Choroidal Thickness in Correlation with Axial Length and Myopia Degree

Purpose: To study the influence of age, sex, refractive error, and axial length (AL) on choroidal thickness (CT) in normal myopic eyes, among Egyptian population, using swept-source optical coherence tomography (SS-OCT). Patients and Methods: CT was measured by an SS-OCT in 97 eyes of 49 normal myopic volunteers. The subjects were classified according to age, degree of myopia, and AL. Correlation between CT and age, AL, and myopia was done for different groups. AL was measured using IOL Master. OCT measurements were performed using Topcon DRI-1 SS-OCT. CT was automatically calculated and shown as a colored topographic map with nine subfields defined by the Early Treatment Diabetic Retinopathy Study style grid. Results: CT tends to decrease with advance of age. A negative correlation found between the central subfoveal CT (SFCT) and the age (r = −0.329, P = 0.001, R2 = 0.108). Although there was no significant correlation between CT and degree of myopia (r = 0.159, P = 0.120, R2 = 0.025), CT decreases with increase of myopia except with >−8 D group. CT tends to decrease as the AL increases. A negative correlation found between the central SFCT and AL (r = −0.340, P = 0.001, R2 = 0.115). Conclusions: AL and age have a negative correlation with CT, while the sex and spherical equivalent of refractive error in myopes do not affect CT.

Aim: To find out the correlation of choroidal thickness (CHT) with refractive error (RE) & axial length (AL) in North-Indian population of age group of 18-35 years having myopia or emmetropia using A-scan and Oct imaging. Objective is to check for a relationship of CHT with AL & RE in myopic – emmetropic individuals with help of A-scan and Oct imaging. Methods this study is an observation- analysis based cross sectional study which involved 200 eyes of individuals presented at outpatient department of Eye care solution consisting 50 beings with ≥4 D Myopia & 50 other Emmetropic presenting for ailments other than refractive error taken as Control group. The criteria for selection of subjects were done on basis of selective age 18-35 years, degree of refractive error and clear ocular media. However, subjects with history of any intraocular pathology, surgery, inflammation or any associated systemic disorder such or vascular diseases were excluded another thing where in person with OCT scan less signal strength, motion artifact & focal signal loss were too excluded. A written-informed consent was taken from all subjects prior to enrolment. Results: This study investigated the structural characteristics of the eye across three groups of myopic individuals and a control group. Myopia Group I (with myopia ranging from -3.00 D to -4.75 D) showed an average axial length of 24.78 mm, macular thickness of 100.08 µm, and choroidal thickness of 309.54 µm. Myopia Group II (with myopia between -5.00 D and -6.75 D) exhibited a greater axial length of 25.83 mm, a macular thickness of 112.34 µm, and a choroidal thickness of 289.47 µm. Myopia Group III (with myopia of -7.00 D and above) had the longest axial length at 26.10 mm, a macular thickness of 110.38 µm, and the thinnest choroidal thickness at 255.38 µm. In comparison, the control group, consisting of emmetropic individuals, had an average axial length of 23.26 mm, macular thickness of 322.24 µm, and a significantly thicker choroid (242.23 µm) across both Sattler’s and Haller’s layers. These findings highlight the progressive structural changes—particularly axial elongation and choroidal thinning—associated with increasing myopia severity. Conclusion: The results of this study reveal a definite link between the degree of myopia and anatomical variations in the eye. Axial length increases in tandem with myopia, and the choroid significantly thins, especially in the deeper layers (Sattler's and Haller's). According to these results, axial elongation and choroidal thinning are progressive features of myopia, with alterations becoming more noticeable as refractive error increases. Gaining knowledge of these structural changes may help direct future treatment approaches and offer significant understanding into the pathophysiology of myopia

Changes in Choroidal Thickness of Healthy Children during Myopia Progression over 4 Years: Boramae Myopia Cohort Study Report 5.

