Choroid thickness analysis and related influencing factors in adolescents with different types of non-pathological high myopia_Chinese Journal of Ocular Fundus Diseases

Authors：

Ji Yanyan ^1,2,3 , Li Zhongqing ³ , Wang Jia ³ ,  Chen Song ^1,2

1. Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, China;
2. Tian Eye Hospital, Tianjin 300020, China;
3. Liaocheng Aier Eye Hospital, Liaocheng 252100, China;

Corresponding?author：

Chen Song, Email: chensong9999@126.com

Keywords：

Myopia, degenerative; Root cause analysis; Tomography, optical coherence; Choroidal thickness

DOI：

10.3760/cma.j.cn511434-20220411-00209

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the changes of choroid thickness in adolescents with different types of non-pathological high myopia (HM). Methods A retrospective observational study. From January 2021 to April 2022, 179 eyes of 101 adolescents with myopia in Liaocheng Aier Eye Hospital were collected and analyzed. According to the spherical equivalent (SE) and corneal curvature, subjects were divided into mild myopia or emmetical eye group (control group), HM group, occult HM group (OHM group) and super HM group (SHM group). There were 52 eyes in 30 cases, 47 eyes in 26 cases, 42 eyes in 24 cases and 38 eyes in 21 cases, respectively. Medical optometry, intraocular pressure, optical coherence tomography (OCT), axial length (AL) and corneal curvature were measured. The macular foveal choroidal thickness was analyzed by using spectral-domain OCT. The diopter was expressed in SE. The thickness of choroid in the fovea of macular region was measured by enhanced deep imaging with frequency domain OCT. The thickness of choroid was measured in 9 regions within 1 mm, 3 mm from the fovea, including the upper, lower, nasal and temporal regions. Generalized estimating equation was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation between AL, corneal curvature, intraocular pressure and choroidal thickness was analyzed by Pearson correlation. Results The choroidal thickness in the foveal macula and the areas 1 mm and 3 mm away from the fovea were compared among the control group, HM group, OHM group and SHM group, the difference were significant (χ²=76.646, 36.715, 27.660, 35.301, 24.346, 38.093, 36.275, 33.584, 36.050; P＜0.05). Compared with the control group, the choroidal thickness of the fovea and the choroidal thickness in each area within 1 and 3 mm from the fovea in the HM group, the OHM group and the SHM group were significantly thinner than those in the control group, and the difference was statistically significant (P＜0.05). There were statistically significant differences in choroidal thickness in each region between the group and the SHM group, and between the OHM group and the SHM group (P＜0.05). The results of correlation analysis showed that AL was negatively correlated with choroidal thickness in various regions (P＜0.05); SE was positively correlated with choroidal thickness in various regions (P＜0.05); corneal curvature and intraocular pressure had no significant correlation with choroidal thickness in various regions (P＞0.05). Conclusions The choroidal thickness of SHM is significantly lower than that of OHM and HM; OHM patients have lower SE. However, the choroidal thickness is significantly thinner. AL and SE are the influencing factors of choroidal thickness.

Citation： Ji Yanyan, Li Zhongqing, Wang Jia, Chen Song. Choroid thickness analysis and related influencing factors in adolescents with different types of non-pathological high myopia. Chinese Journal of Ocular Fundus Diseases, 2022, 38(6): 462-467. doi: 10.3760/cma.j.cn511434-20220411-00209 Copy

