vascularity index (CVI), stromal choroidal area (SCA) and luminal choroidal area (LCA) at both lower and higher brightness levels were measured. To avoid the bias of operator-dependent error, the lower and higher brightness TCAs were obtained using two methods: the manual tracking mode and fixed area. At the two different brightness levels, LCA, SCA and CVI measurements showed statistically significant changes (p &lt; 0.05), whereas the TCA differences were not statistically significant (p &gt; 0.05). According to the results of this study, highlighting that brightness could affect LCA, SCA and CVI parameters, care should be taken during OCT image acquisition.<\/jats:p>","DOI":"10.3390\/jcm13041020","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T03:50:27Z","timestamp":1707709827000},"page":"1020","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Impact of Brightness on Choroidal Vascularity Index"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2366-6556","authenticated-orcid":false,"given":"Nicola","family":"Rosa","sequence":"first","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4474-3020","authenticated-orcid":false,"given":"Marco","family":"Gioia","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachele","family":"Orlando","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8825-4675","authenticated-orcid":false,"given":"Martina","family":"De Luca","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"D\u2019Aniello","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-3077","authenticated-orcid":false,"given":"Isabella","family":"Fioretto","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5184-3038","authenticated-orcid":false,"given":"Ciro","family":"Sannino","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4566-0064","authenticated-orcid":false,"given":"Maddalena","family":"De Bernardo","sequence":"additional","affiliation":[{"name":"Eye Unit, Department of Medicine, Surgery, and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, via S. Allende, 84081 Baronissi, Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1364\/BOE.4.000397","article-title":"Automatic segmentation of the choroid in enhanced depth imaging optical coherence tomography images","volume":"4","author":"Tian","year":"2013","journal-title":"Biomed. Opt. Express"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"21090","DOI":"10.1038\/srep21090","article-title":"Choroidal vascularity index as a measure of vascular status of the choroid: Measurements in healthy eyes from a population-based study","volume":"6","author":"Agrawal","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.ophtha.2010.09.012","article-title":"Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration","volume":"118","author":"Chung","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/s41433-018-0158-4","article-title":"Pachychoroid disease","volume":"33","author":"Cheung","year":"2019","journal-title":"Eye"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/ICU.0b013e3282fb7c33","article-title":"Polypoidal choroidal vasculopathy and treatments","volume":"19","author":"Gomi","year":"2008","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1097\/IAE.0000000000000035","article-title":"Choroidal thickness in age-related macular degeneration","volume":"34","author":"Jonas","year":"2014","journal-title":"Retina"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1097\/IAE.0000000000001689","article-title":"Disease expression in nonexudative age-related macular degeneration varies with choroidal thickness","volume":"38","author":"Spaide","year":"2018","journal-title":"Retina"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40662-018-0118-x","article-title":"Choriocapillaris changes in dry age-related macular degeneration and geographic atrophy: A review","volume":"5","author":"Arya","year":"2018","journal-title":"Eye Vis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4999","DOI":"10.1038\/s41598-021-84650-7","article-title":"Clustering of eyes with age-related macular degeneration or pachychoroid spectrum diseases based on choroidal thickness profile","volume":"11","author":"Kim","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00417-011-1620-1","article-title":"Subfoveal choroidal thickness in typical age-related macular degeneration and polypoidal choroidal vasculopathy","volume":"249","author":"Koizumi","year":"2011","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.ajo.2009.04.029","article-title":"Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes","volume":"148","author":"Fujiwara","year":"2009","journal-title":"Am. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wang, S., Wang, Y., Gao, X., Qian, N., and Zhuo, Y. (2015). Choroidal thickness and high myopia: A cross-sectional study and meta-analysis. BMC Ophthalmol., 15.","DOI":"10.1186\/s12886-015-0059-2"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/IAE.0000000000003427","article-title":"Influence of high myopia on choriocapillaris perfusion and choroidal thickness in diabetic patients without diabetic retinopathy","volume":"42","author":"Xiong","year":"2022","journal-title":"Retina"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1080\/09273948.2019.1699579","article-title":"Subfoveal Choroidal Thickness and Its Intereye Differences in Fuchs Uveitis Syndrome Evaluated Using Optical Coherent Tomography","volume":"29","year":"2021","journal-title":"Ocul. Immunol. Inflamm."