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Lee YS, Liu L, Wang NK, Chen KJ, Hwang YS, Lai CC, Wu WC. LONGITUDINAL CHANGES IN CHOROIDAL THICKNESS IN CHILDREN WITH A HISTORY OF PREMATURITY: An 18-Month Prospective Cohort Study. Retina 2024; 44:1063-1072. [PMID: 38346114 DOI: 10.1097/iae.0000000000004062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
PURPOSE To evaluate choroidal changes over time in school-age children with a history of prematurity. METHODS A study of 416 eyes of 208 eligible participants, including 88, 190, 36, 56, and 46 eyes in the full-term control, preterm, spontaneously regressed retinopathy of prematurity, intravitreal bevacizumab (injection of bevacizumab)-treated retinopathy of prematurity, and laser-treated retinopathy of prematurity groups, respectively, were enrolled in this study. The choroidal thickness was measured 4 times at 6-month intervals using optical coherence tomography. RESULTS Of all the groups, the laser-treated children had the thinnest choroid compared with full-term children (-52.3 µ m, P = 0.04). Preterm children exhibited greater attenuation in choroidal thickness over time than did full-term children (-6.3 ± 26.9 and -1.1 ± 12.8 µ m/year, P = 0.03), whereas no difference was observed between injection of bevacizumab and laser treatments (-4.6 ± 18.9 and -2.0 ± 15.7 µ m/year, P = 0.46). In all groups, the changes in axial length were negatively associated with the changes in choroidal thickness (all P < 0.05). CONCLUSION A greater attenuation in choroid thickness over time was observed in preterm children than in full-term children, but this attenuation did not differ between injection of bevacizumab and laser treatments. Axial elongation was associated with choroidal thinning in school-age children.
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Affiliation(s)
- Yung-Sung Lee
- Department of Ophthalmology, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Laura Liu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Kuan-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; and
| | - Yih-Shiou Hwang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; and
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; and
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Wei-Chi Wu
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; and
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Deng J, Xu X, Pan CW, Wang J, He M, Zhang B, Yang J, Hou XW, Zhu Z, Borchert G, Chen J, Cheng T, Yu S, Fan Y, Liu K, Zou H, Xu X, He X. Myopic maculopathy among Chinese children with high myopia and its association with choroidal and retinal changes: the SCALE-HM study. Br J Ophthalmol 2024; 108:720-728. [PMID: 37290823 PMCID: PMC11137474 DOI: 10.1136/bjo-2022-321839] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
AIMS To investigate myopic maculopathy in Chinese children with high myopia and its association with choroidal and retinal changes. METHODS This cross-sectional study included Chinese children aged 4-18 years with high myopia. Myopic maculopathy was classified by fundus photography and retinal thickness (RT) and choroidal thickness (ChT) in the posterior pole were measured by swept-source optical coherence tomography. A receiver operation curve was used to determine the efficacy of fundus factors in classifying myopic maculopathy. RESULTS In total, 579 children aged 12.8±3.2 years with a mean spherical equivalent of -8.44±2.20 D were included. The proportions of tessellated fundus and diffuse chorioretinal atrophy were 43.52% (N=252) and 8.64% (N=50), respectively. Tessellated fundus was associated with a thinner macular ChT (OR=0.968, 95% CI: 0.961 to 0.975, p<0.001) and RT (OR=0.977, 95% CI: 0.959 to 0.996, p=0.016), longer axial length (OR=1.545, 95% CI: 1.198 to 1.991, p=0.001) and older age (OR=1.134, 95% CI: 1.047 to 1.228, p=0.002) and less associated with male children (OR=0.564, 95% CI: 0.348 to 0.914, p=0.020). Only a thinner macular ChT (OR=0.942, 95% CI: 0.926 to 0.959, p<0.001) was independently associated with diffuse chorioretinal atrophy. When using nasal macular ChT for classifying myopic maculopathy, the optimal cut-off value was 129.00 µm (area under the curve (AUC)=0.801) and 83.85 µm (AUC=0.910) for tessellated fundus and diffuse chorioretinal atrophy, respectively. CONCLUSION A large proportion of highly myopic Chinese children suffer from myopic maculopathy. Nasal macular ChT may serve as a useful index for classifying and assessing paediatric myopic maculopathy. TRIAL REGISTRATION NUMBER NCT03666052.
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Affiliation(s)
- Junjie Deng
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xian Xu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
| | - Mingguang He
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Bo Zhang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
- School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Xiao-Wen Hou
- School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Zhuoting Zhu
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia
| | - Grace Borchert
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
| | - Tianyu Cheng
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Suqing Yu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ying Fan
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Kun Liu
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, People's Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Cao Y, Gu X, Zhang Y, Zhao J, Zhu D. Assessment of the effects of myopic and hyperopic anisometropia on choroidal vascular structure in children using SS-OCTA. Ophthalmic Physiol Opt 2024; 44:525-536. [PMID: 38456753 DOI: 10.1111/opo.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To compare large- and medium-sized choroidal vascularity and the choriocapillaris (CC) flow area in children with different refractive errors using swept-source optical coherence tomography angiography (SS-OCTA). METHODS Forty-two anisometropic children were enrolled and divided into hyperopic anisometropia (HA) and myopic anisometropia (MA) groups. SS-OCTA was performed to analyse choroidal vascularity. Mean choroidal thickness (CT), choroidal vascularity volume (CVV), choroidal vascularity index (CVI) and CC flow area were compared between the two eyes. The inter-ocular differences between the two groups were also determined. RESULTS Mean CT and CVV were highest in eyes with shorter axial lengths in both refractive groups, and the difference between the two eyes was positively correlated with the difference in axial length at the foveal region. Significant differences in the CVI in the MA group were only found in the parafoveal region. Inter-ocular differences in the CC were significantly reduced in eyes with longer axial lengths in the foveal and parafoveal regions of the HA and MA groups, respectively. Comparing inter-ocular differences, CC was significantly greater in the parafoveal region of the MA group than the HA group. CONCLUSIONS All layers of choroidal vasculature were thinner in eyes with longer axial lengths in all groups. The inter-ocular CC difference was greater in the MA than in the HA group, with similar differences in axial length. This suggests that both medium-to-large choroidal vascular and choroidal capillaries may play a role in myopia development.
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Affiliation(s)
- Yiwen Cao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Xiaopeng Gu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Yadi Zhang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Jingjing Zhao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Dehai Zhu
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
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Liu M, Wang Y, Li H, Zhao Y, Ma M, Xu S, Wei X, Xu R, Tian R, Zhou X, Wu H. Differences in choroidal responses to near work between myopic children and young adults. EYE AND VISION (LONDON, ENGLAND) 2024; 11:12. [PMID: 38561862 PMCID: PMC10986059 DOI: 10.1186/s40662-024-00382-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Near work is generally considered as a risk factor for myopia onset and progression. This study aimed to investigate the choroidal responses to a brief-period of near work in children and young adults. METHODS Thirty myopic medical students (aged 18-28 years) and 30 myopic children (aged 8-12 years) participated in this study. The submacular total choroidal area (TCA), luminal area (LA), stromal area (SA), choroidal vascularity index (CVI) and choriocapillaris flow deficit (CcFD), as well as subfoveal choroidal thickness (SFCT) were measured with swept-source optical coherence tomography/optical coherence tomography angiography (SS-OCT/OCTA) before and immediately after 20 min, 40 min, 60 min of near work at a distance of 33 cm. RESULTS In adults, 20 min of near work induced a significant reduction in SFCT (- 5.1 ± 6.5 μm), LA [(- 19.2 ± 18.6) × 103 μm2], SA [(- 8.2 ± 12.6) × 103 μm2] and TCA [(- 27.4 ± 24.9) × 103 μm2] (all P < 0.01). After 40 min of near work, LA was still reduced [(- 9.4 ± 18.3) × 103 μm2], accompanied with a decreased CVI (- 0.39% ± 0.70%) and an increased CcFD (0.30% ± 0.78%) (all P < 0.05). After 60 min of near work, CVI was still reduced (- 0.28% ± 0.59%), and CcFD was still increased (0.37% ± 0.75%) (all P < 0.05). In children, 20 min of near work induced a significant increase in CcFD (0.55% ± 0.64%), while 60 min of near work induced increases in SA [(7.2 ± 13.0) × 103 μm2] and TCA [(9.7 ± 25.3) × 103 μm2] and a reduction in CVI (- 0.28% ± 0.72%) (all P < 0.05). Children exhibited lower near work-induced LA and TCA reduction than adults, with a mean difference of - 0.86% and - 0.82%, respectively (all P < 0.05). CONCLUSIONS The temporal characteristics and magnitude of changes of choroidal vascularity and choriocapillaris perfusion during near work was not identical between children and adults. The initial response to near work was observed in choriocapillaris in children, whereas it was observed in the medium- and large-sized vessels in adults. TRIAL REGISTRATION Clinical Trial Registry (ChiCTR), ChiCTR2000040205. Registered on 25 November 2020, https://www.chictr.org.cn/bin/project/edit?pid=64501 .
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Affiliation(s)
- Mengqi Liu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yuanyuan Wang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Haoer Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Yunpeng Zhao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Min Ma
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Shihan Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiaohuan Wei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ruiyan Xu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Ruikang Tian
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xiangtian Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China.
| | - Hao Wu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
- State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
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Ostrin LA, Sah RP, Queener HM, Patel NB, Tran R, Shukla D, Mirhajianmoghadam H. Short-Term Myopic Defocus and Choroidal Thickness in Children and Adults. Invest Ophthalmol Vis Sci 2024; 65:22. [PMID: 38597724 PMCID: PMC11008753 DOI: 10.1167/iovs.65.4.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
Purpose Studies report conflicting findings regarding choroidal thickness changes in response to myopic defocus in humans. This study aimed to investigate the choroidal response to myopic defocus in children and adults using automated analysis. Methods Participants (N = 46) were distance-corrected in both eyes and viewed a movie on a screen for 10 minutes. Two optical coherence tomography (OCT) radial scans were collected for each eye, then +3 diopters was added to one eye. Participants continued to watch the movie, OCT scans were repeated every 10 minutes for 50 minutes, and then recovery was assessed at 60 and 70 minutes. Defocus was interrupted for approximately two out of each 10 minutes for OCT imaging. OCT images were analyzed using an automated algorithm and trained neural network implemented in MATLAB to determine choroidal thickness at each time point. Repeated-measures ANOVA was used to assess changes with time in three age groups (6-17, 18-30, and 31-45 years) and by refractive error group (myopic and nonmyopic). Results Choroidal thickness was significantly associated with spherical equivalent refraction, with the myopic group having a thinner choroid than the nonmyopic group (P < 0.001). With imposed myopic defocus, there were no significant changes in choroidal thickness at any time point for any age group and for either refractive error group (P > 0.05 for all). Conclusions Findings demonstrate that, using the described protocol, the choroidal thickness of children and adults does not significantly change in response to short-term, full-field myopic defocus, in contrast to several previously published studies.
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Affiliation(s)
- Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, United States
| | - Raman P. Sah
- University of Houston College of Optometry, Houston, TX, United States
| | - Hope M. Queener
- University of Houston College of Optometry, Houston, TX, United States
| | - Nimesh B. Patel
- University of Houston College of Optometry, Houston, TX, United States
| | - Raphaella Tran
- University of Houston College of Optometry, Houston, TX, United States
| | - Divya Shukla
- University of Houston College of Optometry, Houston, TX, United States
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Jolly JK, Rodda BM, Edwards TL, Ayton LN, Ruddle JB. Optical coherence tomography in children with inherited retinal disease. Clin Exp Optom 2024; 107:255-266. [PMID: 38252959 DOI: 10.1080/08164622.2023.2294807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
Recent advances have led to therapeutic options becoming available for people with inherited retinal disease. In particular, gene therapy has been shown to hold great promise for slowing vision loss from inherited retinal disease. Recent studies suggest that gene therapy is likely to be most effective when implemented early in the disease process, making consideration of paediatric populations important. It is therefore necessary to have a comprehensive understanding of retinal imaging in children with inherited retinal diseases, in order to monitor disease progression and to determine which early retinal biomarkers may be used as outcome measures in future clinical trials. In addition, as many optometrists will review children with an inherited retinal disease, an understanding of the expected imaging outcomes can improve clinical care. This review focuses on the most common imaging modality used in research assessment of paediatric inherited retinal diseases: optical coherence tomography. Optical coherence tomography findings can be used in both the clinical and research setting. In particular, the review discusses current knowledge of optical coherence tomography findings in eight paediatric inherited retinal diseases - Stargardt disease, Bests disease, Leber's congenital amaurosis, choroideremia, RPGR related retinitis pigmentosa, Usher syndrome, X-linked retinoschisis and, Batten disease.
