Longitudinal changes in choroidal thickness in high myopia: Correlation with maculopathy progression and visual...

Area of Science:

• Ophthalmology
• Retinal Imaging
• Myopia Research

Background:

• High myopia is a leading cause of visual impairment.
• Choroidal thickness (CT) is a crucial indicator of ocular health.
• Understanding longitudinal CT changes is vital for managing myopic complications.

Purpose of the Study:

• To investigate longitudinal changes in choroidal thickness (CT) in highly myopic eyes.
• To correlate CT changes with the progression of myopic maculopathy (MAM) and visual outcomes.
• To analyze the impact of staphyloma and axial length on CT.

Main Methods:

• Retrospective cohort study of 1228 eyes from 781 highly myopic patients with >5-year follow-up.
• Myopic atrophic maculopathy (MAM) graded using ATN classification.
• Subfoveal CT measured via spectral-domain OCT; staphyloma classified using Curtin's system.

Main Results:

• Mean baseline subfoveal CT was 54.3 μm, decreasing with MAM severity.
• Fastest thinning observed in diffuse atrophy (3.1 μm/year).
• Baseline CT <40 μm independently predicted macular atrophy (OR 3.84) and visual decline (OR 2.76).
• Lower CT associated with longer axial length (≥29 mm) and myopic macular neovascularization (mMNV).

Conclusions:

• Rapid choroidal thinning is linked to diffuse chorioretinal atrophy.
• Severely reduced baseline CT increases the risk of macular atrophy and visual impairment.
• Staphyloma type influences CT patterns, highlighting the complexity of high myopia progression.