Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.
Acta Ophthalmol. 2020 Mar;98(2):172-176. doi: 10.1111/aos.14178. Epub 2019 Aug 6.
To assess the association between clinical and perinatal characteristics and subfoveal choroidal thickness in 9-year-old children.
The study included data from the population-based Generation R cohort, whose participants underwent cycloplegic refractometry, ocular biometry, height, weight and subfoveal choroidal thickness measurements using a swept-source optical coherence tomography (SS-OCT) instrument. Birth parameters were obtained using medical records. Statistical analyses were performed using multivariate regression models adjusted for age, ethnicity and sex.
A total of 1018 children (52.5% girls, 47.5% boys) with a mean age of 9.9 ± 0.3 years and a mean cycloplegic spherical equivalent refraction of 0.80 ± 1.1 D in boys and 0.81 ± 1.4 in girls were eligible for analysis. The subfoveal choroid was 17 μm thicker in girls (298 ± 60.6 μm) than in boys (281 ± 55.0 μm; p < 0.001), a difference of 9.1 μm persisting after adjustment for age, ethnicity and axial length (p = 0.017). Subfoveal choroidal thickness decreased with increasing ocular axial length (-16.2 μm/mm, 95% CI -21.2 to -12.4, p < 0.001) and with increasing myopic refraction (-10.0 μm/D, 95% CI 6.8-13.1; p < 0.001, adjusted for age, ethnicity, axial length and sex) while it increased with increasing body height (1.3 μm/cm, 95% CI 0.8 to 1.9, p < 0.001). Additionally, choroidal thickness increased with increasing birthweight (13.0 μm/kg; 95% CI 0.006-0.020; p < 0.001) and increasing size for gestational age (8.2 μm/kg; 95% CI 4.6-11.8; p < 0.001). Smoking up until the time that pregnancy became known was associated with a thinner choroid (p = 0.016). There was no detectable effect of alcohol consumption. The distributions of axial length, refraction and choroidal thickness were narrower than in older populations.
The subfoveal choroid was thicker in girls than in boys, and higher body height, higher birthweight and larger size for gestational age were associated with a thicker subfoveal choroid. The implications of these findings for myopia development need further evaluation in longitudinal studies.
评估 9 岁儿童的临床和围产期特征与黄斑中心凹下脉络膜厚度之间的关系。
该研究纳入了基于人群的 Generation R 队列的数据，参与者接受了睫状肌麻痹折射测量、眼生物测量、身高、体重和黄斑中心凹下脉络膜厚度测量，使用了扫频源光学相干断层扫描（SS-OCT）仪器。通过医疗记录获取出生参数。使用多元回归模型进行统计分析，模型调整了年龄、种族和性别。
共有 1018 名儿童（52.5%女孩，47.5%男孩）符合分析条件，他们的平均年龄为 9.9±0.3 岁，男孩的平均睫状肌麻痹球镜等效屈光度为 0.80±1.1 D，女孩为 0.81±1.4 D。女孩的黄斑中心凹下脉络膜比男孩厚 17μm（298±60.6μm），差异有统计学意义（p<0.001），调整年龄、种族和眼轴长度后，差异仍有统计学意义（p=0.017）。黄斑中心凹下脉络膜厚度随眼轴长度的增加而减少（-16.2μm/mm，95%置信区间-21.2 至-12.4，p<0.001），随近视屈光度的增加而减少（-10.0μm/D，95%置信区间 6.8 至 13.1；p<0.001，调整了年龄、种族、眼轴长度和性别），随身高的增加而增加（1.3μm/cm，95%置信区间 0.8 至 1.9，p<0.001）。此外，脉络膜厚度随出生体重的增加而增加（13.0μm/kg；95%置信区间 0.006-0.020；p<0.001），随胎龄的增加而增加（8.2μm/kg；95%置信区间 4.6-11.8；p<0.001）。直至妊娠时才知道吸烟与脉络膜变薄有关（p=0.016）。饮酒没有可检测到的影响。眼轴长度、屈光度和脉络膜厚度的分布比老年人群更窄。
女孩的黄斑中心凹下脉络膜比男孩厚，而较高的身高、较高的出生体重和较大的胎龄与黄斑中心凹下脉络膜较厚有关。这些发现对近视发展的影响需要在纵向研究中进一步评估。
