Is Choroidal or Scleral Thickness Related to Myopic Macular Degeneration?

Wong, Chee Wai; Phua, Val; Lee, Shu Yen; Wong, Tien Yin; Cheung, Chui Ming Gemmy

doi:10.1167/iovs.16-20742

Cited by 85 publications

(79 citation statements)

References 31 publications

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“…The correlation with the severity of maculopathy was found to be stronger for choroidal thickness than it was for scleral thickness, suggesting that a vascular mechanism related to choroidal ischaemia may be playing a more prominent role in the pathogenesis of the condition than a mechanical mechanism involving scleral stretch. Studies have also shown that the reductions in visual acuity observed in myopic maculopathy, are significantly correlated with macular choroidal thickness, further supporting a role for the choroid in these conditions …”

Section: Choroidal Changes In Myopiamentioning

confidence: 85%

“…In a study using swept‐source OCT, examining posterior scleral and choroidal thickness of eyes with myopic macular degeneration, a thinner choroid was found to be strongly positively correlated with the severity of myopic macular degeneration . The correlation with the severity of maculopathy was found to be stronger for choroidal thickness than it was for scleral thickness, suggesting that a vascular mechanism related to choroidal ischaemia may be playing a more prominent role in the pathogenesis of the condition than a mechanical mechanism involving scleral stretch.…”

Section: Choroidal Changes In Myopiamentioning

confidence: 99%

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

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Fuss

Vincent

et al. 2019

Clinical and Experimental Optometry

113

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The choroid is a vascular tissue which plays a range of critical roles in the normal physiology of the eye, such as supplying the outer retina with oxygen and nutrients and the regulation of intraocular pressure. There is also substantial evidence, particularly from animal studies, that the choroid plays an important role in the regulation of eye growth and the development of common refractive errors like myopia. In recent years, advances in optical coherence tomography technology have improved our ability to image and measure the choroid in the human eye. Research using this technology over the past decade has dramatically improved our knowledge of the normal choroid, and its potential role in the regulation of eye growth and refractive error development. This review aims to provide an overview of recent work examining the normal human choroid, its changes with myopia and the possible role of the choroid in the mechanism regulating eye growth. Studies have demonstrated that choroidal thinning accompanies the development and progression of myopia, and have established a close link between eye growth and choroidal thickness changes. Dramatic thinning of the choroid is seen with high myopia, and associations are also observed between choroidal thinning and reduced vision, and the development of retinal pathology associated with high myopia. In the short-term, environmental factors known to be associated with myopia development and more rapid eye growth typically lead to a thinning of the choroid, whereas factors linked to a slowing of eye growth are typically associated with short-term choroidal thickening. Collectively, these findings suggest that the choroid is an important biomarker of eye growth in the human eye, and additional research to better understand the human choroid is likely to further our knowledge of the signals and pathways regulating eye growth, myopia development and progression.

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Section: Choroidal Changes In Myopiamentioning

confidence: 85%

Section: Choroidal Changes In Myopiamentioning

confidence: 99%

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

Read

Fuss

Vincent

et al. 2019

Clinical and Experimental Optometry

113

View full text Add to dashboard Cite

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“…Significant thinning of the choroid in myopia and its relationship with visual function have been widely studied. 23,31,32 The choroid provides most of the oxygen demand of the photoreceptors. 11,12,33 Thinning of the choroid might result in a lack of oxygen, which is indispensable for photoreceptor metabolism and photosensitivity.…”

Section: Discussionmentioning

confidence: 99%

Photoreceptor Degeneration is Correlated With the Deterioration of Macular Retinal Sensitivity in High Myopia