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2.	Benoudis L, Ingrand P, Jeau J, et al. Relationships between macular pigment optical density and lacquer cracks in high myopia[J]. J Fr Ophtalmol, 2016, 39(7): 615-621. DOI: 10.1016/j.jfo.2016.04.001.
3.	Teberik K, Kaya M. Retinal and choroidal thickness in patients with high myopia without maculopathy[J]. Pak J Med Sci, 2017, 33(6): 1438-1443. DOI: 10.12669/pjms.336.13726.
4.	Wong CW, Phua V, Lee SY, et al. Is choroidal or scleral thickness related to myopic macular degeneration[J]. Invest Ophthalmol Vis Sci, 2017, 58(2): 907-913. DOI: 10.1167/iovs.16-20742.
5.	中華醫學會眼科學分會眼視光學組. 重視高度近視防控的專家共識(2017)[J]. 中華眼視光學與視覺科學雜志, 2017, 19(7): 385-389. DOI: 10.3760/cma.j.issn.1674-845X.2017.07.001.Ophthalmology Group, Ophthalmology Branch of Chinese Medical Association. Attach importance to the consensus of experts on the prevention and control of high myopia(2017)[J]. Chin J Ophthalmol Vis Sci, 2017, 19(7): 385-389. DOI: 10.3760/cma.j.issn.1674-845X.2017.07.001.
6.	吳靜, 張傳偉, 姚易碩, 等. FS-LASIK聯合Triple-A切削模式矯正超高度近視[J]. 中華眼視光學與視覺科學雜志, 2019, 21(6): 420-425. DOI: 10.3760/cma.j.issn.1674-845X.2019.06.004.Wu J, Zhang CW, Yao YS, et al. FS-LASIK combined with triple-a for ultra-high myopia correction[J]. Chin J Ophthalmol Vis Sci, 2019, 21(6): 420-425. DOI: 10.3760/cma.j.issn.1674-845X.2019.06.004.
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8.	王洪亮, 劉剛, 賈萬程. 囊袋張力環植入在超高度近視并發白內障眼超聲乳化白內障摘出術中的應用[J]. 中華實驗眼科雜志, 2020, 38(2): 114-120. DOI: 10.3760/cma.j.issn.2095-0160.2020.02.007.Wang HL, Lu G, Jia WC. Application of capsular tension ring implantation in Phacoemulsification for cataract complicated by high myopia[J]. Chin J Exp Ophthalmol, 2020, 38(2): 114-120. DOI: 10.3760/cma.j.issn.2095-0160.2020.02.007.
9.	韓雅軍, 石晶, 譚小波, 等. 兒童隱匿性高度近視黃斑區視網膜厚度分析[J]. 國際眼科雜志, 2021, 21(6): 1107-1111. DOI: 10.3980/j.issn.1672-5123.2021.6.34.Han YJ, Shi J, Tan XB, et al. Analysis of macular retinal thickness in children with latent high myopia[J]. Int Eye Sci, 2021, 21(6): 1107-1111. DOI: 10.3980/j.issn.1672-5123.2021.6.34.
10.	韓雅軍, 石晶, 譚小波, 等. 隱匿性高度近視兒童黃斑區脈絡膜厚度分析[J]. 中華眼底病雜志, 2020, 36(12): 922-928. DOI: 10.3760/cma.j.cn511434-20201020-00496.Han YJ, Shi J, Tan XB, et al. Analysis of choroidal thickness in macular region of children with latent high myopia[J]. Chin J Ocul Fundus Dis, 2020, 36(12): 922-928. DOI: 10.3760/cma.j.cn511434-20201020-00496.
11.	Nickla DL, Totonelly K. Brief light exposure at night disrupts the circadian rhythms in eye growth and choroidal thickness in chicks[J]. Exp Eye Res, 2016, 146: 189-195. DOI: 10.1016/j.exer.2016.03.003.
12.	Zhou LX, Shao L, Xu L, et al. The relationship between scleral staphyloma and choroidal thinning in highly myopic eyes: the Beijing eye study[J/OL]. Sci Rep, 2017, 7(1): 9825[2017-08-29]. https://pubmed.ncbi.nlm.nih.gov/28852194/. DOI: 10.1038/s41598-017-10660-z.
13.	Nickla DL, Wallman J. The multifunctional choroid[J]. Prog Retin Eye Res, 2010, 29(2): 144-168. DOI: 10.1016/j.preteyeres.2009.12.002.
