Visual Acuity and Subfoveal Choroidal Thickness: The Beijing Eye Study

Shao, Lei; Xu, Liang; Wei, Wen Bin; Chen, Chang Xi; Du, Kui Fang; Li, Xiao Peng; Yang, Ming; Wang, Ya Xing; You, Qi Sheng; Jonas, Jost B

doi:10.1016/j.ajo.2014.05.023

Cited by 93 publications

(84 citation statements)

References 23 publications

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“…While COMET did not find a relationship with gender, earlier studies in young adults (mean age 24.9 years) 18 and older adults (50 years or older) 39-40 found that males had thicker choroids. However, studies investigating pediatric populations have not found a gender difference.…”

Section: Discussioncontrasting

confidence: 67%

Choroidal Thickness Profiles in Myopic Eyes of Young Adults in the Correction of Myopia Evaluation Trial Cohort

Dirkes¹,

Zangwill²,

Gwiazda

et al. 2015

American Journal of Ophthalmology

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Purpose To examine the relationship of choroidal thickness with axial length (AL) and myopia in young adult eyes in the ethnically diverse Correction of Myopia Evaluation Trial (COMET) cohort. Design Cross-sectional, multi-center, study Methods In addition to measures of myopia by cycloplegic autorefraction and AL by A-scan ultrasonography, participants underwent optical coherence tomography imaging of the choroid (RTVue) in both eyes at their last visit (14 years after baseline). Using digital calipers, two independent readers measured choroidal thickness in the right eye (left eye if poor quality; n=37) at seven locations: fovea and 750, 1500, 2250μm nasal (N) and temporal (T) to the fovea. Results Choroidal thickness measurements were available from 294/346 (85%) of imaged participants (mean age: 24.3±1.4 years; 44.9% male) with mean myopia of -5.3±2.0D and mean AL of 25.5±1.0mm. Overall, choroidal thickness varied by location (p<0.0001) and was thickest at the fovea (273.8±70.9 μm) and thinnest nasally (N2250,191.5±69.3 μm). Multivariable analyses showed significantly thinner choroids in eyes with more myopia and longer AL at all locations except T2250 (p≤0.001) and presence of peri-papillary crescent at all locations except T1500 and T2250 (p≤0.0001). Choroidal thickness varied by ethnicity at N2250 (p<0.0001), with Asians having the thinnest and African Americans the thickest choroids. Conclusion Choroids are thinner in longer, more myopic young adult eyes. The thinning was most prominent nasally and in eyes with a crescent. In the furthest nasal location, ethnicity was associated with choroidal thickness. The findings suggest that choroidal thickness should be evaluated, especially in the nasal regions where myopic degenerations are most commonly seen clinically.

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Section: Discussioncontrasting

confidence: 67%

Choroidal Thickness Profiles in Myopic Eyes of Young Adults in the Correction of Myopia Evaluation Trial Cohort

Dirkes¹,

Zangwill²,

Gwiazda

et al. 2015

American Journal of Ophthalmology

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“…Recent studies have suggested that lower bestcorrected visual acuity was associated with a thinner choroid (also called leptochoroid), in particular with a subfoveal choroid thinner than 30 lm. 31,32 In the children and teenager population of our study, choroidal thickness was not related with best-corrected visual acuity in the multivariate analysis. It may suggest that the association between a leptochoroid and decreased visual acuity may develop in adult life.…”

Section: Discussioncontrasting

confidence: 52%

Macular Choroidal Thickness in Children: The Shandong Children Eye Study

Zhang

Chen

et al. 2015

Invest. Ophthalmol. Vis. Sci.

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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...

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“…6 Moreover, better visual acuity has been related to greater central subfoveal thickness in patients older than 50 years, as well as to other factors, such as age or axial length (AL). 13 The recent technological development of an enhanced depth imaging (EDI) system and spectral domain optical coherence tomography (SD-OCT) has allowed accurate in vivo deep choroidal imaging and measurements. 12,14,15 Because of the scattering of light caused by the pigmented cells of the RPE and its posterior location, 16 these assessments have been difficult to obtain with the existing OCT technologies.…”

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confidence: 99%