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Published on: January 22, 2019
Age- and Myopia-Related 3-Dimensional Remodeling of Choroidal Thickness in Children
Luxiao Chen1,2,3, Jixuan Yuan1,2,4, Ziyao Wang5
1Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China.
Insights
This study reveals distinct patterns in children's choroidal thickness (ChT) related to age and myopia. Nasal thinning correlates with age, while foveal thinning is linked to axial length, suggesting ChT as a myopia biomarker.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Pediatric Research
Background:
- Choroidal thickness (ChT) is crucial for ocular health.
- Understanding its changes in children is vital for myopia research.
- Population-based data on 3D topographic remodeling of ChT is limited.
Purpose of the Study:
- To investigate 3D topographic remodeling patterns of macular choroidal thickness (ChT) in children.
- To explore associations between ChT patterns, age, and myopia-related ocular growth.
Main Methods:
- A cross-sectional, population-based study of 3508 children (ages 7-18).
- Spectral-domain OCT and deep learning algorithms (Choroidalyzer) were used for 3D ChT mapping.
- Analysis included mean and grid-specific ChT values, correlated with age and axial length (AL).
Main Results:
- Mean ChT was 271.8 ± 56.1 μm, varying significantly with myopia severity.
- Age-related ChT showed nasal thinning (strongest negative correlation with age) and central thinning, with relative stability temporally.
- Axial length-related ChT exhibited concentric thinning, most pronounced in the fovea.
Conclusions:
- Identified two major spatial remodeling patterns: age-related temporal-nasal asymmetry and AL-related concentric thinning.
- These patterns suggest physiological growth and myopia-related changes.
- Choroidal thickness may serve as a potential biomarker for myopia development and progression.
Purpose:
To investigate the 3-dimensional (3D) topographic remodeling patterns of choroidal thickness (ChT) in the macular region in children, and their associations with age and myopia related ocular growth.
Design:
Cross-sectional, population-based study.
Participants:
A total of 3508 children (mean age 13.6 ± 3.0 years, range 7-18 years, 47.7% male).
Methods:
Spectral-domain OCT with a 31-horizontal B-scan protocol was performed on right eyes. Choroidal thickness in each B-scan was automatically segmented and quantified using modified open-source deep learning algorithms (Choroidalyzer). For each eye, a 3D ChT map covering 6 × 6 mm macular region and composed of 12 × 12 grids centered on fovea was generated, and both mean thickness and grid-specific thickness values were calculated.
Main Outcome Measures:
ChT of each grid, cluster, and macular region; correlation with age, axial length (AL), and sex.
Results:
The mean ChT was 271.8 ± 56.1 μm, with significant variations across nonmyopia, low, moderate, and high myopia groups (P < 0.001). Age-related ChT changes showed a distinct temporal-nasal asymmetry pattern, with the nasal region showing the strongest negative correlation with age (r = -0.12), the central region demonstrating a weak correlation (r = -0.07, both P < 0.001), whereas the temporal region remained relatively stable (r = -0.02, P = 0.255), resulting in 4.3- and 2.6-fold (95% confidence interval: -0.4 to 8.9; -0.4 to 5.7) greater thinning in the nasal and central choroid than in the temporal region, respectively. Axial length-related ChT changes showed a concentric thinning pattern, characterized by more pronounced foveal thinning (r = -0.51, B = -35.2 μm/mm, both P < 0.001) compared with parafoveal (r = -0.48, B = -28.7 μm/mm, both P < 0.001) and perifoveal changes (r = -0.42, B = -22.3 μm/mm, both P < 0.001), corresponding to 1.6- and 1.3-fold (95% confidence interval: 1.4-1.7; 1.2-1.4) greater thinning in the fovea and parafovea than in the perifovea.
Conclusions:
Using 3D topographic mapping, we provide population-based data on ChT in children, and identified 2 major spatial remodeling patterns: temporal-nasal asymmetry with age and concentric thinning with increasing axial length. These spatially and temporally distinct remodeling patterns likely reflect both physiological growth and myopia-related structural change, supporting the potential role of ChT as a biomarker for myopia development and progression.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