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Affiliation(s)
- Jasleen K Jolly
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Brent M Rodda
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, Victoria, Australia
| | - Thomas L Edwards
- Ophthalmology, Department of Surgery, The University of Melbourne, East Melbourne, Victoria, Australia
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Lauren N Ayton
- Department of Optometry and Vision Sciences, The University of Melbourne, Carlton, Victoria, Australia
- Ophthalmology, Department of Surgery, The University of Melbourne, East Melbourne, Victoria, Australia
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Jonathan B Ruddle
- Centre for Eye Research Australia, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Department of Ophthalmology, Royal Children's Hospital, Parkville, Victoria, Australia
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Jiang Z, Bo W, Yang Z, Luo X, Ni Y, Zeng J. Choriocapillaris flow features in children with myopic anisometropia. Br J Ophthalmol 2024:bjo-2022-323020. [PMID: 38527770 DOI: 10.1136/bjo-2022-323020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/29/2024] [Indexed: 03/27/2024]
Abstract
AIMS To examine differences between the eyes in choriocapillaris perfusion and choroidal thickness in children with myopic anisometropia. METHODS In this observational and prospective study, 46 children with myopic anisometropia were enrolled. Choriocapillaris perfusion parameters, including the percentage of flow voids, the total number of flow voids and the average flow void area were obtained by optical coherence tomography angiography (OCTA). The OCTA image was divided into a 1 mm-diameter central circle (C1) and a 2.5 mm-diameter annulus (without the inner central 1 mm circle, C1-2.5). Both C1 and C1-2.5 are centred on the foveola. The C1-2.5 was divided into nasal (N1-2.5), temporal (T1-2.5), inferior (I1-2.5) and superior (S1-2.5) areas. Differences in these parameters in different regions between eyes were analysed. RESULTS There were no significant differences in the percentage of flow voids and the average flow void area between the fellow eyes. The total number of signal voids was significantly higher in the less myopic eyes in C1-2.5 (p=0.032), S1-2.5 (p=0.008) and N1-2.5 (p=0.019). Changes in spherical equivalent refraction and axial length were both correlated with the changes in the total number of flow voids in N1-2.5 (R=-0.431, p=0.03; R=-0.297, p=0.047). CONCLUSIONS The choroid in the macular region becomes thinner and the total number of flow voids in the nasal macular region decreased with the amplitude of myopia. This suggests that a decrease in total number of flow voids may indicate an early change in myopia.
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Affiliation(s)
- Zhihao Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wu Bo
- South China Hospital of Shenzhen University, Shenzhen University, Shenzhen, Guangdong, China
| | - Zhengfei Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaoling Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yao Ni
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Shen M, Han X, Yang Y, Huang H, Hou J, Jin L, Yu X, Zeng Y, He M. Longitudinal Changes in Choroidal Thickness Varied With Refractive Progression in Myopic and Non-Myopic Children: A Two-Year Cohort Study. Invest Ophthalmol Vis Sci 2024; 65:17. [PMID: 38470328 PMCID: PMC10939140 DOI: 10.1167/iovs.65.3.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
Purpose To evaluate the longitudinal changes in subfoveal choroidal thickness (SFCT) in children with different refractive status. Methods A total of 2290 children 3 to 14 years old who attended the first year of kindergarten (G0), first year of primary school (G1), fourth year of primary school (G4), or first year of junior high school (G7) in Guangzhou, China, were recruited and followed up for 2 years. All participants received cycloplegic autorefraction, axial length measurement and SFCT measurement using a CIRRUS HD-OCT device. Children were divided into groups of persistent non-myopia (PNM), persistent myopia (PM), or newly developed myopia (NDM). Children in the PNM and PM groups were further divided into subgroups of stable refraction (absolute mean annual spherical equivalent refraction [SER] change < 0.5 D) and refractive progression (absolute mean annual SER change ≥ 0.5 D). Results The mean ± SD ages for the G1 to G7 cohorts were 3.89 ± 0.30, 6.79 ± 0.47, 9.71 ± 0.34, and 12.54 ± 0.38, years, respectively. SFCT consistently decreased in the NDM group across the G1 to G7 cohorts (all P < 0.001) and exhibited variability across different age cohorts in the PNM and PM groups. Further subgroup analysis revealed significant thickening of SFCT in the PNM-stable group among the G0, G1, and G7 cohorts (all P < 0.05), whereas it remained stable among all cohorts in the PM-stable group (all P > 0.05). Conversely, SFCT exhibited thinning in the G4 and G7 cohorts in the PM-progressive group (both P < 0.01) and for the entire cohort of children in the PNM-progressive group (P = 0.012). Conclusions SFCT increased in nonmyopic children with stable refraction, remained stable in myopic children maintained stable refraction, and decreased in those with refractive progression, whether they were myopic or not.
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Affiliation(s)
- Menglu Shen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yan Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Hailu Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Jinen Hou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Xinping Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Yangfa Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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9
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Wei R, Li J, Yang W, Liu C, Wang Y, Wang L, Liu S, Yu Y, Huang C, Song K, Ju L, He W, Zhong H, Pan Y, Fu F, Wang X, Chen Y, Ge Z, He M, Zhou X, Li M. ASSOCIATION OF TESSELLATION DENSITY WITH PROGRESSION OF AXIAL LENGTH AND REFRACTION IN CHILDREN: An Artificial Intelligence-Assisted 4-Year Study. Retina 2024; 44:527-536. [PMID: 37972986 DOI: 10.1097/iae.0000000000003991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To investigate fundus tessellation density (TD) and its association with axial length (AL) elongation and spherical equivalent (SE) progression in children. METHODS 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). RESULTS 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). CONCLUSION 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.
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Affiliation(s)
- Ruoyan Wei
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Ruoyan Wei is also affiliated to Shanghai Medical College and Zhongshan Hospital Immunotherapy Translational Research Center, Shanghai, China
| | - Jun Li
- Department of Ophthalmology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Weiming Yang
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Chang Liu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yunzhe Wang
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lin Wang
- Beijing Airdoc Technology Co., Ltd, Beijing, China
- Monash University, Clayton, Victoria, Australia
| | - Shixue Liu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Biostatistics, School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Kaimin Song
- Beijing Airdoc Technology Co., Ltd, Beijing, China
| | - Lie Ju
- Beijing Airdoc Technology Co., Ltd, Beijing, China
- Monash University, Clayton, Victoria, Australia
| | - Wanji He
- Beijing Airdoc Technology Co., Ltd, Beijing, China
| | - Hua Zhong
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yanting Pan
- Kunming Medical University, Kunming, China; and
| | - Fayan Fu
- Department of Ophthalmology, Affiliated Hospital of Yunnan University, Kunming, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Yuzhong Chen
- Beijing Airdoc Technology Co., Ltd, Beijing, China
| | - Zongyuan Ge
- Monash University, Clayton, Victoria, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Meiyan Li
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Nilsen NG, Gilson SJ, Lindgren H, Kjærland M, Pedersen HR, Baraas RC. Seasonal and Annual Change in Physiological Ocular Growth of 7- to 11-Year-Old Norwegian Children. Invest Ophthalmol Vis Sci 2023; 64:10. [PMID: 38064230 PMCID: PMC10709800 DOI: 10.1167/iovs.64.15.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
Purpose To investigate seasonal and annual change in physiological eye growth in Norwegian school children. Methods Measurements of ocular biometry, non-cycloplegic spherical equivalent autorefraction (SER), and choroidal thickness (ChT) were obtained for 92 children (44 females) aged 7 to 11 years at four time points over a year (November 2019-November 2020). Seasons (3- and 5-month intervals) were classified as winter (November-January), winter-spring (January-June), and summer-autumn (June-November). Cycloplegic SER was obtained in January and used to group children. The seasonal and annual changes were tested with a linear mixed-effects model (P values were adjusted for multiple comparisons). Results All the children experienced annual ocular growth, irrespective of SER, but less so during the summer-autumn. The baseline SER was lower (P < 0.001), axial length (AL) was longer (P < 0.038), and choroids were thicker in 10- to 11-year-old than 7- to 8-year-old mild hyperopes (P = 0.002). Assuming mild hyperopes (n = 65) experience only physiological eye growth, modeling revealed seasonal and annual increases in AL across sex and age (P < 0.018), with less change during the summer-autumn than winter-spring. The 7- to 8-year-olds had a larger decrease annually and over winter-spring in SER (P ≤ 0.036) and in ChT over winter-spring than the 10- to 11-year-olds (P = 0.006). Conclusions There were significant seasonal and annual changes in AL in children who had physiological eye growth irrespective of age within this cohort. Annual changes in SER and seasonal choroidal thinning were only observed in 7- to 8-year-old children. This indicates continued emmetropization in 7- to 8-year-olds and a transition to maintaining emmetropia in 10- to 11-year-olds.
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Affiliation(s)
- Nickolai G. Nilsen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Stuart J. Gilson
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Helene Lindgren
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Marianne Kjærland
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Hilde R. Pedersen
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Rigmor C. Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
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11
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Zhang Z, Mu J, Wei J, Geng H, Liu C, Yi W, Sun Y, Duan J. Correlation between refractive errors and ocular biometric parameters in children and adolescents: a systematic review and meta-analysis. BMC Ophthalmol 2023; 23:472. [PMID: 37990308 PMCID: PMC10662558 DOI: 10.1186/s12886-023-03222-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Refractive errors are one of the most common ocular conditions among children and adolescents, with myopia showing an increasing prevalence and early onset in this population. Recent studies have identified a correlation between refractive errors and ocular biometric parameters. METHODS A systematic search was conducted in electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, and Medline from January 1, 2012, to May 1, 2023. Various ocular biometric parameters were summarized under different refractive states, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), corneal curvature (CC), Corneal curvature radius (CR),axial length-to-corneal radius ratio (AL/CR ratio), choroidal thickness (ChT), retinal thickness (RT), retinal nerve fiber layer thickness (RNFL), and retinal blood density (VD). The differences in these parameters among different refractive states were analyzed using Stata software with fixed or random-effects models, taking into account the assessed heterogeneity level. RESULTS This meta-analysis included a total of 69 studies involving 128,178 eyes, including 48,795 emmetropic eyes, 60,691 myopic eyes, 13,983 hyperopic eyes, 2,040 low myopic eyes, 1,201 moderate myopic eyes, and 1,468 high myopic eyes. The results of our study demonstrated that, compared to the control group (emmetropic group), the myopic group and low, moderate, and high myopic groups showed significant increases in AL, AL/CR ratio, and ACD, while the hyperopic group exhibited significant decreases. Compared to the control group, the myopic group had a significantly increase for CC, while CR, CCT, perifoveal RT, subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal (except nasal) ChT, and pRNFL (except temporal) significantly decreased. Compared to the control group, the hyperopic group had a significantly increase for subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal ChT, and nasal pRNFL. Compared to the control group, the low and moderate myopic groups had a significantly decreases for the CCT, parafoveal RT (except nasal), perifoveal RT (except nasal), and pRNFL (except superior and temporal). Compared to the control group, the high myopic group had a significantly increase for CR, while LT, perifoveal ChT (except nasal), parafoveal RT, perifoveal RT, and pRNFL (except temporal) had significant decreased. CONCLUSION The changes of ocular biometric parameters in children and adolescents are closely related to refractive errors. Ocular biometric parameters devices, as effective non-invasive techniques, provide objective biological markers for monitoring refractive errors such as myopia.
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Affiliation(s)
- Zengrui Zhang
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jingyu Mu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jing Wei
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Haoming Geng
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Chunmeng Liu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Wenhua Yi
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Yue Sun
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Junguo Duan
- Chengdu University of TCM, Chengdu, Sichuan, China.
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China.
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection with TCM Laboratory, Chengdu, Sichuan, China.
