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Parapapillary Diffuse Choroidal Atrophy in Children Is Associated With Extreme Thinning of Parapapillary Choroid
Tae Yokoi1, Dan Zhu2, Hong Sheng Bi3
1Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Insights
Segmental parapapillary diffuse choroidal atrophy (PDCA) in children involves abrupt temporal choroidal thinning. This finding is linked to subfoveal choroidal thinning, even after accounting for refractive error and age.
Area of Science:
- Ophthalmology
- Retinal imaging
- Pediatric eye diseases
Background:
- High myopia in children can lead to various ocular complications.
- Understanding the structural changes in the choroid is crucial for managing myopia-related pathology.
- Segmental parapapillary diffuse choroidal atrophy (PDCA) is a less understood condition in pediatric high myopia.
Purpose of the Study:
- To analyze the morphologic features of segmental parapapillary diffuse choroidal atrophy (PDCA) in children.
- To investigate the association between PDCA and choroidal thickness (CT) in pediatric high myopia.
Main Methods:
- Study included children (age ≤15 years) with high myopia from Tokyo High Myopia Clinic.
- Control group from the Gobi Desert Children Eye Study (GobiDCES).
- Fundus photography and optical coherence tomography (OCT) for PDCA and CT measurement.
Main Results:
- 41 eyes of 21 children with PDCA (mean age 9.4 years, -11.5 D myopia) were analyzed.
- All PDCA eyes showed extreme, abrupt thinning of the temporal parapapillary choroid.
- Significantly reduced choroidal thickness (<60 μm) at 2500 μm nasal to foveola in PDCA eyes compared to controls (P < 0.001).
Conclusions:
- PDCA in children is characterized by abrupt segmental thinning of the temporal parapapillary choroid.
- This thinning is observed alongside subfoveal choroidal thinning, independent of refractive error and age.
- Findings highlight specific structural changes in pediatric high myopia associated with PDCA.
Purpose:
To analyze morphologic features of segmental parapapillary diffuse choroidal atrophy (PDCA) in children.
Methods:
The study group included children (age ≤15 years) with high myopia who attended the Tokyo High Myopia Clinic. Control groups comprised participants of the population-based Gobi Desert Children Eye Study (GobiDCES). Fundus photographs were examined for presence of PDCA and choroidal thickness (CT) was measured by optical coherence tomography.
Results:
The study group included 41 eyes of 21 children with PDCA (mean age: 9.4 ± 3.7 years; mean refractive error: -11.5 ± 3.1 diopters) and the GobiDCES included 1463 children (age: 11.8 ± 3.5 years). In the study group, all eyes showed an extreme and abrupt thinning of the temporal parapapillary choroid. At 2500 μm nasal to the foveola, CT was <60 μm in 31 (76%) eyes of the study group but in none (0/1463) of the GobiDCES (P < 0.001), except for one child with PDCA.
Conclusions:
Parapapillary diffuse choroidal atrophy in children is associated with abrupt segmental thinning of the choroid in the temporal parapapillary region, in addition to the thinning of the subfoveal choroid after adjusting for refractive error and age.
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