Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China.
National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Br J Ophthalmol. 2024 May 21;108(5):720-728. doi: 10.1136/bjo-2022-321839.
To investigate myopic maculopathy in Chinese children with high myopia and its association with choroidal and retinal changes.
This cross-sectional study included Chinese children aged 4-18 years with high myopia. Myopic maculopathy was classified by fundus photography and retinal thickness (RT) and choroidal thickness (ChT) in the posterior pole were measured by swept-source optical coherence tomography. A receiver operation curve was used to determine the efficacy of fundus factors in classifying myopic maculopathy.
In total, 579 children aged 12.8±3.2 years with a mean spherical equivalent of -8.44±2.20 D were included. The proportions of tessellated fundus and diffuse chorioretinal atrophy were 43.52% (N=252) and 8.64% (N=50), respectively. Tessellated fundus was associated with a thinner macular ChT (OR=0.968, 95% CI: 0.961 to 0.975, p<0.001) and RT (OR=0.977, 95% CI: 0.959 to 0.996, p=0.016), longer axial length (OR=1.545, 95% CI: 1.198 to 1.991, p=0.001) and older age (OR=1.134, 95% CI: 1.047 to 1.228, p=0.002) and less associated with male children (OR=0.564, 95% CI: 0.348 to 0.914, p=0.020). Only a thinner macular ChT (OR=0.942, 95% CI: 0.926 to 0.959, p<0.001) was independently associated with diffuse chorioretinal atrophy. When using nasal macular ChT for classifying myopic maculopathy, the optimal cut-off value was 129.00 µm (area under the curve (AUC)=0.801) and 83.85 µm (AUC=0.910) for tessellated fundus and diffuse chorioretinal atrophy, respectively.
A large proportion of highly myopic Chinese children suffer from myopic maculopathy. Nasal macular ChT may serve as a useful index for classifying and assessing paediatric myopic maculopathy.
NCT03666052.
研究中国高度近视儿童的近视性黄斑病变及其与脉络膜和视网膜变化的关系。
本横断面研究纳入了年龄在 4-18 岁的中国高度近视儿童。通过眼底照相对近视性黄斑病变进行分类，并使用扫频源光学相干断层扫描测量后极部视网膜厚度（RT）和脉络膜厚度（ChT）。采用受试者工作特征曲线确定眼底因素在分类近视性黄斑病变中的效能。
共纳入 579 名年龄为 12.8±3.2 岁、等效球镜度为-8.44±2.20 D 的儿童。棋盘格样眼底和弥漫性脉络膜视网膜萎缩的比例分别为 43.52%（N=252）和 8.64%（N=50）。棋盘格样眼底与较薄的黄斑 ChT（OR=0.968，95%CI：0.961 至 0.975，p<0.001）和 RT（OR=0.977，95%CI：0.959 至 0.996，p=0.016）、较长的眼轴（OR=1.545，95%CI：1.198 至 1.991，p=0.001）和较大的年龄（OR=1.134，95%CI：1.047 至 1.228，p=0.002）相关，而与男性儿童（OR=0.564，95%CI：0.348 至 0.914，p=0.020）的相关性较低。只有较薄的黄斑 ChT（OR=0.942，95%CI：0.926 至 0.959，p<0.001）与弥漫性脉络膜视网膜萎缩独立相关。当使用鼻侧黄斑 ChT 对近视性黄斑病变进行分类时，最佳截断值分别为 129.00 μm（曲线下面积（AUC）=0.801）和 83.85 μm（AUC=0.910），用于棋盘格样眼底和弥漫性脉络膜视网膜萎缩。
中国高度近视儿童中存在相当大比例的近视性黄斑病变。鼻侧黄斑 ChT 可能是一种有用的分类和评估儿童近视性黄斑病变的指标。
NCT03666052。