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12
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Cao Y, Zhang Y, Gu X, Zhu D, Yang L. Choroid vascular changes in hyperopic anisometropia amblyopia using SS-OCTA. BMC Ophthalmol 2023; 23:379. [PMID: 37723524 PMCID: PMC10506216 DOI: 10.1186/s12886-023-03121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 08/31/2023] [Indexed: 09/20/2023] Open
Abstract
PURPOSE To observe and understand the structural changes in choroidal vessels in eyes with hyperopic anisometropic amblyopia using swept-source optical coherence tomography angiography (SS-OCTA). METHODS A total of 44 patients were enrolled in this study: 22 children with hyperopic anisometropic amblyopia and 22 age-matched controls. SS-OCTA was used to scan the 6*6 mm macular area of their eyes. The average choroidal thickness (CT) and choroidal capillary flow area (CC) in a 3 mm diameter area centered on the macular area were obtained. The choroidal vascularity volume (CVV) was automatically extracted and 3D reconstructed by inbuild software, and the three-dimensional choroidal vascularity index (3D-CVI) was calculated. The effect of amblyopia on the choroidal vessel structure was assessed using generalized linear estimating equations (GEEs) corrected for axial length, sex, age, and best-corrected visual acuity. RESULTS The CC was greater in amblyopic eyes than in fellow eyes (P = 0.014) but was not significantly different from that in control eyes (P = 0.963). After correcting for sex, age, axial length, and visual acuity using GEEs, the mean CT in the amblyopic eyes was greater than that in the fellow eyes (P = 0.030) but was not significantly different from that in the control eyes (P = 0.160). The 3D-CVI in amblyopic eyes was higher than that in control eyes (P = 0.038) but was not significantly different from that in fellow eyes (P = 0.407). The three-dimensional choroidal vascularity volume (3D-CVV) was higher in amblyopic eyes than in fellow eyes (P = 0.046) and control eyes (P = 0.023). CONCLUSIONS We found that eyes with hyperopic anisometropic amblyopia demonstrated higher CT, CC and 3D-CVV values than the contralateral eyes after correction, while the 3D-CVI was unchanged. Compared with control eyes, amblyopic eyes had higher 3D-CVV and 3D-CVI values but similar CT and CC values. Amblyopic eyes may have different choroidal vascular structures from fellow and control eyes.
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Affiliation(s)
- Yiwen Cao
- Department of Pediatric Ophthalmology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Yadi Zhang
- Department of Ophthalmology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Xiaopeng Gu
- Department of Ophthalmology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Dehai Zhu
- Department of Pediatric Ophthalmology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Liu Yang
- Department of Ophthalmology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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Verma A, Magesan K, Mahalingam M, T A, Sadda SR, Corradetti G, Alagorie AR, Gnanaraj R, Sen P. Age-Related Alterations of the Macular Choroid in Healthy Eyes Assessed by Swept-Source Optical Coherence Tomography Angiography. Ophthalmic Surg Lasers Imaging Retina 2023; 54:526-534. [PMID: 37642439 DOI: 10.3928/23258160-20230728-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVE To analyze age-related changes in the choroid in healthy eyes using swept-source optical coherence tomography angiography (SS-OCTA). PATIENTS AND METHODS This was a cross-sectional, prospective, observational study enrolling 222 eyes of 116 healthy participants. SS-OCTA images were captured using the PLEX Elite 9000 (Carl Zeiss Meditec) with a 6 x 6 mm pattern centered on the fovea. Subfoveal choroidal thickness (CT) and choroidal volume (CV) were generated automatically through manufacturer tools available in the Advanced Retinal Imaging (ARI) hub network. Choroidal vascularity index (CVI) and choriocapillaris flow deficits (CCFD) were computed using ImageJ. RESULTS CV was found to be significantly higher in women than men. Overall, there was a significant positive correlation between CVI and CCFD, and a significant negative correlation between CT and CV with age. The relationship, however, was more complex, as a decade-wise analysis showed that CT and CV increased until the second decade, followed by a decrease until the sixth decade, and then an increase again in the seventh and eighth decades. CVI was highest in the seventh decade. In contrast, CCFD increased consistently with age and in all the Early Treatment of Diabetic Retinopathy Study (ETDRS) rings. CONCLUSION The choroidal blood flow and its thickness reduces as the age advances. While the choroidal flow deficits show a consistent increase with age and the distance from the foveal center, the relationship of other parameters with age is more complex. Having a normative database from healthy subjects is imperative for understanding the changes taking place in diseased states. Choroidal parameters can show significant variations with age. These differences are not uniform or consistent with age, highlighting the importance of a normative reference database to assess the significance of choroidal alterations associated with disease. [Ophthalmic Surg Lasers Imaging Retina 2023;54:526-534.].
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14
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Jiang Z, Hou A, Zhang T, Lai Y, Huang L, Ding X. Pattern of choroidal thickness in early-onset high myopia. Front Med (Lausanne) 2023; 10:1156259. [PMID: 37538314 PMCID: PMC10394095 DOI: 10.3389/fmed.2023.1156259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/05/2023] [Indexed: 08/05/2023] Open
Abstract
Purpose To explore the etiology and choroidal thickness (ChT) pattern in children with early-onset high myopia (eoHM). Methods 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. Results 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 N2500 and I2500 among the subgroups (p = 0.039, p = 0.013). FEVR group showed thinner ChT at T2500 (p = 0.023), while STL patients exhibited thin ChT at all locations. Conclusion 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.
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Liu X, Chen S, Leng H, Wang Y, Liu Y, Shen Y, Liu S, Yi H, Li J, Zhong J. New findings on choroidal features in healthy people by ultra-widefield swept-source optical coherence tomography angiography. Sci Rep 2023; 13:9215. [PMID: 37280302 DOI: 10.1038/s41598-023-36374-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/02/2023] [Indexed: 06/08/2023] Open
Abstract
To evaluate the distribution of choroidal thickness (CT) and its trend with age in healthy people using 120° ultra-wide field swept-source optical coherence tomography angiography (UWF SS-OCTA). In this cross-sectional observational study, healthy volunteers underwent single imaging of the fundus with UWF SS-OCTA at a field of view (FOV) of 120° (24 mm × 20 mm) centered on the macula. The characteristics of CT distribution in different regions and its changes with age were analyzed. A total of 128 volunteers with a mean age of 34.9 ± 20.1 years and 210 eyes were enrolled in the study. The thickest mean choroid thickness (MCT) was located at the macular region and supratemporal region, followed by the nasal side of the optic disc, and thinnest below the optic disc. The maximum MCT was: 213.40 ± 36.65 μm for the group aged 20-29, and the minimum MCT was: 162.11 ± 31.96 μm for the group aged ≥ 60. After the age of 50, MCT was significantly and negatively correlated decreased with age (r = - 0.358, p = 0.002), and the MCT in the macular region decreased more remarkably compared to other regions. The 120° UWF SS-OCTA can observe the distribution of choroidal thickness in the range of 24 mm × 20 mm and its variation with age. It was revealed that MCT decreased more rapidly in the macular region relative to other regions after 50 years old.
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Affiliation(s)
- Xinyue Liu
- School of Medicine, University of Electronic Science and Technology of China, No.23, West Section 2, 1St Ring Road, Qing Yang District, Chengdu City, 610072, Sichuan Province, China
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
| | - Sizhu Chen
- School of Medicine, University of Electronic Science and Technology of China, No.23, West Section 2, 1St Ring Road, Qing Yang District, Chengdu City, 610072, Sichuan Province, China
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
| | - Hongmei Leng
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yiya Wang
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yi Liu
- School of Medicine, University of Electronic Science and Technology of China, No.23, West Section 2, 1St Ring Road, Qing Yang District, Chengdu City, 610072, Sichuan Province, China
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
| | - Yadan Shen
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sanmei Liu
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
| | - Hangjin Yi
- School of Medicine, University of Electronic Science and Technology of China, No.23, West Section 2, 1St Ring Road, Qing Yang District, Chengdu City, 610072, Sichuan Province, China
| | - Jie Li
- School of Medicine, University of Electronic Science and Technology of China, No.23, West Section 2, 1St Ring Road, Qing Yang District, Chengdu City, 610072, Sichuan Province, China.
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China.
| | - Jie Zhong
- School of Medicine, University of Electronic Science and Technology of China, No.23, West Section 2, 1St Ring Road, Qing Yang District, Chengdu City, 610072, Sichuan Province, China.
- Department of Ophthalmology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China.
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Ostrin LA, Harb E, Nickla DL, Read SA, Alonso-Caneiro D, Schroedl F, Kaser-Eichberger A, Zhou X, Wildsoet CF. IMI-The Dynamic Choroid: New Insights, Challenges, and Potential Significance for Human Myopia. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37126359 PMCID: PMC10153586 DOI: 10.1167/iovs.64.6.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
The choroid is the richly vascular layer of the eye located between the sclera and Bruch's membrane. Early studies in animals, as well as more recent studies in humans, have demonstrated that the choroid is a dynamic, multifunctional structure, with its thickness directly and indirectly subject to modulation by a variety of physiologic and visual stimuli. In this review, the anatomy and function of the choroid are summarized and links between the choroid, eye growth regulation, and myopia, as demonstrated in animal models, discussed. Methods for quantifying choroidal thickness in the human eye and associated challenges are described, the literature examining choroidal changes in response to various visual stimuli and refractive error-related differences are summarized, and the potential implications of the latter for myopia are considered. This review also allowed for the reexamination of the hypothesis that short-term changes in choroidal thickness induced by pharmacologic, optical, or environmental stimuli are predictive of future long-term changes in axial elongation, and the speculation that short-term choroidal thickening can be used as a biomarker of treatment efficacy for myopia control therapies, with the general conclusion that current evidence is not sufficient.
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Affiliation(s)
- Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, United States
| | - Elise Harb
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
| | - Debora L Nickla
- Department of Biomedical Sciences and Disease, New England College of Optometry, Boston, Massachusetts, United States
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Falk Schroedl
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Alexandra Kaser-Eichberger
- Center for Anatomy and Cell Biology, Institute of Anatomy and Cell Biology-Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Xiangtian Zhou
- Eye Hospital and School of Optometry and Ophthalmology, National Clinical Research Center for Ocular Diseases, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Christine F Wildsoet
- Herbert Wertheim School of Optometry and Vision Science, University of California Berkeley, Berkeley, California, United States
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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17
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Yetkin AA, Karataş M. Effect of Nasal Septum Deviation on the Choroidal Thickness. Cureus 2023; 15:e37840. [PMID: 37213969 PMCID: PMC10198657 DOI: 10.7759/cureus.37840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
INTRODUCTION Nasal cavity blood circulation and ocular blood circulation have common pathways for both arterial blood supply and venous drainage. Therefore, nasal pathologies can affect ocular blood circulation. This study aimed to evaluate the relationship between nasal obstruction and choroidal thickness. METHODS A prospective study was planned by forming a group of 144 patients diagnosed with nasal septum deviation at the otorhinolaryngology clinic and 100 healthy voluntary individuals. Of the total, 69 patients with nasal right septum deviation were evaluated as Group 1, 75 patients with nasal left septum deviation as Group 2, and 100 healthy volunteers as the control group. Detailed ophthalmological examinations of all the participants were performed, and choroidal thickness was measured using spectral domain optical coherence tomography. The relationship between choroidal thickness and ocular parameters was evaluated and compared between the patient groups with nasal septum deviation and the control group. RESULTS When the choroidal thickness measurements of the patients in Group 1 were examined, the choroidal thickness increased in all the regions in the eye contralateral to the deviation side (left), and intraocular pressure (IOP) was higher compared to the eye on the deviation side (right) and the control group at a statistically significant level. In Group 2, the choroidal thickness measurements increased in all the regions in the eye contralateral to the deviation side (right), and IOP was higher compared to the deviation side (left) and the control group. CONCLUSIONS We found that the patients with nasal septum deviation had higher choroidal thickness and IOP values in the eye contralateral to deviation.
