Choroidal thickness and vascular microstructure parameters in Chinese school-age children with high using optical coherence tomography

The association between subfoveal choroidal thickness and refractive error in Taiwanese children: A cross-sectional study

PURPOSE

The aim was to analyze the association of subfoveal choroidal thickness (SFCT) with age, best-corrected visual acuity, refractive error, and axial length in Taiwan pediatric population.

METHODS

A total of 374 eyes in 187 children were enrolled in this retrospective cross-sectional comparative study, who underwent examinations of best-corrected visual acuity (BCVA), cycloplegic refraction, and axial length (AL). Subfoveal choroidal thickness was assessed utilizing spectral domain enhanced depth imaging optical coherence tomography (EDI-OCT), with measurements taken at the subfovea, defined as the distance from the retinal pigment epithelium to the chorioscleral border.

RESULTS

The mean age was 5.6 ± 1.9 years (range 2-16 years). The cycloplegic spherical equivalent refractive error was between + 7.25 and - 15.25 diopters (D) and cycloplegic sphere power was between + 8.25 and - 11.5 diopters (D). The mean SFCT was 299.0 ± 69.80 μm. The mean axial length was 22.87 ± 1.29 mm. In univariate analysis, SFCT had significant positive correlations with spherical equivalent (SE) and sphere power (p < 0.05) and significant negative correlations with age, cylinder power, and axial length (p < 0.05). However, after adjusting in the multivariate regression analysis, spherical equivalent, sphere power and age were not independently associated with SFCT. In multivariate analysis, lower cylinder power and longer axial length have significant correlations with thinner SFCT. The relationship between best-corrected visual acuity and SFCT was not significant in both analyses.

CONCLUSIONS

This study showed that mean subfoveal choroidal thickness was 299.0 ± 69.80 μm among Taiwanese children. The SFCT was thinner in myopic, longer axial length, and lower cylinder power eyes.

Assessment of the effects of myopic and hyperopic anisometropia on choroidal vascular structure in children using SS-OCTA

OBJECTIVE

To compare large- and medium-sized choroidal vascularity and the choriocapillaris (CC) flow area in children with different refractive errors using swept-source optical coherence tomography angiography (SS-OCTA).

METHODS

Forty-two anisometropic children were enrolled and divided into hyperopic anisometropia (HA) and myopic anisometropia (MA) groups. SS-OCTA was performed to analyse choroidal vascularity. Mean choroidal thickness (CT), choroidal vascularity volume (CVV), choroidal vascularity index (CVI) and CC flow area were compared between the two eyes. The inter-ocular differences between the two groups were also determined.

RESULTS

Mean CT and CVV were highest in eyes with shorter axial lengths in both refractive groups, and the difference between the two eyes was positively correlated with the difference in axial length at the foveal region. Significant differences in the CVI in the MA group were only found in the parafoveal region. Inter-ocular differences in the CC were significantly reduced in eyes with longer axial lengths in the foveal and parafoveal regions of the HA and MA groups, respectively. Comparing inter-ocular differences, CC was significantly greater in the parafoveal region of the MA group than the HA group.

CONCLUSIONS

All layers of choroidal vasculature were thinner in eyes with longer axial lengths in all groups. The inter-ocular CC difference was greater in the MA than in the HA group, with similar differences in axial length. This suggests that both medium-to-large choroidal vascular and choroidal capillaries may play a role in myopia development.

Short-term Effect of Strabismus Surgery on Choroidal Vasculature

PURPOSE

To investigate the effect of strabismus surgery on choroidal structure using the binarization method.

METHODS

Forty-two eyes of 27 patients who had surgery for horizontal strabismus were included in the study. Optical coherence tomography (OCT) images of the patients before the operation and at 1 day and 1 week after the operation were binarized. Total choroidal area (TCA), stromal area (SA), luminal area (LA), and choroidal vascularity index (CVI) were calculated and compared.

RESULTS

The mean age of the patients was 16.7 ± 13.5 years; 12 were female, and 15 were male. The mean spherical equivalent was 0.125 ± 0.50 diopters (D). The mean axial length value was 23.3 ± 1.3 mm. Preoperative TCA was 599686 ± 113451, LA was 394259 ± 67259, SA was 209180 ± 47723, and CVI was 0.66 ± 0.02. At 1 day postoperatively, TCA was 615575 ± 103686, LA was 395364 ± 60314, SA was 218418 ± 45620, and CVI was 0.65 ± 0.02. At 1 week postoperatively, TCA was 610997 ± 110578, LA was 394002 ± 65186, SA was 214995 ± 46481, and CVI was 0.66 ± 0.04. A statistically significant decrease in CVI and increase in TCA and SA were observed on the first postoperative day; these changes were observed as returning to preoperative values at 1 week postoperatively.

CONCLUSIONS

Strabismus surgery temporarily decreases the CVI by increasing the SA of the choroidal layer, possibly due to hemodynamic changes and/or inflammatory causes in the early period. [J Pediatr Ophthalmol Strabismus. 2024;61(2):114-119.].