Choroidal Thickness in 3001 Chinese Children Aged 6 to 19 Years Using Swept-Source OCT

Abstract

The purpose of the cross-sectional study is to describe the values and distribution of choroidal thickness and to explore its related factors, especially age, in Chinese children. A total of 3001 Chinese school children aged 6 to 19 years underwent comprehensive ophthalmic examinations, including axial length and cycloplegic refraction. Choroidal thickness was measured by swept-source optical coherence tomography (SS-OCT). There was a greater difference in the more central regions between the myopes and emmetropes. Multiple regression analysis was performed to determine the associated factors of choroidal thickness. The results demonstrated that age was independently positively related to choroidal thickness for emmetropes (β = 3.859, p < 0.001), and mild myopes with spherical equivalent greater than −2.00 D (−1.25 D < spherical equivalent ≤ −0.50 D: β = 3.476, p = 0.006; −2.00 D < spherical equivalent ≤ −1.25 D: β = 3.232, p = 0.020). However, no significant relationship between age and choroidal thickness was found in children with spherical equivalent ≤ −2.00 D, suggesting that the protective effect of physiologic choroidal growth with age against rapid axial elongation disappeared while axial elongation becomes the dominant determinant of choroidal thickness among children with myopia worse than −2.00 D.

Choroidal changes in human myopia: insights from optical coherence tomography imaging

“…Consistent with studies of adults, most studies also note substantial between‐subject variability in subfoveal choroidal thickness measures in children. Studies that have examined the topographical variations in choroidal thickness in the macular region of children, also note that topographical thickness variations are generally similar to that previously reported in adults . Figure A illustrates a topographical map of the average macular choroidal thickness from a population of 60 children with non‐myopic refractive errors, and it can be noted that the choroid is generally thickest in central regions and shows its most prominent thinning in nasal regions approaching the optic nerve, as previously reported in adults.…”

“…The choroidal thinning associated with myopia is typically reported to be related to the magnitude of refractive error, with greater amounts of thinning associated with a more myopic spherical equivalent refraction and a longer axial length . Similar findings are also reported in cross‐sectional studies of paediatric populations, and a significantly thinner choroid is also reported in myopic children, with the degree of choroidal thinning significantly associated with axial length …”

“…Normal choroidal thickness has also been examined in healthy children and adolescents, and estimates of the mean subfoveal choroidal thickness in paediatric populations from these studies have ranged from 245 to 361 μm . Consistent with studies of adults, most studies also note substantial between‐subject variability in subfoveal choroidal thickness measures in children.…”

“…Studies examining the relationship between age in childhood and choroidal thickness, that have primarily included emmetropic children in their analyses, have noted that choroidal thickness tends to increase significantly with age in childhood . In contrast to this, studies including large proportions of myopic children in their analyses have typically noted a significant decrease in choroidal thickness with age, indicating an interaction between the development of myopia and normal developmental changes in the choroid in childhood.…”

Distribution Pattern of Choroidal Thickness at the Posterior Pole in Chinese Children With Myopia

“…In previous studies, there was a decreasing ChT with increasing age in Asian children and an increasing ChT with increasing age in white children in the central foveal region. [6][7][8][10][11][12][13][14][15] Moreover, one research with large sample size carried our by our study group showed that age was positively related to ChT in emmetropic and mild myopic (SE > À2.00 D) children, while no relationship was found between age and ChT in children with SE À2.00 D. 16 Another our previous study also showed that the ChT was associated with height, 11 while height was not included in the model in this study. Different age distribution of the samples and different measurement methods of ChT may have contributed to these markedly different results.…”