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Macular and peripapillary Choroidal Vascularity Index in children with different refractive status
Ziyi Qi1,2, Xiaoxiao Liu1, Shuyu Xiong1
1Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
Insights
In children, choroidal vascular index (CVI) decreases with myopia and is linked to axial length and choroidal thinning. Further research is needed to understand CVI
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Imaging
Background:
- Choroidal vascularity plays a role in refractive development.
- Understanding choroidal vascular index (CVI) in children is crucial for myopia research.
Purpose of the Study:
- To characterize choroidal vascular changes in children across different refractive statuses.
- To investigate the relationship between choroidal vascular index (CVI) and refractive error in pediatric eyes.
Main Methods:
- A large cohort of 5864 children (aged 6-9 years) underwent comprehensive eye exams.
- Swept Source-Optical Coherence Tomography (SS-OCT) was used to measure choroidal thickness (ChT) and calculate choroidal vascular index (CVI).
- Cycloplegic autorefraction and axial length (AL) measurements were performed for refractive status assessment.
Main Results:
- Choroidal vascular index (CVI) was significantly lower in myopic children compared to emmetropic and hyperopic children.
- CVI showed a non-uniform distribution in the posterior pole, varying across macular and peripapillary regions.
- Spherical equivalent (SE), axial length (AL), intraocular pressure (IOP), choroidal thickness (ChT), age, and gender were significantly associated with CVI.
Conclusions:
- Choroidal vascularity, assessed by CVI, is reduced in myopia and associated with axial elongation and thinner choroids in children.
- The non-uniform distribution of CVI in the posterior pole highlights regional differences in choroidal vascularization.
- Further investigation into CVI dynamics during myopia progression is warranted to elucidate its role in myopia development.
Objectives:
To characterize choroidal vascular changes in children with different refractive status.
Methods:
A study including 5864 children aged 6-9 years was performed to investigate the choroidal vascular index (CVI) in myopic, emmetropic and hyperopic eyes. Each participant had a comprehensive ocular examination with cycloplegic autorefraction performed, axial length (AL) measured and Swept Source-Optical Coherence Tomography (SS-OCT) scans acquired. Choroidal thickness (ChT) was measured by built-in software, and CVI was calculated using a previously validated self-developed algorithm.
Results:
The mean ChT and CVI were 275.88 ± 53.34 μm and 34.91 ± 3.83 in the macula region, and 191.96 ± 46.28 μm and 32.35 ± 4.21 in the peripapillary region. CVI was significantly lowest for myopes, followed by emmetropes and hyperopes (P < 0.001). CVI varied between different sectors separated by the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid (P < 0.001). Macular CVI decreased horizontally from nasal to temporal quadrant with lowest in center fovea, and vertically from superior to inferior quadrants. Peripapillary CVI was highest in the nasal and lowest in the inferior sector. Multiple regression showed that spherical equivalent (SE), AL, intraocular pressure (IOP), ChT, age, and gender were significantly related to CVI (P < 0.05).
Conclusions:
In children, the distribution of CVI in the posterior pole is not uniform. A decreased CVI was observed from hyperopia to myopia and was associated with decreased SE, elongated AL, and choroidal thinning. Further study of changes in CVI during myopia onset and progression is required to better understand the role of the choroidal vasculature in myopia development.
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