Wang

Shen

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate structural changes in the retinal outer layers and choroid using adaptive optics (AO) and optical coherence tomography (OCT) in eyes with myopia, and to correlate the changes with decreased macular light sensitivity (MLS). METHODS. This prospective study included 27 subjects with emmetropia and low myopia (EM/ LM), 25 with moderate myopia (MM), and 25 with high myopia (HM). Microperimetry was used to quantify MLS in each subject, while AO and OCT images of fundus were analyzed to quantify cone density and regularity and thickness of outer retinal sublayers and choroid. Differences of MLS, cone distribution, and chorioretinal thicknesses were compared among the three groups, and the associations among photoreceptor morphological alterations, MLS, and other parameters were analyzed. RESULTS. In HM, the MLS, cone density and regularity, and thicknesses of the myoid and ellipsoid zone (MEZ), Henle fiber layer and outer nuclear layer, interdigitation zone and RPE/ Bruch complex, and choroid were lower than in EM/LM. Decreased MLS was correlated with lower cone density and regularity, and thinner MEZ and choroid in the inner region, and with lower cone density, thinner MEZ and choroid, and longer axial length in the outer region. Multivariate regression showed that better MLS was correlated with thicker MEZ in the inner region and with higher cone density in the outer region. CONCLUSIONS. Altered cone distribution and outer retinal thickness, especially cone density and MEZ thickness, were significantly correlated with decline of MLS in HM, which may help to evaluate and monitor visual impairment in HM.

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“…Several studies had reported a negative correlation between mChT and MM severity. 23,31 The thinning of choroidal thickness may contribute to various myopic pathologic changes, such as chorioretinal atrophy, LCs, and CNV. 20,[32][33][34][35] However, the definition of MM in these studies was based on atrophic and neovascular changes, and there are no studies reporting a correlation between choroidal thinning and myopic tractional changes.…”

Section: This Study Is To the Best Of Our Knowledge The Firstmentioning

confidence: 99%

Morphological Characteristics and Risk Factors of Myopic Maculopathy in an Older High Myopia Population—Based on the New Classification System (ATN)

Chen¹,

He²,

Hu³

et al. 2019

American Journal of Ophthalmology

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PURPOSE: To investigate the characteristics, mergers, and risk factors of different types of myopic maculopathy (MM) in a highly myopic population. DESIGN: Population-based, cross-sectional study. METHODS: A total of 1086 eyes (762 patients) were enrolled. Each participant underwent detailed ocular examinations. Combining the fundus photographs and optical coherence tomography images, types of MM were assessed as myopic atrophy maculopathy (MAM), myopic tractional maculopathy (MTM), or myopic neovascular maculopathy (MNM) according to the ATN classification system. Peripapillary atrophy (PPA) area, tilt ratio, and macular choroidal thickness (mChT) were measured individually.RESULTS: Eyes with larger PPA area were more likely to have MAM (odds ratio [OR], 1.220; P [ .037 per 1-mm 2 increase) and MNM (OR, 1.723; P < .001 per 1-mm 2 increase), and eyes with thicker mChT were less likely to have MAM (OR, 0.740; P < .001 per 10-mm increase) and MNM (OR, 0.784; P < .001 per 10-mm increase), whereas eyes with higher tilt ratio were less likely to have MTM (OR, 0.020; P < .001 per 1 increase). The severity of MTM and MNM was not precisely consistent with that of MAM.CONCLUSIONS: Different types of MM have different risk factors; larger PPA area and thinner mChT are risk factors for MAM and MNM, whereas lower tilt ratio is a risk factor for MTM. Our results indicate that the pathogenesis of MTM is different from that of MAM and MNM, and a tractional component should be considered as a possible component to the myopic macular classification. (Am J Ophthalmol 2019;208: 356-366. Ó

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Is Choroidal or Scleral Thickness Related to Myopic Macular Degeneration?

Cited by 85 publications

References 31 publications

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

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

Photoreceptor Degeneration is Correlated With the Deterioration of Macular Retinal Sensitivity in High Myopia

Morphological Characteristics and Risk Factors of Myopic Maculopathy in an Older High Myopia Population—Based on the New Classification System (ATN)

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