Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Lee, Samantha Sze‐Yee; Alonso‐Caneiro, David; Lingham, Gareth; Chen, Fred K.; Sanfilippo, Paul; Yazar, Seyhan; Mackey, David A.

doi:10.1167/iovs.63.5.34

Cited by 15 publications

(8 citation statements)

References 59 publications

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“…Previous studies revealed an association between AL and ChT; the present study further demonstrated 34.5% of the shortened AL could be explained by thickened ChT. AL shortening not only occurs in LLRL treatment, but also in the treatment of atropine or orthokeratology lens .…”

Section: Discussionsupporting

confidence: 75%

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

Cao,

Tian,

et al. 2024

JAMA Ophthalmol

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ImportanceTreatments are needed to slow progression of or reduce incidence of myopia.ObjectiveTo evaluate the efficacy and safety of daily 650-nm low-level red light (LLRL) for myopia treatment.Design, Setting, and ParticipantsSingle-masked, randomized clinical trial at 1 site in China. Baseline measurements were completed from August to September 2021. Participants were children aged 6 to 12 years with spherical equivalent error (SER) of −6 diopters (D) to 3 D. Data were analyzed from March to July 2023.InterventionsIrradiation daily with 650-nm LLRL for 3 minutes twice daily 4 or more hours apart or no intervention.Main Outcomes and MeasuresPrimary outcomes were changes in cycloplegia SER and axial length (AL) at 6- and 12-month follow-up visits. Safety was assessed on masked fundus photograph evaluations.ResultsA total of 336 children were randomly allocated into the LLRL group or control group in a 1:1 ratio. The control group contained 86 female patients (51.2%), and the treatment group contained 90 female patients (53.6%). The mean (SD) age, SER, and AL were 9.0 (1.9) years, −1.3 (1.5) D, and 23.8 (1.0) mm for all patients. A total of 161 (95.8%) in the LLRL group and 159 (94.6%) in the control group returned for the 6-month follow-up. A total of 157 (93.5%) in the LLRL group and 152 (90.5%) in the control group returned for the 12-month follow-up. Mean (SD) changes in SER were 0.15 (0.16) D and −0.26 (0.21) D for the LLRL group and the control group, respectively (difference, −0.41 D; 95% CI, −0.48 to −0.34 D; P &lt; .001), at 6 months and 0.24 (0.27) D and −0.65 (0.33) D for the LLRL group and the control group, respectively (difference, −0.89 D; 95% CI, −0.95 to −0.83 D; P &lt; .001), at 12 months. Mean (SD) changes in AL were −0.06 (0.08) mm and 0.13 (0.12) mm for the LLRL group and control group, respectively (difference, 0.19 mm; 95% CI, 0.16 to 0.22 mm; P &lt; .001), at 6 months and −0.11 (0.10) mm and 0.26 (0.16) mm for the LLRL group and control group, respectively (difference, 0.37 mm; 95% CI, 0.34 to 0.40 mm; P &lt; .001). Masked fundus photograph review did not identify retinal changes in either group.Conclusions and relevanceThese findings suggest daily use of 650-nm LLRL for 1 year can slow progression of SER and AL without safety concerns identified. Confirmation of these findings at independent sites seems warranted, as well as determining whether these effects can be sustained with or without continued treatment and whether LLRL has any effect on pathological myopia.Trial RegistrationChiCTR2200058963

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Section: Discussionsupporting

confidence: 75%

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

Cao,

Tian,

et al. 2024

JAMA Ophthalmol

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“… 82 Choroidal thickness was evaluated in a subset of the above Australian birth cohort. 99 Myopia progression was associated with choroid thinning, whereas, overall, thickening was observed over an 8-year period. The association of baseline choroidal thickness with both myopic shift and axial elongation achieved borderline significance and was unrelated to refractive error at baseline.…”

Section: Factors Associated With Adult Myopia Onset and Progressionmentioning

confidence: 97%

IMI—Onset and Progression of Myopia in Young Adults

Bullimore

Lee

Schmid

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Myopia typically starts and progresses during childhood, but onset and progression can occur during adulthood. The goals of this review are to summarize published data on myopia onset and progression in young adults, aged 18 to 40 years, to characterize myopia in this age group, to assess what is currently known, and to highlight the gaps in the current understanding. Specifically, the peer-reviewed literature was reviewed to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults, regardless of age of onset, both during the college years and later; describe the rate of axial elongation in myopic adults; identify risk factors for adult onset and progression; report myopia progression and axial elongation in adults who have undergone refractive surgery; and discuss myopia management and research study design. Adult-onset myopia is common, representing a third or more of all myopia in western populations, but less in East Asia, where onset during childhood is high. Clinically meaningful myopia progression continues in early adulthood and may average 1.00 diopters (D) between 20 and 30 years. Higher levels of myopia are associated with greater absolute risk of myopia-related ocular disease and visual impairment, and thus myopia in this age group requires ongoing management. Modalities established for myopia control in children would be options for adults, but it is difficult to predict their efficacy. The feasibility of studies of myopia control in adults is limited by the long duration required.

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“…Second, this study focused on choroidal changes in children 3 to 14 years old. Recent research by Lee et al 34 revealed that the choroid continued to thicken in young adults without myopic progression during the third decade of life. Extended observations covering a wider age range would provide further insights into the continuous evolution of the choroid throughout life.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Changes in Choroidal Thickness Varied With Refractive Progression in Myopic and Non-Myopic Children: A Two-Year Cohort Study

Shen,

Han,

Yang

et al. 2024

Invest. Ophthalmol. Vis. Sci.

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Purpose To evaluate the longitudinal changes in subfoveal choroidal thickness (SFCT) in children with different refractive status. Methods A total of 2290 children 3 to 14 years old who attended the first year of kindergarten (G0), first year of primary school (G1), fourth year of primary school (G4), or first year of junior high school (G7) in Guangzhou, China, were recruited and followed up for 2 years. All participants received cycloplegic autorefraction, axial length measurement and SFCT measurement using a CIRRUS HD-OCT device. Children were divided into groups of persistent non-myopia (PNM), persistent myopia (PM), or newly developed myopia (NDM). Children in the PNM and PM groups were further divided into subgroups of stable refraction (absolute mean annual spherical equivalent refraction [SER] change < 0.5 D) and refractive progression (absolute mean annual SER change ≥ 0.5 D). Results The mean ± SD ages for the G1 to G7 cohorts were 3.89 ± 0.30, 6.79 ± 0.47, 9.71 ± 0.34, and 12.54 ± 0.38, years, respectively. SFCT consistently decreased in the NDM group across the G1 to G7 cohorts (all P < 0.001) and exhibited variability across different age cohorts in the PNM and PM groups. Further subgroup analysis revealed significant thickening of SFCT in the PNM-stable group among the G0, G1, and G7 cohorts (all P < 0.05), whereas it remained stable among all cohorts in the PM-stable group (all P > 0.05). Conversely, SFCT exhibited thinning in the G4 and G7 cohorts in the PM-progressive group (both P < 0.01) and for the entire cohort of children in the PNM-progressive group ( P = 0.012). Conclusions SFCT increased in nonmyopic children with stable refraction, remained stable in myopic children maintained stable refraction, and decreased in those with refractive progression, whether they were myopic or not.

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Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change

Cited by 15 publications

References 59 publications

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

Daily Low-Level Red Light for Spherical Equivalent Error and Axial Length in Children With Myopia

IMI—Onset and Progression of Myopia in Young Adults

Longitudinal Changes in Choroidal Thickness Varied With Refractive Progression in Myopic and Non-Myopic Children: A Two-Year Cohort Study

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