[Prognostic role of early changes in choroidal thickness during optical therapy with HAL lenses in children with...

Early changes in choroidal thickness (CT) following the initiation of optical or pharmacological therapy may serve as a predictor of the subsequent rate of axial length (AL) increase and progression of myopia, as well as a biomarker of individual sensitivity to the treatment.

This study aimed to investigate the relationship between the dynamics of myopia progression in children wearing newly prescribed spectacles with highly aspherical lenslets (HAL) and the early choroidal response to this optical correction.

The study included 36 children (72 eyes) aged 7-13 years (mean age 10.41±1.14 years) with myopia of 3.74±0.64 D who wore HAL spectacle lenses for 12 months. Based on the choroidal response after the first month of optical correction, patients were divided into two groups: group 1 included 24 children (48 eyes) with an increase in CT of ≥5 µm, and group 2 consisted of 12 children (24 eyes) in which CT either did not change or decreased. Changes in AL and refractive error were assessed after one year.

In group 1 (CT increase), refractive progression was 0.03±0.3 D and axial elongation was 0.04±0.16 mm after one year; in group 2, these values were 0.12±0.2 D and 0.18±0.2 mm, respectively (p<0.05).

Early increase in CT was associated with greater stability of refractive error and AL during one year of follow-up. The early response of the choroid may serve as a predictor of further treatment effectiveness and a criterion for selecting myopia control strategies.