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近视儿童的脉络膜厚度分布及其相关因素。

Choroidal Thickness Profiles and Associated Factors in Myopic Children.

机构信息

Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin, Dublin, Ireland.

出版信息

Optom Vis Sci. 2023 Jan 1;100(1):57-66. doi: 10.1097/OPX.0000000000001973. Epub 2022 Dec 6.

Abstract

SIGNIFICANCE

This study addresses the lack of choroidal thickness (ChT) profile information available in European children and provides a baseline for further evaluation of longitudinal changes in ChT profiles in myopic children as a potential biomarker for myopia treatment and identifying children at risk of myopic progression.

PURPOSE

This study aimed to investigate ChT profiles and associated factors in myopic children.

METHODS

Baseline data of 250 myopic children aged 6 to 16 years in the Myopia Outcome Study of Atropine in Children clinical trial were analyzed. Choroidal thickness images were obtained using swept-source optical coherence tomography (DRI-OCT Triton Plus; Topcon Corporation, Tokyo, Japan). The macula was divided into nine Early Treatment of Diabetic Retinopathy Study locations with diameters of 1, 3, and 6 mm corresponding to the central fovea, parafoveal, and perifoveal regions. Multiple linear regression models were used to investigate determinants of ChT.

RESULTS

Choroidal thickness varied across the macular Early Treatment of Diabetic Retinopathy Study locations ( P < .001): thickest in the perifoveal superior region (mean ± standard deviation, 249.0 ± 60.8 μm) and thinnest in the perifoveal nasal region (155.1 ± 50.3 μm). On average, ChT was greater in all parafoveal (231.8 ± 57.8 μm) compared with perifoveal (218.1 ± 49.1 μm) regions except superiorly where the ChT was greater in the perifoveal region. Longer axial length and higher myopic spherical equivalent refraction were consistently associated with thinner ChT at all locations in the multiple linear regression models. Asian race was significantly associated with thinner ChT only at parafoveal and perifoveal superior regions after Bonferroni correction ( P = .004 and P = .001, respectively).

CONCLUSIONS

Choroidal thickness was thinnest in the nasal macular region and varied systematically across all macular locations, with axial length and spherical equivalent refraction being the strongest determinants of ChT. Longitudinal evidence will need to evaluate whether any differences in ChT profiles are predictive of myopic progression and to determine the role of ChT measurements in identifying myopic children most in need of myopia control treatment.

摘要

意义

本研究解决了欧洲儿童缺乏脉络膜厚度(ChT)谱信息的问题,并为进一步评估近视儿童的 ChT 谱纵向变化提供了基线,作为近视治疗的潜在生物标志物,并确定了近视进展风险的儿童。

目的

本研究旨在调查近视儿童的 ChT 谱和相关因素。

方法

分析了儿童阿托品近视结局研究(Myopia Outcome Study of Atropine in Children clinical trial)中 250 名 6 至 16 岁近视儿童的基线数据。使用扫频源光学相干断层扫描(DRI-OCT Triton Plus;Topcon Corporation,东京,日本)获得脉络膜厚度图像。黄斑分为 9 个早期糖尿病性视网膜病变研究(Etdrs)位置,直径为 1、3 和 6 毫米,对应于中央凹、旁中心和周边区域。采用多元线性回归模型探讨 ChT 的决定因素。

结果

脉络膜厚度在黄斑 Etdrs 位置上存在差异(P <.001):最厚的是周边上侧(平均±标准差,249.0±60.8μm),最薄的是周边鼻侧(155.1±50.3μm)。平均而言,所有旁中心(231.8±57.8μm)的 ChT 均大于周边(218.1±49.1μm),除了上侧,周边的 ChT 更厚。在多元线性回归模型中,眼轴长度较长和近视等效球镜屈光度较高与所有位置的 ChT 变薄均呈一致相关。在 Bonferroni 校正后,亚洲种族仅与旁中心和周边上侧的 ChT 变薄显著相关(P =.004 和 P =.001)。

结论

ChT 在鼻侧黄斑区最薄,在所有黄斑区系统地变化,眼轴长度和等效球镜屈光度是 ChT 的最强决定因素。需要进行纵向研究来评估 ChT 谱的任何差异是否可预测近视进展,并确定 ChT 测量在识别最需要近视控制治疗的近视儿童方面的作用。

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