Choroidal structural and perfusion characteristics across refractive groups in children

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Optical Coherence Tomography

Background:

• Myopia is a growing public health concern in children.
• Understanding choroidal changes associated with myopia is crucial for early detection and management.

Purpose of the Study:

• To characterize choroidal structural and perfusion changes in children across a spectrum of refractive error (emmetropia, low myopia, moderate myopia).
• To investigate the association of these changes with spherical equivalent refraction (SER) and axial length (AL).

Main Methods:

• Retrospective cross-sectional study of 140 children (aged 8-14) using enhanced depth imaging optical coherence tomography (EDI-OCT) and optical coherence tomography angiography (OCTA).
• Measurements included choroidal thickness, Haller's layer thickness, Sattler's layer-choriocapillaris complex thickness, and choroidal vascularity index (CVI).
• OCTA quantified choroidal perfusion density and flow deficits.

Main Results:

• Choroidal thickness significantly decreased with increasing myopia severity, primarily due to thinning of Haller's layer.
• Reductions in luminal area and total choroidal area were observed in both full-thickness and sublayer analyses.
• No significant differences in OCTA-derived perfusion or flow-deficit parameters were found between groups.

Conclusions:

• Increasing myopia severity in children is associated with significant choroidal structural alterations, predominantly affecting Haller's layer.
• Structural OCT metrics appear more sensitive in detecting early choroidal changes in pediatric myopia than OCTA perfusion parameters.
• These findings highlight the importance of structural choroidal assessment in understanding myopia development.