14.	Ho M, Liu DT, Chan VC, et al. Choroidal thickness measurement in myopic eyes by enhanced depth optical coherence tomography[J]. Ophthalmology, 2013, 120(9): 1909-1914. DOI: 10.1016/j.ophtha.2013.02.005.
15.	莫亞, 肖西立, 何葉紅, 等. 高度近視黃斑區視網膜及脈絡膜厚度與中心視野相關性分析[J]. 中國實用眼科雜志, 2013, 31(2): 128-131. DOI: 10.3760/cma.j.issn.1006-4443.2013.02.009.Mo Y, Xiao XL, He YH, et al. Correlation between macular retinal and choroidal thickness and central visual field in high myopia[J]. Chin J Pract Ophthalmol, 2013, 31(2): 128-131. DOI: 10.3760/cma.j.issn.1006-4443.2013.02.009.
16.	Wang NK, Lai CC, Chou CL, et al. Choroidal thickness and biometric markers for the screening of lacquer cracks in patients with high myopia[J/OL]. PLoS One, 2013, 8(1): e53660[2013-01-22]. https://pubmed.ncbi.nlm.nih.gov/23349728/. DOI: 10.1371/journal.pone.0053660.
17.	Nishida Y, Fujiwara T, Imamura Y, et al. Choroidal thickness and visual acuity in highly myopic eyes[J]. Retina, 2012, 32(7): 1229-1236. DOI: 10.1097/IAE.0b013e318242b990.
18.	楊倩琪, 廖妙云, 張玉明. 近視兒童中心凹下脈絡膜厚度的相關性[J]. 國際眼科雜志, 2019, 19(12): 2080-2083. DOI: 10.3980/j.issn.1672-5123.2019.12.19.Yang QQ, Liao MY, Zhang YM. Correlation between subconcave choroid thickness and family history of myopia in children with myopia[J]. Int Eye Sci, 2019, 19(12): 2080-2083. DOI: 10.3980/j.issn.1672-5123.2019.12.19.
19.	田雨, 王松田, 郭珊, 等. 不同近視程度對青少年脈絡膜厚度變化的影響[J]. 實用醫藥雜志, 2020, 37(2): 117-120. DOI: 10.14172/j.issn1671-4008.2020.02.006.Tian Y, Wang ST, Guo S, et al. Effect of different degree of myopia on chorioretinal thickness in adolescents[J]. Prac J Med & Pharm, 2020, 37(2): 117-120. DOI: 10.14172/j.issn1671-4008.2020.02.006.
20.	Read SA, Collins MJ, Vincent SJ, et al. Choroidal thickness in myopic and nonmyopic children assessed with enhanced depth imaging optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2013, 54(12): 7578-7586. DOI: 10.1167/iovs.13-12772.
21.	Qi Y, Li L, Zhang F. Choroidal thickness in Chinese aged 8 to 11 years with mild and moderate myopia[J/OL]. J Ophthalmol, 2018, 2018: 72701027[2018-05-31]. https://pubmed.ncbi.nlm.nih.gov/29955394/. DOI: 10.1155/2018/7270127.
22.	徐玲, 易敬林, 杜紅巖. 近視兒童黃斑中心凹下脈絡膜厚度的變化特征及影響因素[J]. 國際眼科雜志, 2021, 21(3): 540-544. DOI: 10.3980/j.issn.1672-5123.2021.3.34.Xu L, Yi JL, Du HY. Variation characteristics and influencing factors of choroidal thickness of subfoveal fovea in children with myopia[J]. Int Eye Sci, 2021, 21(3): 540-544. DOI: 10.3980/j.issn.1672-5123.2021.3.34.
23.	Read SA, Collins MJ, Vincent SJ, et al. Choroidal thickness in childhood[J]. Invest Ophthalmol Vis Sci, 2013, 54(5): 3586-3593. DOI: 10.1167/iovs.13-11732.
24.	Turan KE, Sekeroglu HT, Baytaroglu A, et al. Normative values for opitcal coherence tomography parameters in healthy children and interexaminer agreement for choroidal thickness measurements[J]. Arq Bras Oftalmol, 2018, 81(1): 3-6. DOI: 10.5935/0004-2749.20180003.
25.	EI-Shazly AA, Farweez YA, EI Sebaay ME, et al, Correlation between choroidal thickness and degree of myopia assessed with enhanced depth imaging optical coherence tomography[J]. Eur J Ophthalmol, 2017, 27(5): 577-584. DOI: 10.5301/ejo.5000936.

