Abstract
Myopia is a common cause of visual impairment worldwide. Choroidal thickness (ChT) reflects the characteristic changes in myopic children and may be used as an important index of myopia. The purpose of this study was to investigate ChT and its distribution across the posterior pole in young myopic Chinese patients using enhanced depth imaging optical coherence tomography (EDI-OCT) and to explore the factors associated with it. A total of 402 myopic Chinese patients aged 6–16 years who underwent complete ophthalmic examinations, including those for axial length, cycloplegic refraction, and intraocular pressure, were examined with EDI-OCT. The mean subfoveal ChT was 303.08 ± 76.87 μm and displayed large variations at different positions (p < 0.05). The thickest sector was located 3 mm temporally from the fovea. Multivariate regression analysis showed a significant negative correlation of the subfoveal ChT values with axial length (AL), whereas the ChT was moderately influenced by the patient's sex. AL accounted for 7.9% of the ChT variance, whereas sex explained 9.6% of the ChT variance. In the population aged 11 years and older, AL accounted for 13.1% of the ChT variance. However, in those younger than 11 years, age was the only significant explanatory factor accounting for 5.2% of the ChT variance. In conclusion, we found a significant decrease in ChT with age in myopic children younger than 11 years. The negative association between age and ChT in children aged 11 years and older may be offset by the choroidal thickening mediated by pubertal growth spurts. The positive correlation between ChT and spherical equivalent in myopic adolescents aged 11 years and older suggests that the protective effect of lens thinning against rapid axial elongation disappears with age. Axial elongation becomes the dominant determinant of ChT in this age group.
Highlights
As a pigmented vascular tissue, the choroid serves a number of functions including the metabolic support of the retina [1]
A total of 402 myopes (190 boys and 212 girls) were enrolled in this study. e mean age was 10.97 ± 2.24 years, mean axial length was 24.67 ± 0.93 mm, mean intraocular pressure (IOP) was 15.61 ± 2.55 mmHg, and the mean spherical equivalent refraction (SER) was −2.68 ± 1.41 D. e general characteristics of the participants are listed in Table 1. ere were no significant differences between boys and girls for mean age, SER, IOP, or choroidal thickness (ChT), whereas the mean axial length was significantly larger in boys than in girls (p < 0.01; Table 1)
We observed a trend for negative correlation between age and ChT (Table 4; Figure 3), but statistical significance was only observed in children
Summary
As a pigmented vascular tissue, the choroid serves a number of functions including the metabolic support of the retina [1]. In addition to its roles in nourishing the retina [2,3,4,5,6], the choroid plays an active role in changing the refractive state through the modulation of its thickness as demonstrated by Wallman et al [7]. Enhanced depth imaging optical coherence tomography (EDI-OCT) [9] enables in vivo cross-sectional visualization of the choroid and has allowed a better understanding of choroidal changes [10,11,12]. E most common application of EDI-OCT in the analysis of refractive error is the detection of significantly decreased choroidal thickness (ChT) in patients with myopia [4, 14,15,16] in both the stromal and vascular components [17]. ChT has been associated with age [4, 15, 16, 18], refractive error [7, 17, 19,20,21,22,23], axial length (AL) [15, 16, 18, 20,21,22, 24,25,26], and sex [16, 18, 23,24,25,26], in both adults and children with conflicting results
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