Four-year longitudinal choroidal thickness changes and tessellated fundus progression in an eastern Chinese...

To assess the longitudinal change of choroidal thickness (ChT) and tessellated fundus progression in Chinese adults over 4 years.

In this population-based longitudinal cohort study, 1646 right eyes of 1646 participants were examined. Fundus photographs were obtained and ChT was measured using swept-source optical coherence tomography. Participants were categorized into high-myopia, low-myopia, and non-myopia groups, and the tessellated fundus was graded 0-3 based on the fundus photographs.

The mean baseline age, refractive error, axial length (AL), and macular ChT were 62.51 ± 9.89 years, -0.48 ± 3.18 D, 23.71 ± 1.58 mm, and 199.7 ± 77.3 μm, respectively. At the 4-year follow-up, a significant reduction in macular ChT of 4.05 ± 6.24, 4.44 ± 6.87, and 3.51 ± 5.17 μm per year was observed in the non-myopia, low-myopia, and high-myopia groups, respectively. Age, baseline ChT, and AL changes (with β^non-M = -78.439, β^HM = -56.505) were independently related to the rate of macular ChT change (all p < 0.05). Furthermore, the decrease in the ChT distribution pattern varied with different refractive groups. Moreover, 4.31% of the participants had tessellated fundus progression; these participants had more ChT reduction over 4 years than those without tessellated fundus progression (p < 0.001).

Choroidal thinning was found to be associated with age and AL elongation. For every 1 mm increase in AL, the decrease rate of ChT in the high-myopia group was slower than that in the non-myopia group. Progression of tessellated fundus was associated with a faster decrease in ChT, highlighting its potential as a biomarker for myopia progression.