Subfoveal choroidal thickness at age 9years in relation to clinical and perinatal characteristics in the population-based Generation R Study.

Abstract

To assess the association between clinical and perinatal characteristics and subfoveal choroidal thickness in 9-year-old children. The study included data from the population-based Generation R cohort, whose participants underwent cycloplegic refractometry, ocular biometry, height, weight and subfoveal choroidal thickness measurements using a swept-source optical coherence tomography (SS-OCT) instrument. Birth parameters were obtained using medical records. Statistical analyses were performed using multivariate regression models adjusted for age, ethnicity and sex. A total of 1018 children (52.5% girls, 47.5% boys) with a mean age of 9.9±0.3years and a mean cycloplegic spherical equivalent refraction of 0.80±1.1 D in boys and 0.81±1.4 in girls were eligible for analysis. The subfoveal choroid was 17μm thicker in girls (298±60.6μm) than in boys (281±55.0μm; p<0.001), a difference of 9.1μm persisting after adjustment for age, ethnicity and axial length (p=0.017). Subfoveal choroidal thickness decreased with increasing ocular axial length (-16.2μm/mm, 95% CI -21.2 to -12.4, p<0.001) and with increasing myopic refraction (-10.0μm/D, 95% CI 6.8-13.1; p<0.001, adjusted for age, ethnicity, axial length and sex) while it increased with increasing body height (1.3μm/cm, 95% CI 0.8 to 1.9, p<0.001). Additionally, choroidal thickness increased with increasing birthweight (13.0μm/kg; 95% CI 0.006-0.020; p<0.001) and increasing size for gestational age (8.2μm/kg; 95% CI 4.6-11.8; p<0.001). Smoking up until the time that pregnancy became known was associated with a thinner choroid (p=0.016). There was no detectable effect of alcohol consumption. The distributions of axial length, refraction and choroidal thickness were narrower than in older populations. The subfoveal choroid was thicker in girls than in boys, and higher body height, higher birthweight and larger size for gestational age were associated with a thicker subfoveal choroid. The implications of these findings for myopia development need further evaluation in longitudinal studies.