We would like to thank Drs Uzun and Pehlivan for their letter and interest in our study.
Referring to their first comment, we did not consider the menstrual cycle of the female participants. All female participants, as far as they knew, were not pregnant. We acknowledge that according to the study by Ulaş and associates on 23 patients, the subfoveal choroidal thickness may potentially be associated with the menstrual cycle. In view of the relatively low magnitude of the observed changes in subfoveal choroidal thickness, we believe, however, that this potential flaw in the design of our study may not have markedly influenced the results and conclusions of our study.
Referring to the second and fourth comments made by Drs Uzun and Pehlivan, population-based studies have suggested that subfoveal choroidal thickness was not significantly correlated with blood pressure and arterial hypertension, cigarette smoking and alcohol consumption, serum concentrations of lipids and glucose, and prevalence of diabetes mellitus. One may infer that it was not mandatory to adjust for the presence of these systemic diseases and parameters in our study population with respect to the subfoveal choroidal thickness. In addition, the study participants were generally healthy; thus, it was unlikely that they suffered from a systemic disease, nor did they take medication against it. We fully agree with Drs Uzun and Pehlivan that these systemic diseases, if present, may affect the retinal vascular networks.
Finally, a potential influence of diurnal changes on the retinal vascular networks, as has been shown for subfoveal choroidal thickness, may be addressed in future studies, as has also been pointed out in our article.