1. Flores-Moreno I, Lugo F, Duker JS, et al. The relationship between axial length and choroidal thickness in eyes with high myopia[J]. Am J Ophthalmol, 2013, 155(2): 314-319. DOI: 10.1016/j.ajo.2012.07.015.
2. Benoudis L, Ingrand P, Jeau J, et al. Relationships between macular pigment optical density and lacquer cracks in high myopia[J]. J Fr Ophtalmol, 2016, 39(7): 615-621. DOI: 10.1016/j.jfo.2016.04.001.
3. Teberik K, Kaya M. Retinal and choroidal thickness in patients with high myopia without maculopathy[J]. Pak J Med Sci, 2017, 33(6): 1438-1443. DOI: 10.12669/pjms.336.13726.
4. Wong CW, Phua V, Lee SY, et al. Is choroidal or scleral thickness related to myopic macular degeneration[J]. Invest Ophthalmol Vis Sci, 2017, 58(2): 907-913. DOI: 10.1167/iovs.16-20742.
5. 中華醫學會眼科學分會眼視光學組. 重視高度近視防控的專家共識(2017)[J]. 中華眼視光學與視覺科學雜志, 2017, 19(7): 385-389. DOI: 10.3760/cma.j.issn.1674-845X.2017.07.001.Ophthalmology Group, Ophthalmology Branch of Chinese Medical Association. Attach importance to the consensus of experts on the prevention and control of high myopia(2017)[J]. Chin J Ophthalmol Vis Sci, 2017, 19(7): 385-389. DOI: 10.3760/cma.j.issn.1674-845X.2017.07.001.
6. 吳靜, 張傳偉, 姚易碩, 等. FS-LASIK聯合Triple-A切削模式矯正超高度近視[J]. 中華眼視光學與視覺科學雜志, 2019, 21(6): 420-425. DOI: 10.3760/cma.j.issn.1674-845X.2019.06.004.Wu J, Zhang CW, Yao YS, et al. FS-LASIK combined with triple-a for ultra-high myopia correction[J]. Chin J Ophthalmol Vis Sci, 2019, 21(6): 420-425. DOI: 10.3760/cma.j.issn.1674-845X.2019.06.004.
7. 徐廣第．屈光手術的適應癥及手術注意事項[M]//徐廣第. 眼科屈光學. 北京: 軍事醫學科學出版社, 2001: 48-60. Xu GD. The indication of refractive surgery and points for attention[M]//Xu GD. Ophthalmic refraction. Beijing: Military Medical Science Press, 2001: 48-60.
8. 王洪亮, 劉剛, 賈萬程. 囊袋張力環植入在超高度近視并發白內障眼超聲乳化白內障摘出術中的應用[J]. 中華實驗眼科雜志, 2020, 38(2): 114-120. DOI: 10.3760/cma.j.issn.2095-0160.2020.02.007.Wang HL, Lu G, Jia WC. Application of capsular tension ring implantation in Phacoemulsification for cataract complicated by high myopia[J]. Chin J Exp Ophthalmol, 2020, 38(2): 114-120. DOI: 10.3760/cma.j.issn.2095-0160.2020.02.007.
9. 韓雅軍, 石晶, 譚小波, 等. 兒童隱匿性高度近視黃斑區視網膜厚度分析[J]. 國際眼科雜志, 2021, 21(6): 1107-1111. DOI: 10.3980/j.issn.1672-5123.2021.6.34.Han YJ, Shi J, Tan XB, et al. Analysis of macular retinal thickness in children with latent high myopia[J]. Int Eye Sci, 2021, 21(6): 1107-1111. DOI: 10.3980/j.issn.1672-5123.2021.6.34.
10. 韓雅軍, 石晶, 譚小波, 等. 隱匿性高度近視兒童黃斑區脈絡膜厚度分析[J]. 中華眼底病雜志, 2020, 36(12): 922-928. DOI: 10.3760/cma.j.cn511434-20201020-00496.Han YJ, Shi J, Tan XB, et al. Analysis of choroidal thickness in macular region of children with latent high myopia[J]. Chin J Ocul Fundus Dis, 2020, 36(12): 922-928. DOI: 10.3760/cma.j.cn511434-20201020-00496.
11. Nickla DL, Totonelly K. Brief light exposure at night disrupts the circadian rhythms in eye growth and choroidal thickness in chicks[J]. Exp Eye Res, 2016, 146: 189-195. DOI: 10.1016/j.exer.2016.03.003.
12. Zhou LX, Shao L, Xu L, et al. The relationship between scleral staphyloma and choroidal thinning in highly myopic eyes: the Beijing eye study[J/OL]. Sci Rep, 2017, 7(1): 9825[2017-08-29]. https://pubmed.ncbi.nlm.nih.gov/28852194/. DOI: 10.1038/s41598-017-10660-z.
13. Nickla DL, Wallman J. The multifunctional choroid[J]. Prog Retin Eye Res, 2010, 29(2): 144-168. DOI: 10.1016/j.preteyeres.2009.12.002.