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Affiliation(s)
- Ali A Yetkin
- Department of Ophthalmology, Adiyaman University Faculty of Medicine, Adiyaman, TUR
| | - Mehmet Karataş
- Department of Otorhinolaryngology, Adiyaman University Faculty of Medicine, Adiyaman, TUR
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18
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Read SA, Hopkins S, Black AA, Bentley SA, Scott J, Wood JM. Prevalence of vision conditions in children in a very remote Australian community. Clin Exp Optom 2023; 106:195-201. [PMID: 36442517 DOI: 10.1080/08164622.2022.2133597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CLINICAL RELEVANCE Understanding the prevalence of vision conditions in a population is critical for determining the most appropriate strategies for detecting and correcting eye conditions in a community. This is particularly important in very remote regions where access to vision testing services is limited. BACKGROUND Although recent studies have provided detailed analyses of the prevalence of vision conditions in Aboriginal and/or Torres Strait Islander children in urban and regional areas of Australia, there is a paucity of research examining vision conditions in children in remote regions. Importantly, a significant proportion of the population in remote and very remote regions identify as Aboriginal and/or Torres Strait Islander people. METHODS Comprehensive eye examinations were provided to 193 primary school children in a very remote Australian region. Ninety eight percent of children identified as Aboriginal and/or Torres Strait Islander. The eye examination included measures of visual acuity, cycloplegic autorefraction, binocular vision and accommodative function, ocular health and colour vision. Previous history of eye examinations and refractive correction were assessed through parental questionnaire. RESULTS Although the average unaided vision in the population was good (mean: 0.02 ± 0.13 logMAR) and the prevalence of reduced unaided visual acuity (>0.3 logMAR in either eye) was low (4%), vision conditions were detected in 32% of children. The most common conditions were clinically significant refractive errors (18% of children) and binocular vision or accommodative disorders (16%). Of the total population of children tested, 10% had previously had an eye examination, and 2% were reported to have previously been prescribed spectacles. CONCLUSIONS In this population of children in a very remote Australian region, up to 1 in 3 children had a vision condition, with many of these conditions being uncorrected and undetected. These findings highlight the important need for additional resources to be made available to very remote communities for the detection and correction of vision conditions in childhood.
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Affiliation(s)
- Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Hopkins
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Sharon A Bentley
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - John Scott
- Centre for Justice, School of Justice, Faculty of Creative Industries, Education and Social Justice, Queensland University of Technology, Brisbane, Australia
| | - Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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19
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Kobia-Acquah E, Flitcroft DI, Lingham G, Paudel N, Loughman J. Choroidal Thickness Profiles and Associated Factors in Myopic Children. Optom Vis Sci 2023; 100:57-66. [PMID: 36705715 DOI: 10.1097/opx.0000000000001973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE This study addresses the lack of choroidal thickness (ChT) profile information available in European children and provides a baseline for further evaluation of longitudinal changes in ChT profiles in myopic children as a potential biomarker for myopia treatment and identifying children at risk of myopic progression. PURPOSE This study aimed to investigate ChT profiles and associated factors in myopic children. METHODS Baseline data of 250 myopic children aged 6 to 16 years in the Myopia Outcome Study of Atropine in Children clinical trial were analyzed. Choroidal thickness images were obtained using swept-source optical coherence tomography (DRI-OCT Triton Plus; Topcon Corporation, Tokyo, Japan). The macula was divided into nine Early Treatment of Diabetic Retinopathy Study locations with diameters of 1, 3, and 6 mm corresponding to the central fovea, parafoveal, and perifoveal regions. Multiple linear regression models were used to investigate determinants of ChT. RESULTS Choroidal thickness varied across the macular Early Treatment of Diabetic Retinopathy Study locations ( P < .001): thickest in the perifoveal superior region (mean ± standard deviation, 249.0 ± 60.8 μm) and thinnest in the perifoveal nasal region (155.1 ± 50.3 μm). On average, ChT was greater in all parafoveal (231.8 ± 57.8 μm) compared with perifoveal (218.1 ± 49.1 μm) regions except superiorly where the ChT was greater in the perifoveal region. Longer axial length and higher myopic spherical equivalent refraction were consistently associated with thinner ChT at all locations in the multiple linear regression models. Asian race was significantly associated with thinner ChT only at parafoveal and perifoveal superior regions after Bonferroni correction ( P = .004 and P = .001, respectively). CONCLUSIONS Choroidal thickness was thinnest in the nasal macular region and varied systematically across all macular locations, with axial length and spherical equivalent refraction being the strongest determinants of ChT. Longitudinal evidence will need to evaluate whether any differences in ChT profiles are predictive of myopic progression and to determine the role of ChT measurements in identifying myopic children most in need of myopia control treatment.
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Affiliation(s)
| | | | - Gareth Lingham
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin, Dublin, Ireland
| | - Nabin Paudel
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin, Dublin, Ireland
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20
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Zhu D, Wang H, Li R, Wen J, Li R, Zhao J. Choroidal thickness and vascular microstructure parameters in Chinese school-age children with high hyperopia using optical coherence tomography. Front Pediatr 2023; 11:1092153. [PMID: 36814589 PMCID: PMC9939826 DOI: 10.3389/fped.2023.1092153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/13/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The current study was to evaluate the choroidal thickness (CT) and vascular microstructure parameters in Chinese children with high hyperopia through enhanced depth imaging optical coherence tomography (EDI-OCT). METHODS Cross-sectional study. A total of 23 children with high hyperopia and 29 children with normal refractive status were retrospectively enrolled in the study. The measurement of the macular CT, 7 points: the sub-foveal area point, the temporal and nasal points at a radius of 0.5-mm, 1.5-mm, and 3-mm were measured. After binarization of the OCT images, the total choroidal area (TCA), stromal area (SA) as well as the luminal area (LA) were identified and measured. The choroidal vascularity index (CVI) was defined as the ratio of LA to TCA. The independent t-test for normal distributions and Kruskal-Wallis tests for non-normal distributions were used to compare other parameters between groups. The Tamhane's T2 test was performed to adjust for multiple comparisons between groups within each analysis. RESULTS The subfoveal CT (SFCT) in the high hypermetropic group was significantly thicker than that in normal controls (309.22 ± 53.14 μm vs. 291.27 ± 38.27 μm; P = 0.019). At 0.5 mm, 1.5 mm, and 3.0 mm in diameter, the nasal choroidal sectors of the high hyperopia eyes were significantly thicker than that of the control (P < 0.05). There was significant difference in the choroidal vascular parameters. TCA and LA in the high hyperopia eyes was significantly larger than that of the normal control eyes (3078129.54 ± 448271.18 μm2 vs. 2765218.17 ± 317827.19 μm2, 1926819.54 ± 229817.56 μm2 vs. 1748817.18 ± 191827.98 μm2; P = 0.009, P = 0.011; Table 2). SA values were 1086287.55 ± 212712.11 um2 in the high hyperopia eyes and 999712.71 ± 209838.12 μm2 in the control eyes. The CVI and LA/SA ratio values were differed significantly in the two groups (P = 0.019, P = 0.030, respectively). AL was significantly correlated with SFCT (r = -0.325, P = 0.047), but not significantly correlated with other parameters. Spherical equivalent (SE) was significantly correlated with AL and SFCT (r = -0.711, r = 0.311; P = 0.001, P = 0.016), whereas no significant association between sphere and other parameters. CONCLUSION The choroidal structure of the high hyperopia eyes was different from the normal control eyes. The thicker SFCT, higher LA, and TCA were characteristic of high hyperopia eyes. Choroidal blood flow may be decreased in amblyopic eyes. SFCT of high hyperopia children abnormally increased and correlated with shorter AL and higher SE. AL and SE affect choroidal structure and vascular density.
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Affiliation(s)
- Dehai Zhu
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China.,Peking University Children Vision Institute, Beijing, China
| | - Hui Wang
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Ruoshi Li
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China.,Peking University Children Vision Institute, Beijing, China
| | - Jing Wen
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China.,Peking University Children Vision Institute, Beijing, China
| | - Ruiying Li
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China.,Peking University Children Vision Institute, Beijing, China
| | - Jingjing Zhao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China.,Peking University Children Vision Institute, Beijing, China
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21
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Ocular findings in central precocious puberty. J AAPOS 2022; 26:316.e1-316.e5. [PMID: 36270587 DOI: 10.1016/j.jaapos.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate ocular findings in central precocious puberty (PP). METHODS This prospective study included 38 children with PP and 34 healthy control children. All participants were evaluated in terms of refractive error, axial length (AL), and anterior segment parameters, including keratometry (K), corneal volume (CV), anterior chamber depth (ACD), anterior chamber volume (ACV), and iridocorneal angle (ICA). Central macular thickness (CMT), retinal nerve fiber layer (RNFL) thickness and central subfoveal choroidal thickness (ChT) were also analyzed. The correlation of these parameters with Tanner stage was also investigated in the PP group. RESULTS Compared with the control group, spherical refraction was less hyperopic (P = 0.017) and AL was significantly higher (P = 0.001) in the PP group. Spherical value and AL were significantly associated with the Tanner stage. None of the anterior segment parameters obtained by Pentacam was different in the PP group compared with controls. In PP cases, CMT and RNFL thicknesses in all sectors did not differ from controls. Subfoveal ChT was significantly higher in the PP group, regardless of Tanner stage (P < 0.001). CONCLUSIONS In our cohort of children with central PP, AL and ChT were higher than in children without PP.
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22
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Jiang L, Liu X, Zhou L, Busoy JMF, Khine MT, Dan YS, Ke M, Brennan NA, Catbagan KJV, Schmetterer L, Barathi VA, Hoang QV. Choroidal Thickness in Early Postnatal Guinea Pigs Predicts Subsequent Naturally Occurring and Form-Deprivation Myopia. Invest Ophthalmol Vis Sci 2022; 63:10. [PMID: 36239975 PMCID: PMC9586133 DOI: 10.1167/iovs.63.11.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To identify choroidal characteristics associated with susceptibility to development of naturally occurring and experimentally induced myopia. Methods We compared choroidal properties between pigmented and albino guinea pig (GP) strains. Biometry, cycloplegic refractive error (RE), and eye wall sublayer thickness were measured from 171 GPs at postnatal day (P)6, 14, and 28. Forty-three P14 GPs underwent two-week monocular form-deprivation myopia (FDM). En face images of choroidal vasculature were obtained with a customized swept-source optical coherence tomography. Multivariate regression analyses were performed, with P28 RE as the outcome and P14 choroidal thickness (ChT) as the main predictor variable. Proteomic analysis was performed on choroidal tissue from P14 albino and pigmented GPs. Results At P14, RE was correlated with thickness of the choroid (β = 0.06), sclera (β = 0.12), and retina (β = 0.27; all P < 0.001). P14 ChT was correlated with P28 RE both with (β = 0.06, P = 0.0007) and without FDM (β = 0.05, P = 0.008). Multivariate regression analysis, taking into account FDM (versus physiological growth) and strain, revealed that for every 10-µm greater ChT at P14, P28 RE was 0.50D more positive (P = 0.005, n = 70). En face images of choroidal sublayers showed that albino choroids were relatively underdeveloped, with frequent avascular regions. Consistent with this finding, proteomic analysis suggested abnormalities of the nitric oxide system in the albino GP choroid. Conclusions Current results are consistent with the notion that greater ChT could protect from or delay the onset of myopia, while lower ChT is associated with greater susceptibility to myopia development. The underlying mechanism could be related to dysfunction of the choroidal vascular system.
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Affiliation(s)
- Liqin Jiang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Xinyu Liu
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Lei Zhou
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Joanna M Fianza Busoy
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Myo Thu Khine
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Yee Shan Dan
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Mengyuan Ke
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Noel A Brennan
- Johnson & Johnson Vision, Jacksonville, Florida, United States
| | - Karen J V Catbagan
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore
| | - Leopold Schmetterer
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore.,School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
| | - Veluchamy A Barathi
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Ophthalmology, Columbia University, New York, New York, United States
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23
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Zhang Y, Jeong H, Mori K, Ikeda SI, Shoda C, Miwa Y, Nakai A, Chen J, Ma Z, Jiang X, Torii H, Kubota Y, Negishi K, Kurihara T, Tsubota K. Vascular endothelial growth factor from retinal pigment epithelium is essential in choriocapillaris and axial length maintenance. PNAS NEXUS 2022; 1:pgac166. [PMID: 36714840 PMCID: PMC9802415 DOI: 10.1093/pnasnexus/pgac166] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/16/2022] [Indexed: 06/18/2023]
Abstract
Myopia, which prevalence is rapidly increasing, causes visual impairment; however, the onset mechanism of pathological axial length (AL) elongation remains unclear. A highly vascularized choroid between the retinal pigment epithelium (RPE) and sclera not only maintains physiological activities, but also contributes to ocular development and growth regulation. Vascular endothelial growth factor (VEGF) secreted from the RPE to the choroid is essential for retinal function and maintenance of the choriocapillaris. Herein, we demonstrated that the loss of VEGF secreted from the RPE caused abnormal choriocapillaris development and AL elongation, with features similar to those of the lens-induced myopia (LIM) mouse model, whereas VEGF overexpression by knocking-out von Hippel-Lindau (VHL) specific to the RPE expands the choriocapillaris and shortens the AL. Additionally, LDL Receptor Related Protein 2 (LRP2) deletion in the RPE downregulated VEGF expression and leads to pathological AL elongation. Furthermore, high-myopia patients without choriocapillaris demonstrated longer ALs than did those with preserved choriocapillaris. These results suggest that physiological secretion of VEGF from the RPE is required for proper AL development by maintaining the choriocapillaris. The pinpoint application of VEGF to the choriocapillaris may become a potential intervention for the prevention and treatment of axial myopia progression.
