Valizadeh Ghazal, Hoseini-Yazdi Hosein, Read Scott, Alonso-Caneiro David, Collins Michael
Save Sight Institute, Discipline of Ophthalmology, The University of Sydney, Sydney, New South Wales, Australia.
Queensland University of Technology (QUT), Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, Optometry and Vision Science, Kelvin Grove, Queensland, Australia.
Transl Vis Sci Technol. 2025 May 1;14(5):3. doi: 10.1167/tvst.14.5.3.
This retrospective cross-sectional study examined regional changes in choroidal vascularity index (CVI) with physiological aging in healthy emmetropes.
Deep learning methods were used for segmentation and binarization of enhanced depth imaging optical coherence tomography images of the choroid collected from 280 healthy emmetropic subjects (mean spherical equivalent refraction: +0.39 ± 0.38 D), including 83 children (5-12 years), 77 adolescents (13-17 years), and 120 adults (18-41 years). The CVI, calculated as the ratio of luminal versus total choroidal area (in percent), and luminal and stromal choroidal thickness were measured across the 5-mm horizontal macular region centered on the fovea. Linear mixed models were used to examine age-related regional changes in the choroid while controlling for gender and imaging time of day.
The macular CVI reduced significantly from childhood (65% ± 0.5%) and adolescence (63% ± 0.5%) to adulthood (59% ± 0.4%) (P < 0.001). Significant regional variations were observed (P < 0.001) with the CVI increasing from the fovea (61% ± 0.3%) toward the perifovea (64% ± 0.3%) and from the temporal (61.4% ± 0.3%) toward the nasal hemiretina (63% ± 0.3%). The age-related decrease in the CVI was greater in the nasal (-7% ± 0.7%) than the temporal (-6% ± 0.7%) macula (P = 0.014) and was associated with a significant nasal stromal thickening (45 ± 5 µm; P < 0.001) and temporal luminal thinning (-16 ± 6 µm; P = 0.033) from childhood to adulthood.
Physiological aging was associated with a significant region-dependent decline in the CVI driven, primarily by stromal thickening in the nasal and luminal thinning in the temporal macula.
These age-related changes in the CVI provide new insights into the physiological morphology of the choroid during aging and may aid clinicians in understanding the spatial and age-associated predilections of certain chorioretinal diseases.
本回顾性横断面研究探讨了健康正视者脉络膜血管指数（CVI）随生理年龄的区域变化。
采用深度学习方法对从280名健康正视受试者（平均球镜等效屈光度：+0.39±0.38 D）收集的脉络膜增强深度成像光学相干断层扫描图像进行分割和二值化处理，其中包括83名儿童（5 - 12岁）、77名青少年（13 - 17岁）和120名成年人（18 - 41岁）。以管腔面积与脉络膜总面积的比值（百分比）计算CVI，并在以黄斑中心凹为中心的5毫米水平黄斑区域测量管腔和基质脉络膜厚度。使用线性混合模型在控制性别和成像时间的同时，研究脉络膜与年龄相关的区域变化。
黄斑CVI从儿童期（65%±0.5%）和青少年期（63%±0.5%）到成年期（59%±0.4%）显著降低（P<0.001）。观察到显著的区域差异（P<0.001），CVI从中心凹（61%±0.3%）向中心凹周围（64%±0.3%）增加，从颞侧（61.4%±0.3%）向鼻侧半视网膜（63%±0.3%）增加。与年龄相关的CVI降低在鼻侧黄斑（-7%±0.7%）比颞侧黄斑（-6%±0.7%）更大（P = 0.014），并且与从儿童期到成年期鼻侧基质显著增厚（45±5 µm；P<0.001）和颞侧管腔变薄（-16±6 µm；P = 0.033）相关。
生理衰老与CVI显著的区域依赖性下降相关，主要由鼻侧基质增厚和颞侧黄斑管腔变薄驱动。
CVI的这些与年龄相关的变化为衰老过程中脉络膜的生理形态提供了新的见解，并可能有助于临床医生理解某些脉络膜视网膜疾病的空间和年龄相关易感性。