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1080\/09273948.2018.1530364","article-title":"Choroidal Vascularity Index and Choroidal Thickness in Human Leukocyte Antigen-B27-Associated Uveitis","volume":"27","author":"Kim","year":"2019","journal-title":"Ocul. Immunol. Inflamm."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1016\/j.semarthrit.2020.08.010","article-title":"Efficacy and safety of immunomodulatory drugs in patients with non-infectious intermediate and posterior uveitis, panuveitis and macular edema: A systematic literature review","volume":"50","author":"Loza","year":"2020","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1159\/000521071","article-title":"Structural and Vascular Changes of the Choroid in Polypoidal Choroidal Vasculopathy after Intravitreal Anti-VEGF Therapy","volume":"245","author":"Montorio","year":"2022","journal-title":"Ophthalmologica"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1136\/bjophthalmol-2018-312625","article-title":"Subfoveal choroidal thickness as a prognostic factor in exudative age-related macular degeneration","volume":"103","author":"Kumar","year":"2019","journal-title":"Br. J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1007\/s00417-018-04216-8","article-title":"Increased choroidal thickness: A new feature to monitor age-related macular degeneration recurrence","volume":"257","author":"Bouteleux","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.ophtha.2022.10.002","article-title":"Longitudinal Changes and Predictive Value of Choroidal Thickness for Myopia Control after Repeated Low-Level Red-Light Therapy","volume":"130","author":"Xiong","year":"2023","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/IAE.0b013e3181eef053","article-title":"Subfoveal choroidal thickness after treatment of Vogt-Koyanagi-Harada disease","volume":"31","author":"Maruko","year":"2011","journal-title":"Retina"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1007\/s00417-020-05032-9","article-title":"Changes in choroidal imaging parameters following adalimumab therapy for refractory noninfectious uveitis","volume":"259","author":"Nishisho","year":"2021","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s11325-015-1306-8","article-title":"Choroidal thickness changes in obstructive sleep apnea syndrome: A systematic review and meta-analysis","volume":"20","author":"He","year":"2016","journal-title":"Sleep Breath."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1097\/IAE.0000000000002117","article-title":"Association of obstructive sleep apnea with central serous chorioretinopathy and choroidal thickness: A Systematic Review and Meta-Analysis","volume":"38","author":"Wu","year":"2018","journal-title":"Retina"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Li, S., Lang, X., Wang, W., Yang, Y., Wang, J., Li, H., Wang, Y., and Wang, K. (2019). Choroidal vascular changes in internal carotid artery stenosis: A retrospective cohort study in Chinese population. BMC Ophthalmol., 19.","DOI":"10.1186\/s12886-019-1218-7"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1159\/000506056","article-title":"Relationship between Coronary Artery Calcification and Central Chorioretinal Thickness in Patients with Subclinical Atherosclerosis","volume":"244","author":"Kim","year":"2021","journal-title":"Ophthalmologica"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1167\/iovs.18-25764","article-title":"Choroidal Structural Changes in Smokers Measured Using Choroidal Vascularity Index","volume":"60","author":"Wei","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_28","first-page":"299","article-title":"Changes in the diabetic choroidal vasculature: Scanning electron microscopy findings","volume":"20","author":"Fryczkowski","year":"1988","journal-title":"Ann. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.ajo.2008.05.032","article-title":"Enhanced depth imaging spectral-domain optical coherence tomography","volume":"146","author":"Spaide","year":"2008","journal-title":"Am. J. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1167\/iovs.14-14933","article-title":"Choroidal thickness in geographic atrophy secondary to age-related macular degeneration","volume":"56","author":"Lindner","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1097\/IAE.0000000000000489","article-title":"Choroidal degeneration in birdshot chorioretinopathy","volume":"35","author":"Young","year":"2015","journal-title":"Retina"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3378","DOI":"10.1167\/iovs.12-11503","article-title":"Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients","volume":"54","author":"Kim","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1007\/s00417-020-04907-1","article-title":"Choroidal evaluation in patients under alpha-lytic therapy","volume":"258","author":"Altieri","year":"2020","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"16398","DOI":"10.1038\/s41598-021-95812-y","article-title":"Choroidal structural evaluation in celiac disease","volume":"11","author":"Vitiello","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2336","DOI":"10.1038\/s41433-020-0969-y","article-title":"Choroidal vascularity index as an indicator of vascular status of choroid, in eyes with nanophthalmos","volume":"34","author":"Aksoy","year":"2020","journal-title":"Eye"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.ajo.2015.03.005","article-title":"Luminal and stromal areas of choroid determined by binarization method of optical coherence tomographic images","volume":"159","author":"Sonoda","year":"2015","journal-title":"Am. J. