Wei Ruoyan, Li Jun, Yang Weiming, Liu Chang, Wang Yunzhe, Wang Lin, Liu Shixue, Yu Yongfu, Huang Chen, Song Kaimin, Ju Lie, He Wanji, Zhong Hua, Pan Yanting, Fu Fayan, Wang Xiaoying, Chen Yuzhong, Ge Zongyuan, He Mingguang, Zhou Xingtao, Li Meiyan
Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
Retina. 2024 Mar 1;44(3):527-536. doi: 10.1097/IAE.0000000000003991.
To investigate fundus tessellation density (TD) and its association with axial length (AL) elongation and spherical equivalent (SE) progression in children.
The school-based prospective cohort study enrolled 1,997 individuals aged 7 to 9 years in 11 elementary schools in Mojiang, China. Cycloplegic refraction and biometry were performed at baseline and 4-year visits. The baseline fundus photographs were taken, and TD, defined as the percentage of exposed choroidal vessel area in the photographs, was quantified using an artificial intelligence-assisted semiautomatic labeling approach. After the exclusion of 330 ineligible participants because of loss to follow-up or ineligible fundus photographs, logistic models were used to assess the association of TD with rapid AL elongation (>0.36 mm/year) and SE progression (>1.00 D/year).
The prevalence of tessellation was 477 of 1,667 (28.6%) and mean TD was 0.008 ± 0.019. The mean AL elongation and SE progression in 4 years were 0.90 ± 0.58 mm and -1.09 ± 1.25 D. Higher TD was associated with longer baseline AL (β, 0.030; 95% confidence interval: 0.015-0.046; P < 0.001) and more myopic baseline SE (β, -0.017; 95% confidence interval: -0.032 to -0.002; P = 0.029). Higher TD was associated with rapid AL elongation (odds ratio, 1.128; 95% confidence interval: 1.055-1.207; P < 0.001) and SE progression (odds ratio, 1.123; 95% confidence interval: 1.020-1.237; P = 0.018).
Tessellation density is a potential indicator of rapid AL elongation and refractive progression in children. TD measurement could be a routine to monitor AL elongation.
研究儿童眼底镶嵌密度（TD）及其与眼轴长度（AL）延长和等效球镜度（SE）进展的关系。
这项基于学校的前瞻性队列研究纳入了中国墨江11所小学的1997名7至9岁的儿童。在基线和4年随访时进行散瞳验光和生物测量。拍摄基线眼底照片，并使用人工智能辅助的半自动标记方法对TD进行量化，TD定义为照片中暴露的脉络膜血管面积的百分比。在排除330名因失访或眼底照片不符合要求而不符合条件的参与者后，使用逻辑模型评估TD与快速AL延长（>0.36 mm/年）和SE进展（>1.00 D/年）的关系。
1667名儿童中，镶嵌的患病率为477例（28.6%），平均TD为0.008±0.019。4年中平均AL延长和SE进展分别为0.90±0.58 mm和-1.09±1.25 D。较高的TD与更长的基线AL相关（β，0.030；95%置信区间：0.015-0.046；P<0.001）和更近视的基线SE相关（β，-0.017；95%置信区间：-0.032至-0.002；P=0.029）。较高的TD与快速AL延长相关（比值比，1.128；95%置信区间：1.055-1.207；P<0.001）和SE进展相关（比值比，1.123；95%置信区间：1.020-1.237；P=0.018）。
镶嵌密度是儿童快速AL延长和屈光进展的潜在指标。TD测量可能是监测AL延长的常规方法。