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Affiliation(s)
- Yan Zhang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Heonuk Jeong
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kiwako Mori
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shin-Ichi Ikeda
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Chiho Shoda
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi City, Tokyo 173-8610, Japan
| | - Yukihiro Miwa
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Aichi Animal Eye Clinic, 3 Chome-17-3 Honjitori, Minami Ward, Nagoya, Aichi 457-0074, Japan
| | - Ayaka Nakai
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi City, Tokyo 173-8610, Japan
| | - Junhan Chen
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Ziyan Ma
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Xiaoyan Jiang
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hidemasa Torii
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yoshiaki Kubota
- Department of Anatomy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Tsubota Laboratory Inc., 34 Shinanomachi, 304 Toshin Shinanomachi Ekimae Building, Shinjuku-ku, Tokyo 160-0016, Japan
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A comparison of deep learning U-Net architectures for posterior segment OCT retinal layer segmentation. Sci Rep 2022; 12:14888. [PMID: 36050364 PMCID: PMC9437058 DOI: 10.1038/s41598-022-18646-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/17/2022] [Indexed: 11/08/2022] Open
Abstract
Deep learning methods have enabled a fast, accurate and automated approach for retinal layer segmentation in posterior segment OCT images. Due to the success of semantic segmentation methods adopting the U-Net, a wide range of variants and improvements have been developed and applied to OCT segmentation. Unfortunately, the relative performance of these methods is difficult to ascertain for OCT retinal layer segmentation due to a lack of comprehensive comparative studies, and a lack of proper matching between networks in previous comparisons, as well as the use of different OCT datasets between studies. In this paper, a detailed and unbiased comparison is performed between eight U-Net architecture variants across four different OCT datasets from a range of different populations, ocular pathologies, acquisition parameters, instruments and segmentation tasks. The U-Net architecture variants evaluated include some which have not been previously explored for OCT segmentation. Using the Dice coefficient to evaluate segmentation performance, minimal differences were noted between most of the tested architectures across the four datasets. Using an extra convolutional layer per pooling block gave a small improvement in segmentation performance for all architectures across all four datasets. This finding highlights the importance of careful architecture comparison (e.g. ensuring networks are matched using an equivalent number of layers) to obtain a true and unbiased performance assessment of fully semantic models. Overall, this study demonstrates that the vanilla U-Net is sufficient for OCT retinal layer segmentation and that state-of-the-art methods and other architectural changes are potentially unnecessary for this particular task, especially given the associated increased complexity and slower speed for the marginal performance gains observed. Given the U-Net model and its variants represent one of the most commonly applied image segmentation methods, the consistent findings across several datasets here are likely to translate to many other OCT datasets and studies. This will provide significant value by saving time and cost in experimentation and model development as well as reduced inference time in practice by selecting simpler models.
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25
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Chen X, Li Q, Liu L. Personalized Predictive Modeling of Subfoveal Choroidal Thickness Changes for Myopic Adolescents after Overnight Orthokeratology. J Pers Med 2022; 12:jpm12081316. [PMID: 36013265 PMCID: PMC9410041 DOI: 10.3390/jpm12081316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/13/2022] [Indexed: 11/16/2022] Open
Abstract
The changes in subfoveal choroidal thickness after orthokeratology are crucial in myopia retardation; this study aimed to identify the risk factors that could be incorporated into a predictive model for subfoveal choroidal thickness (SFChT) that would provide further personalized and clinically specific information for myopia control. A one-year prospective study was conducted in the West China Hospital, Sichuan University. Basic information (age, gender, and height) was collected from all subjects. Initial spherical equivalent, axial length, intraocular pressure, central corneal thickness, and subfoveal choroidal thickness were measured, and the ocular environmental factors were also collected. All the measured parameters were recorded in the follow-up period for one year. After the analysis of univariate analysis, statistically significant factors were substituted into the multivariate three-level model. Thirty-three adolescents aged 8−14 years old were enrolled in this study; the results show that the subfoveal choroidal thickness in both eyes changed significantly after 12 months of lens wearing (pR < 0.0001, pL < 0.0001). The axial length was negatively correlated with the change in the SFChT after 12 months of lens wearing (r = −0.511, p = 0.002). After multilevel model analysis, the statistically significant factor was shown to have an important influence on the changes in the subfoveal choroidal thickness, which was the average near-work time. This suggested that the SFChT personal predictions can be made regarding changes in myopic adolescents after orthokeratology using the factor of daily average near-work time. Clinical practitioners will benefit from the results by obtaining a better understanding of the effects of orthokeratology on choroid and myopia progression.
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Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu 610041, China
- The Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiushi Li
- Department of Outpatient, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China Hospital, Sichuan University, Chengdu 610041, China
- The Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence:
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Lee SSY, Alonso-Caneiro D, Lingham G, Chen FK, Sanfilippo PG, Yazar S, Mackey DA. Choroidal Thickening During Young Adulthood and Baseline Choroidal Thickness Predicts Refractive Error Change. Invest Ophthalmol Vis Sci 2022; 63:34. [PMID: 35616928 PMCID: PMC9150825 DOI: 10.1167/iovs.63.5.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Purpose The purpose of this study was to explore the age-related change in choroidal thickness (ChT) and test the hypothesis that baseline ChT is predictive of refractive error change in healthy young adults. Methods Participants underwent spectral-domain optical coherence tomography (SD-OCT) imaging and autorefraction at 20 (baseline) and 28 years old. The enhanced depth imaging mode on the SD-OCT was used to obtain images of the choroid. Scans were exported from the SD-OCT and analyzed with a custom software that automatically measures the central ChT. The longitudinal change in subfoveal ChT and association between baseline subfoveal ChT and 8-year change in refractive error (spherical equivalent) were determined using linear mixed models. Results In total, 395 eyes of 198 participants (44% men; 18-22 years at baseline) were included. Over 8 years, mean spherical equivalent decreased by 0.25 diopters (D) and axial length increased by 0.09 mm. Subfoveal choroid thickened by 1.3 µm/year (95% confidence interval [CI] = 0.6-2.0), but this was reduced by 0.9 µm/year (95% CI = 1.6-0.2) for every 1 mm increase in axial length. For every 10 µm increase in baseline ChT, average annual change in spherical equivalent and axial length reduced by 0.006 D/year and 0.003 mm/year, respectively. Conclusions In a community-based cohort of young adults, the choroid continued to change during early adulthood. Choroidal thickening was less in eyes that were longer at baseline, and the choroid thinned in eyes that showed myopia progression. The association between baseline ChT and longitudinal changes in spherical equivalent and axial length supports the hypothesis that ChT may be predictive of refractive error development and/or myopia progression.
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Affiliation(s)
- Samantha Sze-Yee Lee
- The University of Western Australia, Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), Perth, Western Australia, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optic Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gareth Lingham
- The University of Western Australia, Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), Perth, Western Australia, Australia.,Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin, Ireland, Dublin, Ireland
| | - Fred K Chen
- The University of Western Australia, Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), Perth, Western Australia, Australia.,Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Paul G Sanfilippo
- Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Seyhan Yazar
- Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - David A Mackey
- The University of Western Australia, Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), Perth, Western Australia, Australia.,Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
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Chen X, Xiong Y, Liu F, Wang J, Yang B, Liu L. Factors determining the myopia control effect of an orthokeratology lens: A two‐year multi‐level model. Ophthalmic Physiol Opt 2022; 42:786-796. [PMID: 35499112 DOI: 10.1111/opo.12990] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/28/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaohang Chen
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Yan Xiong
- Department of Pediatrics Affiliated Hospital of North Sichuan Medical University Nanchong China
| | - Fengyang Liu
- Department of Optometry Guizhou Provincial People's Hospital Guiyang China
| | - Jianglan Wang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Bi Yang
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
| | - Longqian Liu
- Department of Optometry and Visual Science, West China School of Medicine Sichuan University Chengdu China
- Laboratory of Optometry and Vision Sciences, West China Hospital Sichuan University Chengdu China
- Department of Ophthalmology, West China Hospital Sichuan University Chengdu China
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Salehi MA, Karimi A, Mohammadi S, Arevalo JF. Spectral-domain OCT measurements in obesity: A systematic review and meta-analysis. PLoS One 2022; 17:e0267495. [PMID: 35476846 PMCID: PMC9045631 DOI: 10.1371/journal.pone.0267495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 04/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies proposed possible applications of spectral-domain optical coherence tomography (SD-OCT) measurements in prognosticating pathologies observed in overweight/obesity, including ocular, vascular, and neurologic consequences. Therefore, we conducted a systematic review and meta-analysis to investigate the changes in the in SD-OCT measurements of the patients with higher body mass index (BMI) compared to normal weight individuals. Materials and methods We conducted a systematic search on PubMed, Scopus, and Embase. The search results underwent two-phase title/abstract and full-text screenings. We then analyzed SD-OCT measurements differences in patients with high BMI and controls, and performed meta-regression, sub-group analysis, quality assessment, and publication bias assessment. The measurements included macular thickness, cup to disc ratio, ganglion cell-inner plexiform layer (GC-IPL) and its sub-sectors, RNFL and peripapillary RNFL (pRNFL) and their sub-layers, and choroidal thickness and its sub-sectors. Results 19 studies were included in this meta-analysis accounting for 1813 individuals, 989 cases and 824 controls. There was an overall trend towards decreased thickness in high BMI patients, but only two measurements reached statistical significance: temporal retinal nerve fiber layer (RNFL) (Standardized mean difference (SMD): -0.33, 95% confidence interval (CI): -0.53 to -0.14, p<0.01) and the choroidal region 1.0 mm nasal to fovea (SMD: -0.38, 95% CI: -0.60 to -0.16, p<0.01). Conclusion Some ocular layers are thinner in patients with higher BMI than the controls. These SD-OCT measurements might correlate with adverse events related to increased body weight and have prognostic abilities. As SD-OCT is a robust, rapid and non-invasive tool, future guidelines and studies are needed to evaluate the possibility of their integration into care of the patients with obesity.
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Affiliation(s)
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - J. Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, United States of America
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OCT Retinal and Choroidal Layer Instance Segmentation Using Mask R-CNN. SENSORS 2022; 22:s22052016. [PMID: 35271165 PMCID: PMC8914986 DOI: 10.3390/s22052016] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/16/2022]
Abstract
Optical coherence tomography (OCT) of the posterior segment of the eye provides high-resolution cross-sectional images that allow visualization of individual layers of the posterior eye tissue (the retina and choroid), facilitating the diagnosis and monitoring of ocular diseases and abnormalities. The manual analysis of retinal OCT images is a time-consuming task; therefore, the development of automatic image analysis methods is important for both research and clinical applications. In recent years, deep learning methods have emerged as an alternative method to perform this segmentation task. A large number of the proposed segmentation methods in the literature focus on the use of encoder–decoder architectures, such as U-Net, while other architectural modalities have not received as much attention. In this study, the application of an instance segmentation method based on region proposal architecture, called the Mask R-CNN, is explored in depth in the context of retinal OCT image segmentation. The importance of adequate hyper-parameter selection is examined, and the performance is compared with commonly used techniques. The Mask R-CNN provides a suitable method for the segmentation of OCT images with low segmentation boundary errors and high Dice coefficients, with segmentation performance comparable with the commonly used U-Net method. The Mask R-CNN has the advantage of a simpler extraction of the boundary positions, especially avoiding the need for a time-consuming graph search method to extract boundaries, which reduces the inference time by 2.5 times compared to U-Net, while segmenting seven retinal layers.