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"18845","DOI":"10.1038\/s41598-022-23665-0","article-title":"A formula to improve the reliability of optical axial length measurement in IOL power calculation","volume":"12","author":"Cione","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1049326","DOI":"10.3389\/fendo.2023.1049326","article-title":"Acute hyperglycemia compromises the responses of choroidal vessels using swept-source optical coherence tomography during dark and light adaptations","volume":"14","author":"Lin","year":"2023","journal-title":"Front. Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.3390\/tomography9040116","article-title":"The Choroidal Vascularity Index Versus Optical Coherence Tomography Angiography in the Evaluation of the Choroid with a Focus on Age-Related Macular Degeneration","volume":"9","author":"Santia","year":"2023","journal-title":"Tomography"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Rosa, N., De Bernardo, M., Abbinante, G., Vecchio, G., Capasso, L., and Cione, F. (2022). Optic Nerve Drusen Evaluation: A Comparison between Ultrasound and OCT. J. Clin. Med., 11.","DOI":"10.3390\/jcm11133715"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E36","DOI":"10.3174\/ajnr.A6091","article-title":"Optic Nerve Evaluation in Idiopathic Intracranial Hypertension","volume":"40","author":"Vitiello","year":"2019","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.ijoa.2018.12.010","article-title":"Optic nerve ultrasonography for evaluating increased intracranial pressure in severe preeclampsia","volume":"38","author":"Vitiello","year":"2019","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_43","first-page":"16","article-title":"Ocular ultrasound evaluation of optic nerve sheath diameter in military environments","volume":"6","author":"Vitiello","year":"2019","journal-title":"Mil. Med. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1016\/j.ajem.2019.02.001","article-title":"Ultrasound and optic neuritis","volume":"37","author":"Cornetta","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1002\/jcu.1870020107","article-title":"Quantitative echography\u2014The basis of tissue differentiation","volume":"2","author":"Ossoinig","year":"1974","journal-title":"J. Clin. Ultrasound."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1167\/iovs.17-22720","article-title":"Comparison of choroidal vascularity markers on optical coherence tomography using two-image binarization techniques","volume":"59","author":"Wei","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1080\/09273948.2017.1343357","article-title":"The Choroidal Vascularity Index Decreases and Choroidal Thickness Increases in Vogt-Koyanagi-Harada Disease Patients during a Recurrent Anterior Uveitis Attack","volume":"26","author":"Liu","year":"2018","journal-title":"Ocul. Immunol. Inflamm."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s00417-016-3283-4","article-title":"Relative changes in luminal and stromal areas of choroid determined by binarization of EDI-OCT images in eyes with Vogt-Koyanagi-Harada disease after treatment","volume":"254","author":"Kawano","year":"2016","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1167\/tvst.5.4.7","article-title":"Choroidal vascularity index in Vogt-Koyanagi-Harada disease: An EDI-OCT derived tool for monitoring disease progression","volume":"5","author":"Agrawal","year":"2016","journal-title":"Trans. Vis. Sci. Technol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/09273948.2017.1332231","article-title":"Choroidal and Retinal Anatomical Responses Following Systemic Corticosteroid Therapy in Vogt-Koyanagi-Harada Disease Using Swept-Source Optical Coherence Tomography","volume":"27","author":"Jaisankar","year":"2019","journal-title":"Ocul. Immunol. Inflamm."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ajo.2019.03.028","article-title":"Choroidal Vascular Changes in Arteritic and Nonarteritic Anterior Ischemic Optic Neuropathy","volume":"205","author":"Pellegrini","year":"2019","journal-title":"Am. J. Ophthalmol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1080\/01658107.2019.1566384","article-title":"Choroidal Vascularity in Non-arteritic Anterior Ischaemic Optic Neuropathy","volume":"43","author":"Guduru","year":"2019","journal-title":"Neuroophthalmology"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1167\/iovs.63.5.22","article-title":"Author Response: Smokers\u2019 Choroidal Changes","volume":"63","author":"Wei","year":"2022","journal-title":"Investig. Ophthalmol. Vis. Sci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/4\/1020\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:58:09Z","timestamp":1760104689000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/4\/1020"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,10]]},"references-count":53,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["jcm13041020"],"URL":"https:\/\/doi.org\/10.3390\/jcm13041020","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,10]]}}}