Jiang Zhaoxin, Hou Aohan, Zhang Ting, Lai Yanting, Huang Li, Ding Xiaoyan
State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Front Med (Lausanne). 2023 Jul 18;10:1156259. doi: 10.3389/fmed.2023.1156259. eCollection 2023.
To explore the etiology and choroidal thickness (ChT) pattern in children with early-onset high myopia (eoHM).
Sixty children with eoHM and 20 healthy controls were enrolled in this study between January 2019 and December 2021. All children underwent comprehensive ophthalmologic examinations including swept-source optical coherence tomography. ChT was measured in the subfoveal region and at 1000 μm and 2,500 μm nasal, temporal, superior, and inferior to the fovea.
Overall, 120 eyes of 60 children with eoHM were examined (mean spherical equivalent, -8.88 ± 3.05 D; mean axial length, 26.07 ± 1.59 mm). Simple high myopia (SHM), familial exudative vitreoretinopathy (FEVR), and Stickler syndrome (STL) were the most frequent etiologies of eoHM and were included in further ChT analysis. Adjusted the effect of SE, multivariate regression analysis showed that children with SHM had thinnest ChT at N and I among the subgroups ( = 0.039, = 0.013). FEVR group showed thinner ChT at T ( = 0.023), while STL patients exhibited thin ChT at all locations.
This study revealed that SHM, STL and FEVR was the most frequent etiology, and showed a distinctive pattern of ChT. Asymmetric nasal ChT thinning is a distinctive biomarker for SHM, asymmetric temporal ChT thinning might serve as a biomarker for FEVR, and symmetric diffuse thinning is more common in STL. These ChT patterns may provide a convenient, fast, and noninvasive strategy to differentiate the potential etiology of eoHM.
探讨早发性高度近视（eoHM）患儿的病因及脉络膜厚度（ChT）模式。
2019年1月至2021年12月，本研究纳入了60例eoHM患儿和20例健康对照。所有患儿均接受了包括扫频光学相干断层扫描在内的全面眼科检查。在黄斑中心凹下区域以及黄斑中心凹鼻侧、颞侧、上方和下方1000μm及2500μm处测量ChT。
总体而言，对60例eoHM患儿的120只眼进行了检查（平均球镜等效度，-8.88±3.05 D；平均眼轴长度，26.07±1.59 mm）。单纯性高度近视（SHM）、家族性渗出性玻璃体视网膜病变（FEVR）和Stickler综合征（STL）是eoHM最常见的病因，并纳入进一步的ChT分析。校正球镜等效度的影响后，多因素回归分析显示，在各亚组中，SHM患儿在鼻侧和下方的ChT最薄（P = 0.039，P = 0.013）。FEVR组在颞侧的ChT较薄（P = 0.023），而STL患者在所有位置的ChT均较薄。
本研究表明，SHM、STL和FEVR是最常见的病因，并呈现出独特的ChT模式。鼻侧ChT不对称变薄是SHM的独特生物标志物，颞侧ChT不对称变薄可能是FEVR的生物标志物，而对称性弥漫性变薄在STL中更为常见。这些ChT模式可能为区分eoHM的潜在病因提供一种方便、快速且无创的策略。