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Wang Y, Zhu X, Xuan Y, Wang M, Zhou X, Qu X. Short-Term Effects of Atropine 0.01% on the Structure and Vasculature of the Choroid and Retina in Myopic Chinese Children. Ophthalmol Ther 2022; 11:833-856. [PMID: 35184254 PMCID: PMC8927555 DOI: 10.1007/s40123-022-00476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To explore the short-term effects of atropine 0.01% on the structure and vasculature of the choroid and retina in myopic Chinese children. Methods This study was a single-center randomized clinical trial. A total of 40 subjects with myopia < − 6.0 D were enrolled and randomized to receive atropine 0.01% once nightly with regular single-vision lenses or to simply wear regular single-vision lenses at an allocation ratio of 1:1. Follow-up visits were planned at 1 month and 3 months. Choroidal thickness (ChT) was obtained by optical coherence tomography (OCT). Retinal vessel density (RVD), retinal thickness (RT), foveal avascular zone (FAZ) and choriocapillaris flow (CCF) were measured by optical coherence tomography angiography (OCTA). The RVD and RT were measured at fovea, parafovea and perifovea area and four quadrants. Results Twenty-one subjects were allocated into the atropine group and 19 subjects into the control group. Over 3 months, the control group showed greater progression of myopia than those in the atropine group. ChT in the atropine group increased 11.12 ± 13.96 μm, which was not significant compared with that of the control group. None of the retinal sectors in atropine-treated eyes showed significant changes of RT and RVD compared with the control group. Besides, FAZ and CCF of the atropine group were not affected by atropine use over time, and there was no difference between the two groups. Conclusion Administration of atropine 0.01% eye drops demonstrated no effect on RVD, FAZ and CCF over 3 months, while a modest increase of ChT was observed in atropine-treated eyes. Trial Registration Number ChiCTR1800017154. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00476-0.
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Choi WS, Park J, Lee KW, Kang HG. Two-year Changes in Postoperative Central Macular Thickness and Subfoveal Choroidal Thickness in Epiretinal Membrane Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.12.1607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate changes in central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) after phacovitrectomy over a 2-year period in idiopathic epiretinal membrane (ERM) patients.Methods: The records of 52 idiopathic ERM patients (52 eyes) who underwent phacovitrectomy, without recurrence of the condition over a 2-year follow-up period, were reviewed retrospectively. Changes in CMT and SFCT, as measured by optical coherence tomography, were analyzed and compared with those of a normal control group over a 2-year period.Results: The mean preoperative CMT and SFCT were 425.67 ± 84.67 and 257.56 ± 90.13 μm, respectively. Postoperative CMT was reduced significantly to 372.17 ± 45.26 μm at 1 year and 363.15 ± 47.35 μm at 2 years (p < 0.001). SFCT at 1 and 2 years postoperatively was significantly reduced to 238.85 ± 84.85 and 230.31 ± 87.95 μm, respectively (p < 0.001). In the control group, there was no significant change in CMT; however, the SFCT decreased by 11.09 ± 22.36 μm during the 2-year follow-up (p = 0.007). In contrast, in the patient group, CMT and SFCT decreased by 62.52 ± 71.45 and 27.25 ± 41.97 μm, respectively, showing a significant difference from the control group (p < 0.001 and p = 0.043, respectively). Both before surgery and at 1 year postoperatively, the thinner the CMT, the better the best-corrected visual acuity (BCVA) (p = 0.010 and p = 0.018, respectively). A better postoperative BCVA at 2 years was associated with a thinner CMT and better BCVA before surgery (p < 0.001 and p < 0.001, respectively).Conclusions: Following a phacovitrectomy procedure, ERM patients showed significant reductions in both the CMT and SFCT at the 2-year follow-up.
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Aşıkgarip N, Temel E, Örnek K. Factors effecting the choroidal vascularity index in children with mild to moderate myopia. Photodiagnosis Photodyn Ther 2021; 37:102652. [PMID: 34838699 DOI: 10.1016/j.pdpdt.2021.102652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/29/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To measure the choroidal structural parameters in a population of myopic children and determine the factors effecting the choroidal vascularity index (CVI). METHODS In total, 200 eyes of 200 children (100 females, 100 males) with a mean age of 11.5 ± 1.6 years were included in the study. Macular imaging was performed using EDI mode of spectral domain-optical coherence tomography. Binarization of the choroidal area was performed with ImageJ software. Total choroidal area, luminal area (LA), stromal area (SA), and CVI were automatically calculated. RESULTS The mean choroidal, stromal and luminal areas were measured as 0.952 ± 0.127 mm2, 0.626 ± 0.103 mm2 and 0.325 ± 0.076 mm2, respectively. The mean CVI was 65.81% ± 6.56. Age and the axial length (AL) of the participants were not found to be associated with the LA and the CVI. (r=-0.078, p=0.274, r=0.017, p=0.808, and r=0,051, p=0.474 and r=-0.128, p=0.071, respectively). There was a statistically significant strong association between the LA and CVI measurements and SE of the participants (r=0.736, p=0.001, and r=-0.605; p=0.001). CONCLUSION Age and AL were not associated with the CVI, but SE was significantly associated with the CVI.
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Affiliation(s)
- Nazife Aşıkgarip
- Kırşehir Ahi Evran Training and Research Hospital, Department of Ophthalmology, Kırşehir, Turkey
| | - Emine Temel
- Kırşehir Ahi Evran Training and Research Hospital, Department of Ophthalmology, Kırşehir, Turkey.
| | - Kemal Örnek
- Kırşehir Ahi Evran University School of Medicine, Department of Ophthalmology, Kırşehir, Turkey
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Liu Y, Wang L, Xu Y, Pang Z, Mu G. The influence of the choroid on the onset and development of myopia: from perspectives of choroidal thickness and blood flow. Acta Ophthalmol 2021; 99:730-738. [PMID: 33550704 DOI: 10.1111/aos.14773] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 01/12/2021] [Indexed: 12/11/2022]
Abstract
Myopia is the most common type of refractive errors characterized by excessive elongation of the ocular globe. With the increasing prevalence of myopia, improved knowledge of factors involved in myopia development is of particular importance. There are growing evidence suggesting that the choroid plays an important role in the regulation of eye growth and the development of myopia. Studies have demonstrated that thinning choroid is a structural feature of myopia, with a negative correlation between choroidal thickness and axial length, suggesting that the change in choroidal thickness may be a predictive biomarker for long-term changes in ocular elongation. Given the fact that the choroid is primarily a vascular structure capable of rapidly changing blood flow, variations of choroidal thickness might be primarily caused by changes in choroidal blood flow. Considering that hypoxia is associated with myopia and choroidal blood flow is the main source of oxygen and nourishment supply, apart from the effect on myopia possibly by changing choroidal thickness, decreasing choroidal blood flow may contribute to scleral ischaemia and hypoxia, resulting in alterations in the scleral structure and thus leading to myopia. This review aims to provide an overview of recent work exploring the influence of the choroid on myopia from perspectives of choroidal thickness and blood flow, which may present new predictive indicators for the onset of myopia and new targets for the development of novel therapeutic approaches for myopia.
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Affiliation(s)
- Yilin Liu
- Department of Ophthalmology Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University Jinan China
| | - Lijun Wang
- Department of Ophthalmology Binzhou Medical University Hospital Binzhou China
| | - Yanyun Xu
- Department of Ophthalmology Shandong Second Provincial General Hospital, Shandong Provincial ENT Hospital Jinan China
| | - Zuoxiang Pang
- Department of Ophthalmology Weifang People's Hospital Weifang China
| | - Guoying Mu
- Department of Ophthalmology Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University Jinan China
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Yazdani N, Ehsaei A, Hoseini-Yazdi H, Shoeibi N, Alonso-Caneiro D, Collins MJ. Wide-field choroidal thickness and vascularity index in myopes and emmetropes. Ophthalmic Physiol Opt 2021; 41:1308-1319. [PMID: 34487376 DOI: 10.1111/opo.12875] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To study regional variations in choroidal thickness (CT), luminal thickness and stromal thickness of the choroid, and choroidal vascularity index (CVI) in low myopic and emmetropic eyes using wide-field optical coherence tomography (OCT). METHODS Sixty-nine healthy young adults between 20 and 38 years of age participated in this study, including 40 low myopes (mean ± SD spherical equivalent (MSE) refractive error: -3.00 ± 1.39 D, range: -6.00 to -0.62 D) and 29 emmetropes (MSE: -0.05 ± 0.09 D, range: -0.25 to +0.12 D). Wide-field CT, luminal thickness, stromal thickness and CVI were measured across five eccentricities (fovea, parafovea, perifovea; near-periphery and periphery) and four quadrants (nasal, temporal, inferior and superior), in vertical and horizontal meridians, while controlling for a range of extraneous factors potentially influencing the CT. Custom-written software was used to segment and binarize the OCT images. RESULTS Wide-field CT, luminal thickness and stromal thickness, averaged across all participants, exhibited significant topographical variation, with the foveal (379 ± 8 µm, 200 ± 4 µm, 179 ± 4 µm, respectively) and peripheral (275 ± 8 µm, 161 ± 4 µm, 114 ± 4 µm, respectively) regions presenting the thickest and thinnest regions (all p < 0.001). Wide-field CVI showed a progressively higher percentage (greater vascularity) with increasing eccentricity from the fovea towards the periphery (p < 0.001). Macular CT and stromal choroidal thickness were significantly thinner in myopes compared to emmetropes (p < 0.05). Myopes (55.7 ± 0.3%) showed a slightly higher CVI compared with emmetropes (54.4 ± 0.4%) (p < 0.05). CONCLUSIONS Low myopia in young adults was associated with significant choroidal thinning across the macular, but not extramacular regions, with this decrease in choroidal thickness mostly attributed to thinning in the stromal component of the choroid, rather than the luminal (vascular) component.
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Affiliation(s)
- Negareh Yazdani
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.,Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Nasser Shoeibi
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Kurultay I, Sancakli O. Evaluation of choroidal thickness in children with acute asthma attack by optical coherence tomography. Eur J Ophthalmol 2021; 32:1424-1429. [PMID: 34482738 DOI: 10.1177/11206721211039349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the change in central choroidal thickness in children with asthma attack before and after treatment with β2 agonists. MATERIALS AND METHODS About 100 eyes of 50 patients (5-17 years old) with visual acuity of 20/20 who had no retinal, choroidal, and systemic comorbidity were examined by enhanced depth optical coherence tomography (EDI-OCT) before and after asthma attack treatment. Sixty eyes of 30 healthy children of similar age and gender were evaluated as the control group. The central choroidal thickness, peak expiratory flow (PEF), forced expiratory volume 1(FEV1), oxygen saturation, and heart rate were evaluated. RESULTS The mean age of the patients was 9.2 ± 3.1 years, and the mean saturation values of patients was 97.2 ± 1.3 before treatment, and it increased to 98.3 ± 0.9 after treatment with a statistically significant difference. The mean FEV1 values were 80.8 ± 15.2 before, and 92.7 ± 12.9 after the treatment and PEF values were 75.9 ± 18.6 before and 89.3 ± 18.9 after treatment. This differences were statistically significant (p < 0.001). The average choroidal thickness before the treatment were 310.4 ± 34.2 μm and decreased to 302.7 ± 34.4 μm after the treatment, this decrease was statistically significant (p < 0.001). The mean choroidal thickness of the control group was 303.0 ± 7.3 μm and compared to the pre-treatment and post-treatment values, it was more similar to the post-treatment values, although there was no statistically difference. CONCLUSION In our study, it was shown that choroidal thickness was significantly reduced in children with asthma who received attack treatment with β2 agonists, and it was similar to the control group after the treatment.
