Macular Choroidal Thickness in Children: The Shandong Children Eye Study

Abstract

PURPOSE.To examine the thickness of the macular choroid and its associations in school children aged 6 to 18 years. METHODS.The school-based cross-sectional Shandong Children Eye Study included 6026 (94.7%) of 6364 eligible children fulfilling the inclusion criterion of an age from 4 to 18 years. Spectral-domain optical coherence tomography (SD-OCT) was performed for a subgroup of 972 school children aged 6þ years. All participants underwent ocular examinations, including measurement of visual acuity, cycloplegic refractometry, biometry, and SD-OCT (enhanced depth imaging mode) for measurement of choroidal thickness. RESULTS.The study included 972 children (501 girls) with a mean age of 11.3 6 3.3 years (range, 6-18 years) and mean axial length of 24.10 6 1.56 mm (range, 16.57-28.82 mm). Mean choroidal thickness was thicker (P < 0.001) at 500 lm temporal to the foveola (290 6 67 lm) than in the subfoveal region (283 6 67 lm; range, 113-507 lm) and the region 500 lm superior to the fovea (283 6 66 lm), where it was thicker (P < 0.001) than at 500 lm inferior of the foveola (281 6 66 lm), and it was thinnest (P < 0.001) at 500 lm nasal of the foveola (268 6 67 lm). In multivariate analysis, thicker SFCT was (overall correlation coefficient r: 0.51) associated with shorter axial length (P < 0.001; standardized correlation coefficient b: À0.48; B: À23.7; 95% confidence interval [CI]: À27.2 to À20.3), male sex (P ¼ 0.006; b: À0.08; B: À10.7; 95% CI: À18.3 to À3.11), and younger age (P ¼ 0.04; b: À0.07; B: À1.46; 95% CI: À2.85 to À0.07).CONCLUSIONS. As in adults, thicker SFCT in children and teenagers was markedly associated with shorter axial length, and to a lesser degree with male sex and older age. As in adults, increasing axial myopia in teenagers is associated with choroidal thinning and development of a leptochoroid.Keywords: choroidal thickness, choroid, optical coherence tomography, leptochoroid, Shandong Children Eye Study D evelopment of the enhanced depth imaging mode of spectral-domain optical coherence tomography (OCT) has made the visualization and measurement of the choroid in vivo feasible. 1,2 Previous investigations have determined the thickness of the choroid in the macular region and have assessed relationships between choroidal thickness measurements and other ocular and systemic variables such as axial length and age.3-5 Most of these studies were performed on adults, whereas children and teenagers have only rarely been examined, and if, then mostly in relatively small study populations. [6][7][8][9][10][11][12][13][14][15] The study by Park and Oh,6 in which the choroidal thickness profiles were assessed in 48 healthy children, revealed a mean subfoveal choroidal thickness (SFCT) of 348 6 83 lm. In the investigation by Read and colleagues 7 on 194 children with an age of 4 to 12 years and a spherical equivalent refractive error ranging between þ1.25 and À0.50 diopters, mean SFCT was 330 6 65 lm (range, 189-538 lm). Interestingly, SFCT increased significantly (P ¼ 0.04) with older age from 312 6...

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

“…8,12,14 The choroid in the macular region was thickest in the temporal sector and thinnest in the nasal sector, which was similar to that in previous studies carried out in pediatric populations. 7,8,[10][11][12][13]15 The mean global PPCT in our study (136 6 33 lm) was also smaller than the mean PPCTs reported by a previous study (165 6 34 lm). 22 Age, race, refractive status as well as the instruments and protocols used may contribute to these differences.…”

Choroidal Thickness and Ametropia in Children: A Longitudinal Study

“…Similar studies carried out on children have also revealed an inverse correlation between ChT and axial length (15)(16)(17)(18)(19)(20)(21)(22)(23).…”

“…In 2015, Zhang et al (22) reported the results of a study on 972 children aged 6 to 18 years, irrespective of refractive errors, including high myopia and high hyperopia, and also found an inverse correlation between axial length and ChT. However, contrary to other authors, they found a decrease in ChT with age in children.…”

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

“…Since the development of enhanced depth imaging optical coherence tomography (EDI-OCT)7 and more recently, swept-source optical coherence tomography (SS-OCT)8 which has enabled the in vivo imaging and measurement of the choroid, the characteristics of the choroid under normal8910111213141516171819202122232425262728293031, as well as under certain pathologic conditions323334353637, have been described. Age89101117, refractive error and axial length (AL)811131417383940 have been well established as major factors that can impact in vivo choroidal thickness in healthy adults, with increasing age, AL and decreasing refractive diopter being associated with a reduction of choroidal thickness.…”