14. Ho M, Liu DT, Chan VC, et al. Choroidal thickness measurement in myopic eyes by enhanced depth optical coherence tomography[J]. Ophthalmology, 2013, 120(9): 1909-1914. DOI: 10.1016/j.ophtha.2013.02.005.
15. 莫亞, 肖西立, 何葉紅, 等. 高度近視黃斑區視網膜及脈絡膜厚度與中心視野相關性分析[J]. 中國實用眼科雜志, 2013, 31(2): 128-131. DOI: 10.3760/cma.j.issn.1006-4443.2013.02.009.Mo Y, Xiao XL, He YH, et al. Correlation between macular retinal and choroidal thickness and central visual field in high myopia[J]. Chin J Pract Ophthalmol, 2013, 31(2): 128-131. DOI: 10.3760/cma.j.issn.1006-4443.2013.02.009.
16. Wang NK, Lai CC, Chou CL, et al. Choroidal thickness and biometric markers for the screening of lacquer cracks in patients with high myopia[J/OL]. PLoS One, 2013, 8(1): e53660[2013-01-22]. https://pubmed.ncbi.nlm.nih.gov/23349728/. DOI: 10.1371/journal.pone.0053660.
17. Nishida Y, Fujiwara T, Imamura Y, et al. Choroidal thickness and visual acuity in highly myopic eyes[J]. Retina, 2012, 32(7): 1229-1236. DOI: 10.1097/IAE.0b013e318242b990.
18. 楊倩琪, 廖妙云, 張玉明. 近視兒童中心凹下脈絡膜厚度的相關性[J]. 國際眼科雜志, 2019, 19(12): 2080-2083. DOI: 10.3980/j.issn.1672-5123.2019.12.19.Yang QQ, Liao MY, Zhang YM. Correlation between subconcave choroid thickness and family history of myopia in children with myopia[J]. Int Eye Sci, 2019, 19(12): 2080-2083. DOI: 10.3980/j.issn.1672-5123.2019.12.19.
19. 田雨, 王松田, 郭珊, 等. 不同近視程度對青少年脈絡膜厚度變化的影響[J]. 實用醫藥雜志, 2020, 37(2): 117-120. DOI: 10.14172/j.issn1671-4008.2020.02.006.Tian Y, Wang ST, Guo S, et al. Effect of different degree of myopia on chorioretinal thickness in adolescents[J]. Prac J Med & Pharm, 2020, 37(2): 117-120. DOI: 10.14172/j.issn1671-4008.2020.02.006.
20. Read SA, Collins MJ, Vincent SJ, et al. Choroidal thickness in myopic and nonmyopic children assessed with enhanced depth imaging optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2013, 54(12): 7578-7586. DOI: 10.1167/iovs.13-12772.
21. Qi Y, Li L, Zhang F. Choroidal thickness in Chinese aged 8 to 11 years with mild and moderate myopia[J/OL]. J Ophthalmol, 2018, 2018: 72701027[2018-05-31]. https://pubmed.ncbi.nlm.nih.gov/29955394/. DOI: 10.1155/2018/7270127.
22. 徐玲, 易敬林, 杜紅巖. 近視兒童黃斑中心凹下脈絡膜厚度的變化特征及影響因素[J]. 國際眼科雜志, 2021, 21(3): 540-544. DOI: 10.3980/j.issn.1672-5123.2021.3.34.Xu L, Yi JL, Du HY. Variation characteristics and influencing factors of choroidal thickness of subfoveal fovea in children with myopia[J]. Int Eye Sci, 2021, 21(3): 540-544. DOI: 10.3980/j.issn.1672-5123.2021.3.34.
23. Read SA, Collins MJ, Vincent SJ, et al. Choroidal thickness in childhood[J]. Invest Ophthalmol Vis Sci, 2013, 54(5): 3586-3593. DOI: 10.1167/iovs.13-11732.
24. Turan KE, Sekeroglu HT, Baytaroglu A, et al. Normative values for opitcal coherence tomography parameters in healthy children and interexaminer agreement for choroidal thickness measurements[J]. Arq Bras Oftalmol, 2018, 81(1): 3-6. DOI: 10.5935/0004-2749.20180003.
25. EI-Shazly AA, Farweez YA, EI Sebaay ME, et al, Correlation between choroidal thickness and degree of myopia assessed with enhanced depth imaging optical coherence tomography[J]. Eur J Ophthalmol, 2017, 27(5): 577-584. DOI: 10.5301/ejo.5000936.

Chinese Journal of Ocular Fundus Diseases

Choroid thickness analysis and related influencing factors in adolescents with different types of non-pathological high myopia

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