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Affiliation(s)
- Isil Kurultay
- Department of Ophthalmology, Baskent University Zubeyde Hanim Practice and Research Center, Izmir, Turkey
| | - Ozlem Sancakli
- Department of Pediatrics, Baskent University Zubeyde Hanim Practice and Research Center, Izmir, Turkey
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Guo B, Lau JK, Cheung SW, Cho P. Repeatability and reproducibility of manual choroidal thickness measurement using Lenstar images in children before and after orthokeratology treatment. Cont Lens Anterior Eye 2021; 45:101484. [PMID: 34303626 DOI: 10.1016/j.clae.2021.101484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To investigate the repeatability and reproducibility of choroidal thickness measurements using Lenstar images in young myopic children before and after one-month orthokeratology (ortho-k) treatment. METHOD Ocular biometry of 39 subjects were performed using the Lenstar 900. The first five measurements with maximum differences of 0.02 mm in axial length in the right eyes were saved and used for measurement of choroidal thickness. Subfoveal choroidal thickness were manually measured by identifying the signals from the retinal pigmented epithelium layer and chorioscleral interface. Repeatability was determined by comparing measurements of the same images made by the same observer on two separate occasions (four weeks apart), while reproducibility was calculated by comparing measurements of the same images made by two independent observers. Data was analysed using intra-class correlation coefficients (ICC) and non-parametric Bland and Altman plots. RESULTS The choroidal peaks could not be identified in all five measurements in all subjects. On average, only 71% subjects had at least four definable images. Compared with the use of fewer than four images, reliability using an average of four definable images improved statistically, but remained clinically unacceptable (>10 µm), although pre- and post-ortho-k ICC values were good to excellent for repeatability (0.867 and 0.975, respectively) and excellent and good for reproducibility (0.959 and 0.868, respectively). Non-parametric pre- and post-ortho-k limits of agreement (2.5% and 97.5% percentiles) obtained were -45.8 to 79.3 µm and -30.3 to 9.5 µm, respectively for repeatability, and -29.0 to 33.5 µm and -21.8 to 70.0 µm, respectively for reproducibility. CONCLUSION Choroidal thickness measurements using the Lenstar did not show good reliability, despite the high ICC values, non-parametric Bland and Altman plots demonstrated a wide variability of measurement errors. Any changes in subfoveal choroidal thickness, measured by Lenstar, of <80 µm may not represent real changes.
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Affiliation(s)
- Biyue Guo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region.
| | - Jason K Lau
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Sin Wan Cheung
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
| | - Pauline Cho
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region
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Data augmentation for patch-based OCT chorio-retinal segmentation using generative adversarial networks. Neural Comput Appl 2021. [DOI: 10.1007/s00521-021-05826-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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38
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Prousali E, Seliniotaki AK, Ziakas N, Mataftsi A. Comment on the Article: Choroidal Thickness in Pediatric Populations. J Curr Ophthalmol 2021; 33:96-97. [PMID: 34084966 PMCID: PMC8102951 DOI: 10.4103/joco.joco_32_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Efthymia Prousali
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Ziakas
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asimina Mataftsi
- 2 Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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39
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Rakusiewicz K, Kanigowska K, Hautz W, Ziółkowska L. Choroidal thickness changes in children with chronic heart failure due to dilated cardiomyopathy. Int Ophthalmol 2021; 41:2167-2177. [PMID: 33966146 PMCID: PMC8172512 DOI: 10.1007/s10792-021-01774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 03/05/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate choroidal thickness (CTh) in children with chronic heart failure (CHF) secondary to dilated cardiomyopathy (DCM) using spectral domain optical coherence tomography (SD-OCT) and to compare their values to those of healthy children. METHODS Sixty eyes of thirty children (mean age 9.9 ± 3.57 years) with chronic heart failure (left ventricular ejection fraction, LVEF ≤ 55%) due to DCM lasting for over 6 months were prospectively enrolled. The control group consisted of 30 age- (mean age 10.16 ± 3.42 years) and sex-matched healthy children. All participants underwent transthoracic echocardiography with LVEF measured using the Simpson method and had the blood serum level of N-terminal-pro-brain natriuretic peptide marker (NT-proBNP) determined. All children underwent SD-OCT and had subfoveal choroidal thickness (SFCTh) and CTh measured at 1500 µm (μm) nasally, temporally, superiorly and inferiorly from the fovea in both eyes by two investigators. RESULTS CTh at all locations was statistically significantly lower in children with DCM compared to the control group. Mean CTh in the group with CHF compared to the control group were (304.03 vs. 369.72 μm, p < 0.05) at the subfoveal location, (245.87 vs. 284 μm, p < 0.05) 1500 μm nasally from the fovea, (291.5 vs. 355.95 μm, p < 0.05) 1500 μm temporally from the fovea, (303.98 vs. 357.58 μm, p < 0.05) 1500 μm superiorly from the fovea and (290.92 vs. 344.96 μm, p < 0.05) 1500 μm inferiorly from the fovea. The average difference CTh between the study groups ranged from 38.13 to 65.69 μm at individual locations. In both groups, CTh was the thickest at subfoveal location (304.03 vs. 369.72 μm, p < 0.05) and the thinnest was 1500 μm nasally from the fovea (262.37 vs. 336.87 μm, p < 0.05). There was no correlation between CTh and age, gender, biometry and refractive error. No correlation was found between CTh and LVEF and NT-proBNP. CONCLUSION Patients with CHF due to DCM had a thinner CTh at all measured locations. The results of our research indicate that CHF affects CTh and this parameter may be very helpful in monitoring the clinical course of the disease in children with DCM.
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Affiliation(s)
- Klaudia Rakusiewicz
- Department of Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland.
| | - Krystyna Kanigowska
- Department of Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Wojciech Hautz
- Department of Ophthalmology, Children's Memorial Health Institute, Warsaw, Poland
| | - Lidia Ziółkowska
- Department of Cardiology, Children's Memorial Health Institute, Warsaw, Poland
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40
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Lin T, Yang Y, Lin J, Zhang J, Wen Q, He X, Chen G. A Comparative Study of Macular and Choroidal Thickness and Blood-Flow Parameters in Patients with Intermediate and Simple Juvenile Moderate Myopia. Int J Gen Med 2021; 14:1343-1348. [PMID: 33889014 PMCID: PMC8057794 DOI: 10.2147/ijgm.s301702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to compare the macular and choroidal thicknesses and blood-flow parameters of patients with intermediate and simple juvenile moderate myopia in order to provide a greater understanding of the pathogenesis of myopia and a basis for its prevention. Methods Participants were selected from patients under the age of 18 with moderate myopia who were treated in our ophthalmic clinic between June and December 2019. Seventy-five right eyes were selected from participants with a mean spherical equivalent ranging from -6.0 to -3.0 D. These samples were divided into two groups based on eye axial length (AL). The thicknesses of the macula and choroid, the area of the foveal avascular zone (FAZ), and the blood flow density of the macular capillaries were measured, intergroup comparison was conducted. Results The average area of the FAZ was larger in the intermediate group than in the simple group. PERIM in the upper half was lower in the intermediate group than in the simple group, and the blood-flow density in the lower half of the macular area was higher in the simple group than in the intermediate group. The blood-flow density within 1 mm of the fovea centralis and the downward blood-flow density were higher in the intermediate group than in the simple group. The thicknesses of the lower part of the FAZ, the choroid of the fovea centralis, and the choroid under the retina were all larger in the intermediate group than in the simple group. Conclusion The area of the FAZ in patients with intermediate juvenile moderate myopia is larger than that in patients with simple myopia; the choroid in the fovea of macula compensatorily increases, and blood flow density also increases; the thickness of the choroid under the retina increases with myopia.
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Affiliation(s)
- TaiNan Lin
- Department of Ophthalmology, Fujian Provincial Governmental Hospital, Fuzhou, 350003, People's Republic of China
| | - Yan Yang
- Fujian Center for Disease Control and Prevention, Fuzhou, 350001, People's Republic of China
| | - JinHua Lin
- Department of Ophthalmology, Fujian Provincial Governmental Hospital, Fuzhou, 350003, People's Republic of China
| | - JiHui Zhang
- Department of Ophthalmology, Fujian Provincial Governmental Hospital, Fuzhou, 350003, People's Republic of China
| | - Qian Wen
- Department of Ophthalmology, Fujian Provincial Governmental Hospital, Fuzhou, 350003, People's Republic of China
| | - XiaoLu He
- Department of Ophthalmology, Fujian Provincial Governmental Hospital, Fuzhou, 350003, People's Republic of China
| | - GuoQing Chen
- Department of Ophthalmology, Fujian Provincial Governmental Hospital, Fuzhou, 350003, People's Republic of China
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41
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Hoseini‐yazdi H, Vincent SJ, Collins MJ, Read SA, Alonso‐caneiro D. Impact of image averaging on wide‐field choroidal thickness measurements using enhanced‐depth imaging optical coherence tomography. Clin Exp Optom 2021; 102:320-326. [DOI: 10.1111/cxo.12855] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Hosein Hoseini‐yazdi
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - David Alonso‐caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia,
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Heravian Shandiz J, Heirani M, Shojaei A, Narooie-Noori F. Reply to Letter to Editor: Choroidal Thickness in Pediatric Population. J Curr Ophthalmol 2021; 33:98-99. [PMID: 34084967 PMCID: PMC8102950 DOI: 10.4103/joco.joco_72_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 08/29/2020] [Accepted: 08/29/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Javad Heravian Shandiz
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Heirani
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Foroozan Narooie-Noori
- Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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43
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Ayyildiz T, Dulkadiroglu R, Yilmaz M, Polat OA, Gunes A. Evaluation of macular, retinal nerve fiber layer and choroidal thickness by optical coherence tomography in children and adolescents with vitamin B 12 deficiency. Int Ophthalmol 2021; 41:2399-2404. [PMID: 33768408 DOI: 10.1007/s10792-021-01794-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/06/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate macular, Retinal Nerve Fiber Layer (RNFL) and choroidal thickness in children and adolescents with vitamin B12 deficiency and no neurological examination finding. METHODS The study group includes of thirty-three children aged 8-17 years who were brought to the Pediatric outpatient clinic with the symptoms of fatigue and forgetfulness and whose Vitamin B12 levels were detected < 200 pg/ml. The control group was the 30 children and adolescents applied to the same policlinic with various symptoms and whose Vitamin B12 levels were found normal. Children and adolescents with chronic systemic/ocular disease history and myopia or hyperopia more than 4 diopters were not included in both groups. Spectral Domain-Optical Coherence Tomography (SD-OCT) was used for measurements. RESULTS Mean Macular thickness value was 261.2 ± 17.6 in the Vitamin B12 deficiency group and 267.7 ± 17.4 in the control group. Mean value of Retinal Nerve Fiber Layer (RNFL) thickness was 103.5 ± 7.5 in the Vitamin B12 deficiency group and 104.3 ± 8.9 in the control group. The mean values of Choroidal thickness were 360.1 ± 59.8 and 316.9 ± 95.4 in Vitamin B12 deficiency and control groups, respectively. There was a statistically significant increase in choroidal thickness in Vitamin B12 deficiency group compared to controls. CONCLUSION Statistically significant increase in the Choroidal thicknesses of children and adolescents with Vitamin B12 deficiency is important in terms of shedding light on studies that will contribute to a better understanding of the relationship between vitamin B12 and inflammation. CLINICAL TRIAL REGISTRATION This study is an observational study.
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Affiliation(s)
- Taha Ayyildiz
- Ophthalmology Department, Bursa City Hospital, Bursa, Turkey
| | - Ramazan Dulkadiroglu
- Department of Pediatrics, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey.
| | - Mevlüt Yilmaz
- Ophthalmology Department, Ulucanlar Eye Hospital, Ankara, Turkey
| | - Osman Ahmet Polat
- Ophthalmology Department, Faculty of Medicine, Kayseri Erciyes University, Kayseri, Turkey
| | - Ali Gunes
- Department of Pediatrics, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
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44
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Orthokeratology and Low-Intensity Laser Therapy for Slowing the Progression of Myopia in Children. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8915867. [PMID: 33575355 PMCID: PMC7861936 DOI: 10.1155/2021/8915867] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/02/2020] [Accepted: 01/15/2021] [Indexed: 12/21/2022]
Abstract
Orthokeratology (OK) is widely used to slow the progression of myopia. Low-level laser therapy (LLLT) provides sufficient low energy to change the cellular function. This research is aimed at verifying the hypothesis that LLLT treatment could control myopia progression and comparing the abilities of OK lenses and LLLT to control the refractive error of myopia. Eighty-one children (81 eyes) who wore OK lenses, 74 children (74 eyes) who underwent LLLT treatment, and 74 children (74 eyes) who wore single-vision distance spectacles for 6 months were included. Changes in axial length (AL) were 0.23 ± 0.06 mm for children wearing spectacles, 0.06 ± 0.15 mm for children wearing OK lens, and -0.06 ± 0.15 mm for children treated with LLLT for 6 months. Changes in subfoveal choroidal thickness (SFChT) observed at the 6-month examination were -16.84 ± 7.85 μm, 14.98 ± 22.50 μm, and 35.30 ± 31.75 μm for the control group, OK group, and LLLT group, respectively. Increases in AL at 1 month and 6 months were significantly associated with age at LLLT treatment. Changes in AL were significantly correlated with the baseline spherical equivalent refraction (SER) and baseline AL in the OK and LLLT groups. Increases in SFChT at 1 month and 6 months were positively associated with age at enrolment for children wearing OK lens. At 6 months, axial elongation had decelerated in OK lens-wearers and LLLT-treated children. Slightly better myopia control was observed with LLLT treatment than with overnight OK lens-wearing. Evaluations of age, SER, and AL can enhance screening for high-risk myopia, improve the myopia prognosis, and help determine suitable control methods yielding the most benefits.
