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Published on: March 29, 2022
Short-term choroidal changes as early indicators for future myopic shift in primary school children: results of a
Hao Wu1,2, Mengqi Liu1, Yuanyuan Wang1
1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Insights
Short-term changes in choroidal thickness and area can predict future myopia progression in children. These early indicators may help identify children at risk for developing myopia.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Myopia Research
Background:
- Myopic shift is a growing concern in children.
- Predicting myopia progression is crucial for timely intervention.
Purpose of the Study:
- To evaluate if short-term choroidal changes predict future myopia progression in children.
- To assess the predictive value of choroidal parameters measured by optical coherence tomography.
Main Methods:
- Prospective study of 289 primary school children (577 eyes) over 2 years.
- Cycloplegic refractions and optical coherence tomography (OCT) measurements of choroidal parameters (choroidal thickness, luminal area, stromal area, total choroidal area) were taken.
- Myopic shift defined as >= -0.50 diopter/year.
Main Results:
- In initially myopic eyes, greater reductions in choroidal thickness, luminal area, stromal area, and total choroidal area at 3 months predicted subsequent myopic shift.
- These choroidal changes significantly improved prediction models for myopic eyes.
- No significant differences were found in non-myopic eyes.
Conclusions:
- Short-term changes in choroidal parameters serve as early indicators of future myopia progression in children.
- These findings can aid in identifying children at higher risk for myopia development.
Background:
To assess predictive value of short-term choroidal changes for future myopic shift in children.
Methods:
577 eyes of 289 primary school children were prospectively followed for 2 years. Cycloplegic refractions at baseline, 1 year and 2 years, and choroidal measurements by optical coherence tomography at baseline and 3 months, were used for analyses. Myopic shift was defined as refraction change of at least -0.50 dioptre/year, at 2 years compared with baseline.
Results:
228 participants (455 eyes) completed 2-year follow-up. Approximately 37.6% of 311 initially non-myopic eyes and 73.6% of 144 initially myopic eyes developed a myopic shift. Notably, at 3 months greater reductions were found in initially myopic eyes with myopic shift, than in those without myopic shift-in choroidal thickness (ChT), luminal area (LA), stromal area (SA) and total choroidal area (TCA), but no significant differences in any choroidal parameters were observed between non-myopic eyes, with and without myopic shift. Multivariable analyses showed that in myopic eyes, each percentage increase in ChT, LA, SA and TCA was associated with reduced odds of myopic shift (all p<0.001). Similar associations were observed in non-myopic eyes, with smaller effects than in myopic eyes. Adding a 3-month percentage change of each choroidal parameter to a basic model including age, gender, parental myopia and baseline refraction significantly improved the predictive performance in myopic eyes (area under the receiver operating characteristic curves increasing from 0.650 to approximately 0.800, all p<0.05), but not in non-myopic eyes.
Conclusion:
Short-term choroidal changes could act as early indicators for future myopic shift in children.
