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Clinical Nomogram for Determining Expected Choroidal Thickness in Children With Myopia
Ian Flitcroft1, Gareth Lingham2, Eoin Kerin3
1From the Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin (I.F., G.L., E.K., E.K.N., E.K.-A., J.L.) Dublin, Ireland; Department of Ophthalmology, Mater Misericordiae Hospital (I.F.), Dublin, Ireland.
American Journal of Ophthalmology
|June 30, 2025
Summary
A new clinical tool, a choroidal thickness (ChT) nomogram, helps identify myopia risks. It compares a child's ChT to expected values, aiding in predicting complications like myopic maculopathy.
Area of Science:
- Ophthalmology
- Biometry
- Medical Imaging
Background:
- Thin choroid is a risk factor for myopia-associated complications and visual impairment.
- Current clinical practice does not fully utilize choroidal thickness (ChT) as a myopia biomarker.
Purpose of the Study:
- To develop a clinical tool to identify individuals with choroidal thickness outside the expected range for their age, sex, and refractive error.
- To assess the risk of future myopic complications based on choroidal thickness variations.
Main Methods:
- A post-hoc patient-level meta-analysis of participants aged 6-30 years from four clinical studies.
- Spherical equivalent refraction (SER) and axial length (AXL) were measured; choroidal thickness (ChT) was measured using OCT.
- Prediction models for ChT were created using multiple linear regression and Machine Learning, considering age, sex, SER, and AXL.
Main Results:
- Regression models explained over 44% of the variance in ChT.
- Inter-individual differences accounted for approximately 50% of the remaining variance, with 44% of participants showing a ChT >50 µm deviation from expected.
- A clinical nomogram was generated from the Ordinary Least Square (OLS) model.
Conclusions:
- Choroidal thickness (ChT) is a valuable myopia biomarker not fully leveraged in clinical practice.
- The developed clinical ChT nomogram is a simple, visual tool.
- This nomogram objectively assesses and tracks myopia-related complication risk in children by comparing measured to expected ChT.
