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Published on: January 16, 2020
Subfoveal choroidal thickness at age 9 years in relation to clinical and perinatal characteristics in the
Kevser Zehra Biyik1,2,3, Jan Willem L Tideman1, Jan Roelof Polling1,4
1Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Insights
Subfoveal choroidal thickness was greater in 9-year-old girls than boys. Higher birthweight, gestational age, and body height correlated with thicker choroids, while longer axial length and myopia were associated with thinner choroids.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Ocular Development
Background:
- Subfoveal choroidal thickness (SFCT) is a key indicator of ocular health and development.
- Understanding factors influencing SFCT in children is crucial for predicting refractive error progression, particularly myopia.
- Population-based studies provide valuable insights into normative SFCT ranges and influencing variables in pediatric populations.
Purpose of the Study:
- To investigate the association between clinical and perinatal characteristics and subfoveal choroidal thickness (SFCT) in 9-year-old children.
- To identify potential predictors of SFCT in a pediatric cohort.
- To establish normative data for SFCT in 9-year-olds and explore sex-based differences.
Main Methods:
- Utilized data from the population-based Generation R cohort, including 1018 children aged 9 years.
- Measurements included cycloplegic refractometry, ocular biometry, height, weight, and SFCT via swept-source optical coherence tomography (SS-OCT).
- Multivariate regression models adjusted for age, ethnicity, and sex were employed to analyze associations with perinatal factors and clinical measurements.
Main Results:
- Girls exhibited significantly thicker subfoveal choroids (298 ± 60.6 μm) compared to boys (281 ± 55.0 μm), a difference of 9.1 μm after adjustment.
- SFCT decreased with increasing axial length and myopic refraction, but increased with greater body height, birthweight, and size for gestational age.
- Maternal smoking during pregnancy was associated with thinner choroids; alcohol consumption showed no detectable effect.
Conclusions:
- Subfoveal choroidal thickness in 9-year-olds is influenced by sex, with girls having thicker choroids.
- Perinatal factors like birthweight and size for gestational age, alongside postnatal growth (height), are positively associated with SFCT.
- Longitudinal studies are needed to determine the implications of these findings for myopia development.
Purpose:
To assess the association between clinical and perinatal characteristics and subfoveal choroidal thickness in 9-year-old children.
Methods:
The study included data from the population-based Generation R cohort, whose participants underwent cycloplegic refractometry, ocular biometry, height, weight and subfoveal choroidal thickness measurements using a swept-source optical coherence tomography (SS-OCT) instrument. Birth parameters were obtained using medical records. Statistical analyses were performed using multivariate regression models adjusted for age, ethnicity and sex.
Results:
A total of 1018 children (52.5% girls, 47.5% boys) with a mean age of 9.9 ± 0.3 years and a mean cycloplegic spherical equivalent refraction of 0.80 ± 1.1 D in boys and 0.81 ± 1.4 in girls were eligible for analysis. The subfoveal choroid was 17 μm thicker in girls (298 ± 60.6 μm) than in boys (281 ± 55.0 μm; p < 0.001), a difference of 9.1 μm persisting after adjustment for age, ethnicity and axial length (p = 0.017). Subfoveal choroidal thickness decreased with increasing ocular axial length (-16.2 μm/mm, 95% CI -21.2 to -12.4, p < 0.001) and with increasing myopic refraction (-10.0 μm/D, 95% CI 6.8-13.1; p < 0.001, adjusted for age, ethnicity, axial length and sex) while it increased with increasing body height (1.3 μm/cm, 95% CI 0.8 to 1.9, p < 0.001). Additionally, choroidal thickness increased with increasing birthweight (13.0 μm/kg; 95% CI 0.006-0.020; p < 0.001) and increasing size for gestational age (8.2 μm/kg; 95% CI 4.6-11.8; p < 0.001). Smoking up until the time that pregnancy became known was associated with a thinner choroid (p = 0.016). There was no detectable effect of alcohol consumption. The distributions of axial length, refraction and choroidal thickness were narrower than in older populations.
Conclusion:
The subfoveal choroid was thicker in girls than in boys, and higher body height, higher birthweight and larger size for gestational age were associated with a thicker subfoveal choroid. The implications of these findings for myopia development need further evaluation in longitudinal studies.
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