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Pediatrics

Short-term choroidal changes predict future myopic shift in children

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Short-term changes in choroidal thickness and other choroidal parameters can effectively predict future myopic shifts in children, according to a study. Specifically, greater reductions in choroidal measures within the first 3 months are associated with an increased likelihood of myopic progression over 2 years, especially in initially myopic eyes.

Researchers followed 577 eyes from 289 primary school children over 2 years, using cycloplegic refractions and optical coherence tomography to measure choroidal thickness and other parameters at baseline, 3 months, 1 year, and 2 years.

Results found that 37.6% of initially non-myopic eyes and 73.6% of initially myopic eyes experienced a myopic shift over the 2 years. Among initially myopic eyes, those that underwent a myopic shift showed greater reductions in choroidal thickness, luminal area, stromal area, and total choroidal area at 3 months compared to those without a myopic shift. In contrast, no significant differences in choroidal parameters were observed between non-myopic eyes that did or did not develop a myopic shift.

According to multivariable analyses, increases in choroidal thickness, luminal area, stromal area, and total choroidal area were associated with lower odds of myopic shift in myopic eyes. Similar but less pronounced associations were found in non-myopic eyes. Incorporating 3-month changes in choroidal parameters into a predictive model significantly improved its performance for myopic eyes, with the area under the receiver operating characteristic curve increasing from 0.650 to approximately 0.800. This improvement was not observed in non-myopic eyes.

Reference
Wu H, Liu M, Wang Y, Li X, Zhou W, Li H, Xie Z, Wang P, Zhang T, Qu W, Huang J, Zhao Y, Wang J, Zhang S, Qu J, Ye C, Zhou X. Short-term choroidal changes as early indicators for future myopic shift in primary school children: results of a 2-year cohort study. Br J Ophthalmol. 2024;bjo-2024-325871. doi: 10.1136/bjo-2024-325871. Epub ahead of print. PMID: 39227133.

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