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45
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Ermerak BC, Yalcinbayir O, Eren E, Sobu E, Erseven C, Yucel AA. Evaluation of choroidal thickness in children with type 1 diabetes: the role of optical coherence tomography in diabetic retinopathy screening. Clin Pediatr Endocrinol 2021; 30:41-47. [PMID: 33446951 PMCID: PMC7783126 DOI: 10.1297/cpe.30.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/05/2020] [Indexed: 12/30/2022] Open
Abstract
The present study aimed to evaluate choroidal changes and alternations within the
structure of the retina prior to visible morphologic signs of diabetic retinopathy (DR) in
pediatric type 1 diabetes (T1D) cases. Two hundred and six eyes of 103 pediatric patients
with T1D without DR and 88 eyes of 44 healthy controls were enrolled. They underwent a
comprehensive ophthalmic examination and optical coherence tomography evaluation.
Choroidal thickness (ChT) measurements were performed manually on macular and
peripapillary regions. There was no significant difference between the two groups in terms
of age, intraocular pressure, and axial length (p > 0.05). ChT measurements of
subfoveal, nasal, and temporal macula were slightly thinner in the diabetic group, and no
statistical significance was found (p = 0.835, p = 0.305, and p = 0.054, respectively).
Peripapillary ChT of eight sectors were also thinner in T1D; however, superonasal, nasal,
inferonasal, and inferior sector values were significantly different (p = 0.010, p =
0.020, p = 0.019, and p = 0.018, respectively). In conclusion; this study demonstrated
evidence of peripapillary choroidal thinning in pediatric diabetic patients without
visible signs of retinopathy.
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Affiliation(s)
- Basak Can Ermerak
- University Hospitals Cleveland Medical Center, Department of Ophthalmology, Rainbow's Babies and Children Hospital, Division of Pediatric Ophthalmology, Ohio, U. S. A
| | - Ozgur Yalcinbayir
- Uludag University School of Medicine, Department of Ophthalmology, Bursa, Turkey
| | - Erdal Eren
- Uludag University School of Medicine, Division of Pediatric Endocrinology, Bursa, Turkey
| | - Elif Sobu
- Uludag University School of Medicine, Division of Pediatric Endocrinology, Bursa, Turkey
| | - Cansu Erseven
- Uludag University School of Medicine, Department of Ophthalmology, Bursa, Turkey
| | - Ahmet Ali Yucel
- Uludag University School of Medicine, Department of Ophthalmology, Bursa, Turkey
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46
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Choroid Segmentation of Retinal OCT Images Based on CNN Classifier and l 2- l q Fitter. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:8882801. [PMID: 33510811 PMCID: PMC7826219 DOI: 10.1155/2021/8882801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/11/2020] [Accepted: 11/30/2020] [Indexed: 11/18/2022]
Abstract
Optical coherence tomography (OCT) is a noninvasive cross-sectional imaging technology used to examine the retinal structure and pathology of the eye. Evaluating the thickness of the choroid using OCT images is of great interests for clinicians and researchers to monitor the choroidal thickness in many ocular diseases for diagnosis and management. However, manual segmentation and thickness profiling of choroid are time-consuming which lead to low efficiency in analyzing a large quantity of OCT images for swift treatment of patients. In this paper, an automatic segmentation approach based on convolutional neural network (CNN) classifier and l 2-l q (0 < q < 1) fitter is presented to identify boundaries of the choroid and to generate thickness profile of the choroid from retinal OCT images. The method of detecting inner choroidal surface is motivated by its biological characteristics after light reflection, while the outer chorioscleral interface segmentation is transferred into a classification and fitting problem. The proposed method is tested in a data set of clinically obtained retinal OCT images with ground-truth marked by clinicians. Our numerical results demonstrate the effectiveness of the proposed approach to achieve stable and clinically accurate autosegmentation of the choroid.
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47
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Smith EL, Hung LF, She Z, Beach K, Ostrin LA, Jong M. Topically instilled caffeine selectively alters emmetropizing responses in infant rhesus monkeys. Exp Eye Res 2021; 203:108438. [PMID: 33428866 DOI: 10.1016/j.exer.2021.108438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 11/30/2022]
Abstract
Oral administration of the adenosine receptor (ADOR) antagonist, 7-methylxanthine (7-MX), reduces both form-deprivation and lens-induced myopia in mammalian animal models. We investigated whether topically instilled caffeine, another non-selective ADOR antagonist, retards vision-induced axial elongation in monkeys. Beginning at 24 days of age, a 1.4% caffeine solution was instilled in both eyes of 14 rhesus monkeys twice each day until the age of 135 days. Concurrent with the caffeine regimen, the monkeys were fitted with helmets that held either -3 D (-3D/pl caffeine, n = 8) or +3 D spectacle lenses (+3D/pl caffeine, n = 6) in front of their lens-treated eyes and zero-powered lenses in front of their fellow-control eyes. Refractive errors and ocular dimensions were measured at baseline and periodically throughout the lens-rearing period. Control data were obtained from 8 vehicle-treated animals also reared with monocular -3 D spectacles (-3D/pl vehicle). In addition, historical comparison data were available for otherwise untreated lens-reared controls (-3D/pl controls, n = 20; +3D/pl controls, n = 9) and 41 normal monkeys. The vehicle controls and the untreated lens-reared controls consistently developed compensating axial anisometropias (-3D/pl vehicle = -1.44 ± 1.04 D; -3D/pl controls = -1.85 ± 1.20 D; +3D/pl controls = +1.92 ± 0.56 D). The caffeine regime did not interfere with hyperopic compensation in response to +3 D of anisometropia (+1.93 ± 0.82 D), however, it reduced the likelihood that animals would compensate for -3 D of anisometropia (+0.58 ± 1.82 D). The caffeine regimen also promoted hyperopic shifts in both the lens-treated and fellow-control eyes; 26 of the 28 caffeine-treated eyes became more hyperopic than the median normal monkey (mean (±SD) relative hyperopia = +2.27 ± 1.65 D; range = +0.31 to +6.37 D). The effects of topical caffeine on refractive development, which were qualitatively similar to those produced by oral administration of 7-MX, indicate that ADOR antagonists have potential in treatment strategies for preventing and/or reducing myopia progression.
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Affiliation(s)
- Earl L Smith
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, Australia.
| | - Li-Fang Hung
- College of Optometry, University of Houston, Houston, TX, United States; Brien Holden Vision Institute, Sydney, Australia
| | - Zhihui She
- College of Optometry, University of Houston, Houston, TX, United States
| | - Krista Beach
- College of Optometry, University of Houston, Houston, TX, United States
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, TX, United States
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia; Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
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Jiang Y, Zhang Z, Wu Z, Sun S, Fu Y, Ke B. Change and Recovery of Choroid Thickness after Short-term Application of 1% Atropine Gel and Its Influencing Factors in 6-7-year-old Children. Curr Eye Res 2021; 46:1171-1177. [PMID: 33390025 DOI: 10.1080/02713683.2020.1863431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the change and recovery of choroid thickness after short-term application of 1% atropine gel and its influencing factors in 6-7-year-old children. MATERIALS AND METHODS 71 right eyes of 71 children were enrolled and divided into myopia and control group. 1% atropine gel was administered twice a day for one week and then stopped. Spherical equivalent (SE), accommodative amplitude (AA), keratometry (K), axial length (AL), and choroidal thickness (CT) were obtained at baseline and 1st, 4th, and 8th weeks. CT was measured at subfovea and 1 mm, 2 mm, and 3 mm temporal, superior, nasal, and inferior from the fovea using spectral-domain optical coherence tomography. RESULTS In both groups, all CTs increased following the change in SE, AA, and AL after administration of 1% atropine for one week. They gradually recovered to baseline levels seven weeks after withdrawal. The change (Δ) in CT at 3 mm superior from the fovea was significantly higher in the myopia group than in the control group. In both groups, ΔCT at subfovea had no significant correlation with SE, AA, and AL, both at baseline and one week. However, ΔCT at subfovea was negatively correlated with ΔAL in the control group. CONCLUSIONS One-week application of 1% atropine gel may increase CT in 6-7-year-old Chinese children. Meanwhile, the recovery process after withdrawal lasts seven weeks. During the recovery process, the changes in structural parameters (AL, CT) and functional parameters (AA, SE) in both groups occurred synchronously. The SE, AA, and AL at baseline may not predict the extent of atropine's effect on CT.
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Affiliation(s)
- Yunjia Jiang
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Zhengwei Zhang
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Zhifeng Wu
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Song Sun
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Yuting Fu
- Department of Ophthalmology, The Affiliated Wuxi No. 2 People's Hospital of Nanjing Medical University, Wuxi, Jiangsu Province, China.,Department of Ophthalmology, The Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu Province, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai, China.,Shanghai Key Laboratory of Fundus Disease, Shanghai, China.,Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.,Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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Zhou X, Ye C, Wang X, Zhou W, Reinach P, Qu J. Choroidal blood perfusion as a potential "rapid predictive index" for myopia development and progression. EYE AND VISION (LONDON, ENGLAND) 2021; 8:1. [PMID: 33397473 PMCID: PMC7780679 DOI: 10.1186/s40662-020-00224-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022]
Abstract
Myopia is the leading cause of visual impairment worldwide. The lack of a "rapid predictive index" for myopia development and progression hinders the clinic management and prevention of myopia. This article reviews the studies describing changes that occur in the choroid during myopia development and proposes that it is possible to detect myopia development at an earlier stage than is currently possible in a clinical setting using choroidal blood perfusion as a "rapid predictive index" of myopia.
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Affiliation(s)
- Xiangtian Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang China
- State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang China
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang China
| | - Cong Ye
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang China
| | - Xiaoyan Wang
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang China
| | - Weihe Zhou
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang China
| | - Peter Reinach
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang China
- State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang China
| | - Jia Qu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang China
- National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang China
- State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang China
- Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang China
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Read SA, Cox RA, Alonso-Caneiro D, Hopkins S, Wood JM. Choroidal Thickness in Indigenous Australian Children. Transl Vis Sci Technol 2020; 9:28. [PMID: 33244448 PMCID: PMC7683852 DOI: 10.1167/tvst.9.12.28] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/11/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose This study aimed to examine the choroidal thickness profiles in visually normal Australian Indigenous children, given the important role of the choroid in refractive error and a range of ocular diseases. Methods Choroidal thickness was assessed across the central 5 mm macular region using enhanced depth imaging spectral domain optical coherence tomography, in 250 children enrolled in an elementary school and a secondary school in rural Queensland, Australia. One hundred (40%) of these children identified as Indigenous Australians. Results The subfoveal choroid was significantly thicker in Indigenous children (mean 369 ± 75 µm), compared to non-Indigenous children (355 ± 73 µm; P = 0.03). Subfoveal choroidal thickness was also significantly associated with age (β = +7.6, r2 = 0.105, P = 0.003), and axial length (β = −19.9, r2 = 0.030, P < 0.001). A significantly thicker choroid in Indigenous children was also found in analyses across the central 5 mm macular region (P = 0.008). A significant interaction between Indigenous status and meridian was observed (P = 0.007) with the largest differences between Indigenous and non-Indigenous children being in the nasal and inferonasal meridians. Conclusions This study establishes the normative characteristics of macular choroidal thickness in Indigenous Australian children and demonstrates a significantly thicker choroid compared to non-Indigenous children from the same geographic region. These results may have implications for our understanding of factors predisposing or protecting Australian Indigenous people from a range of conditions associated with choroidal thickness. Translational Relevance The significantly thicker choroid in Australian Indigenous children should be considered in clinical diagnoses and management of conditions associated with choroidal changes.
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Affiliation(s)
- Scott A Read
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Rebecca A Cox
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - David Alonso-Caneiro
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Shelley Hopkins
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
| | - Joanne M Wood
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland, Australia
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