Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore.
Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Queensland, Australia.
Transl Vis Sci Technol. 2024 Aug 1;13(8):38. doi: 10.1167/tvst.13.8.38.
The purpose of this study was to evaluate longitudinal changes in choroidal vascular characteristics in childhood, and their relationship with eye growth and refractive error.
Analysis of high-resolution optical coherence tomography (OCT) scans, collected over an 18-month period as part of the Role of Outdoor Activity in Myopia (ROAM) study, was conducted in 101 children (41 myopic, 60 non-myopic, age 10-15 years). OCT images were automatically analyzed and binarized using a deep learning software tool. The output was then used to compute changes in macular choroidal vascularity index (CVI), choroidal luminal, and stromal thickness over 18-months. Associations of these variables with refractive error and axial length were analyzed.
CVI decreased significantly, whereas luminal and stromal thickness increased significantly over 18 months (all P < 0.001). The magnitude of change was approximately double in stromal tissue compared to luminal tissue (luminal β = 2.6 µm/year; 95% confidence interval [CI] = -1.0 to 4.1 µm/year; stromal β = 5.2 µm/year; 95% CI = 4.0, 6.5 µm/year). A significant interaction between baseline axial length and change in CVI over time (P = 0.047) was observed, with a greater CVI reduction in those with shorter axial lengths. Significant associations were observed between the change in CVI, luminal thickness, stromal thickness, and change in axial length over time (all P < 0.05).
Faster axial eye growth was associated with smaller reductions in CVI, and less increase in choroidal luminal and stromal thickness. The changes in choroidal vascularity, particularly in the stromal component, may thus be a marker for eye growth.
This knowledge of the longitudinal changes in choroidal vascularity in childhood and their relationship with eye growth may assist clinicians in the future to better predict eye growth and myopia progression in childhood.
本研究旨在评估儿童时期脉络膜血管特征的纵向变化及其与眼球生长和屈光不正的关系。
对作为户外活动与近视关系研究（ROAM）的一部分，在 18 个月期间收集的高分辨率光学相干断层扫描（OCT）图像进行分析。该研究共纳入 101 名儿童（近视 41 名，非近视 60 名，年龄 10-15 岁）。使用深度学习软件工具对 OCT 图像进行自动分析和二值化。然后，使用该输出计算 18 个月内黄斑脉络膜血管指数（CVI）、脉络膜腔和基质厚度的变化。分析这些变量与屈光不正和眼轴的相关性。
CVI 显著降低，而腔和基质厚度在 18 个月内显著增加（均 P < 0.001）。基质组织的变化幅度大约是腔组织的两倍（腔 β = 2.6 µm/年；95%置信区间 [CI] = -1.0 至 4.1 µm/年；基质 β = 5.2 µm/年；95%CI = 4.0，6.5 µm/年）。观察到基线眼轴与 CVI 随时间变化之间存在显著的交互作用（P = 0.047），眼轴较短的患者 CVI 降低更明显。CVI、腔厚度、基质厚度和眼轴随时间变化之间存在显著相关性（均 P < 0.05）。
更快的眼球轴向生长与 CVI 降低幅度较小以及脉络膜腔和基质厚度增加幅度较小相关。脉络膜血管的变化，特别是基质成分的变化，可能是眼球生长的标志物。
李君彦
