Wu Hao, Liu Mengqi, Wang Yuanyuan, Li Xiang, Zhou Weihe, Li Haoer, Xie Zhu, Wang Pengqi, Zhang Tingting, Qu Wei, Huang Jing, Zhao Yunpeng, Wang Jiefang, Zhang Sen, Qu Jia, Ye Cong, Zhou Xiangtian
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Br J Ophthalmol. 2025 Jan 28;109(2):273-280. doi: 10.1136/bjo-2024-325871.
To assess predictive value of short-term choroidal changes for future myopic shift in children.
577 eyes of 289 primary school children were prospectively followed for 2 years. Cycloplegic refractions at baseline, 1 year and 2 years, and choroidal measurements by optical coherence tomography at baseline and 3 months, were used for analyses. Myopic shift was defined as refraction change of at least -0.50 dioptre/year, at 2 years compared with baseline.
228 participants (455 eyes) completed 2-year follow-up. Approximately 37.6% of 311 initially non-myopic eyes and 73.6% of 144 initially myopic eyes developed a myopic shift. Notably, at 3 months greater reductions were found in initially myopic eyes with myopic shift, than in those without myopic shift-in choroidal thickness (ChT), luminal area (LA), stromal area (SA) and total choroidal area (TCA), but no significant differences in any choroidal parameters were observed between non-myopic eyes, with and without myopic shift. Multivariable analyses showed that in myopic eyes, each percentage increase in ChT, LA, SA and TCA was associated with reduced odds of myopic shift (all p<0.001). Similar associations were observed in non-myopic eyes, with smaller effects than in myopic eyes. Adding a 3-month percentage change of each choroidal parameter to a basic model including age, gender, parental myopia and baseline refraction significantly improved the predictive performance in myopic eyes (area under the receiver operating characteristic curves increasing from 0.650 to approximately 0.800, all p<0.05), but not in non-myopic eyes.
Short-term choroidal changes could act as early indicators for future myopic shift in children.
评估儿童短期脉络膜变化对未来近视进展的预测价值。
对289名小学生的577只眼进行了为期2年的前瞻性随访。使用基线、1年和2年时的睫状肌麻痹验光结果，以及基线和3个月时通过光学相干断层扫描测量的脉络膜数据进行分析。近视进展定义为与基线相比，2年时屈光度变化至少为-0.50 D/年。
228名参与者（455只眼）完成了2年随访。最初311只非近视眼中约37.6%以及144只近视眼中73.6%出现了近视进展。值得注意的是，在3个月时，出现近视进展的初始近视眼中，脉络膜厚度（ChT）、管腔面积（LA）、基质面积（SA）和脉络膜总面积（TCA）的减少幅度大于未出现近视进展的初始近视眼，但在有和没有近视进展的非近视眼中，未观察到任何脉络膜参数有显著差异。多变量分析显示，在近视眼中，ChT、LA、SA和TCA每增加一个百分点，近视进展的几率就会降低（所有p<0.001）。在非近视眼中也观察到了类似的关联，但其影响小于近视眼中的影响。将每个脉络膜参数的3个月百分比变化添加到包括年龄、性别、父母近视和基线验光的基本模型中，显著提高了对近视眼的预测性能（受试者工作特征曲线下面积从0.650增加到约0.800，所有p<0.05），但对非近视眼没有改善。
短期脉络膜变化可作为儿童未来近视进展的早期指标。
