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Paediatric ophthalmology
Short-term choroidal changes as early indicators for future myopic shift in primary school children: results of a 2-year cohort study
  1. Hao Wu1,2,
  2. Mengqi Liu1,
  3. Yuanyuan Wang1,
  4. Xiang Li1,
  5. Weihe Zhou1,
  6. Haoer Li1,
  7. Zhu Xie1,
  8. Pengqi Wang1,
  9. Tingting Zhang1,
  10. Wei Qu1,
  11. Jing Huang1,
  12. Yunpeng Zhao1,
  13. Jiefang Wang1,
  14. Sen Zhang2,
  15. Jia Qu1,2,3,
  16. Cong Ye1,
  17. Xiangtian Zhou1,2,3
  1. 1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  2. 2State Key Laboratory of Ophthalmology, Optometry and Vision Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  3. 3Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang, China
  1. Correspondence to Dr Xiangtian Zhou; zxt{at}mail.eye.ac.cn; Dr Cong Ye; yecong{at}wmu.edu.cn

Abstract

Background To assess predictive value of short-term choroidal changes for future myopic shift in children.

Methods 577 eyes of 289 primary school children were prospectively followed for 2 years. Cycloplegic refractions at baseline, 1 year and 2 years, and choroidal measurements by optical coherence tomography at baseline and 3 months, were used for analyses. Myopic shift was defined as refraction change of at least −0.50 dioptre/year, at 2 years compared with baseline.

Results 228 participants (455 eyes) completed 2-year follow-up. Approximately 37.6% of 311 initially non-myopic eyes and 73.6% of 144 initially myopic eyes developed a myopic shift. Notably, at 3 months greater reductions were found in initially myopic eyes with myopic shift, than in those without myopic shift—in choroidal thickness (ChT), luminal area (LA), stromal area (SA) and total choroidal area (TCA), but no significant differences in any choroidal parameters were observed between non-myopic eyes, with and without myopic shift. Multivariable analyses showed that in myopic eyes, each percentage increase in ChT, LA, SA and TCA was associated with reduced odds of myopic shift (all p<0.001). Similar associations were observed in non-myopic eyes, with smaller effects than in myopic eyes. Adding a 3-month percentage change of each choroidal parameter to a basic model including age, gender, parental myopia and baseline refraction significantly improved the predictive performance in myopic eyes (area under the receiver operating characteristic curves increasing from 0.650 to approximately 0.800, all p<0.05), but not in non-myopic eyes.

Conclusion Short-term choroidal changes could act as early indicators for future myopic shift in children.

  • Choroid
  • Child health (paediatrics)
  • Epidemiology

Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request from the corresponding author at zxt@mail.eye.ac.cn.

https://doi.org/10.1136/bjo-2024-325871

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    Data availability statement

    Data are available upon reasonable request. Data are available upon reasonable request from the corresponding author at zxt@mail.eye.ac.cn.

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    Footnotes

    • HW and ML are joint first authors.

    • Contributors Conception and design: HW, XZ and CY. Data collection: HW, ML, YW, XL, HL, ZX, PW, TZ, WQ, JH, YZ, JW and SZ. Analysis and interpretation: HW, ML and WZ. Writing-original draft: HW, ML and CY. Writing-review and editing: HW, XZ and CY. Obtainment of funding: HW, JQ and XZ. The guarantor: XZ.

    • Funding Supported by the National Natural Science Foundation of China (82000931, 82025009, 82388101, 82171094, U23A20438 and U20A20364) and CAMS Innovation Fund for Medical Sciences (2019-I2M-5-048).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.