Purpose: To compare the macular choroidal thickness, ganglion cell complex thickness, peripapillary choroidal thickness and retinal nerve fiber layer thickness among normal, primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients using RTVue (Fourier-domain optical coherence tomography; Optovue, Fremont, CA, USA).Methods: A retrospective analysis of 32 normal controls, 32 POAG and 52 NTG patients was performed.Choroidal thickness, ganglion cell complex thickness and retinal nerve fiber layer thickness were compared among normal controls, POAG and NTG subjects.Additionally, the factors influencing choroidal thickness (age, axial length, spherical equivalent, central corneal thickness, mean deviation, nocturnal dip, blood pressure variability) were analyzed.Results: A total of 32 normal controls, 32 POAG and 52 NTG patients were enrolled in this study.Macular and peripapillary choroidal thicknesses were significantly thinner in the NTG patients.In NTG subjects, the significant influencing factors associated with macular and peripapillary choroidal thicknesses were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness.In POAG patients, significant influencing factors associated with macular and peripapillary choroidal thicknesses were age and axial length.Conclusions: Choroidal thickness was significantly thinner in NTG patients compared with normal controls and POAG patients.Factors influencing choroidal thickness in NTG patients were age, axial length, nocturnal dip (diastolic blood pressure), diastolic blood pressure variability and ganglion cell complex thickness.In POAG patients, significant factors influencing choroidal thickness were age and axial length.

To evaluate choroidal thickness at five macular locations and assess the correlations between choroidal thickness at these locations with age, refractive error, and axial length. Eighty-four eyes from 42 healthy adult volunteers were included. Enhanced depth imaging by spectral-domain optical coherence tomography was performed, and choroidal thickness was measured at five macular locations: subfoveal and 3 mm nasal, temporal, superior, and inferior. Correlations of choroidal thickness at each location with age, refractive error, and axial length were analyzed. Mean choroidal thicknesses at the subfoveal, superior, inferior, temporal, and nasal locations were 293, 308, 264, 263, and 174 μm, respectively. A correlation was found between choroidal thickness, age, refractive error, and axial length at all locations. Mean subfoveal choroidal thickness in healthy adults is approximately 300 μm. A correlation was found between choroidal thickness and all parameters studied.

Purpose To determine central retinal thickness and subfoveal choroidal thickness using optical coherence tomography (OCT) and to evaluate association between both thickness and age, gender and axial length.Methods Spectral domain OCT images (Bioptigen, Bioptigen, inc., Durham, NC) were obtained in 151 eyes of 151 healthy volunteers without retinal diseases. The IOL master (Carl Zeiss Meditech) was used to measure the eye length to compensate axial scale factor of the SD‐OCT images. The choroidal thickness at the fovea and central retinal thickness was measured. Statistical analysis using paired t‐test and Pearson correlation were performed to evaluate the correlation between both thickness and age, axial length, and gender.Results The mean and median age of the 151 subjects were 33.3 and 29 years old, respectively (range, 7 to 80 years). There were 57 males and 94 females. The mean and median axial lengths of the eye were 24.54±0.98 mm and 24.37 mm respectively. The mean central retinal thickness were 213.89±14.64μm. Increasing age and axial length were not correlated with central retinal thickness. The mean choroidal thickness in these normal eyes was 214.43±13.63μm. Increasing age (Pearsun correlation ‐ 0.193, R2=‐0.0372, p=0.018) and increasing axial length (Pearsun correlation ‐ 0.189, R2=‐0.0359, p=0.020) were correlated with decreasing choroidal thickness. Central retinal thickness and subfoveal choroidal thickness have no relationship between them in our study (Pearsun correlation ‐ 0.139, R2=0.0192, p=0.090 ).Conclusion Only the choroidal thickness at the fovea in normal eyes showed an inverse correlation with age and axial length. And there is no significant relationship between central retinal thickness and subfoveal choroidal thickness.

To portray Usher Syndrome type 2, analyzing choroidal thickness and comparing data reported in published literature on RP and healthy subjects. Methods. 20 eyes of 10 patients with clinical signs and genetic diagnosis of Usher Syndrome type 2. Each patient underwent a complete ophthalmologic examination including Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), axial length (AL), automated visual field (VF), and EDI OCT. Both retinal and choroidal measures were measured. Statistical analysis was performed to correlate choroidal thickness with age, BCVA, IOP, AL, VF, and RT. Comparison with data about healthy people and nonsyndromic RP patients was performed. Results. Mean subfoveal choroidal thickness (SFCT) was 248.21 ± 79.88 microns. SFCT was statistically significant correlated with age (correlation coefficient −0.7248179, p < 0.01). No statistically significant correlation was found between SFCT and BCVA, IOP, AL, VF, and RT. SFCT was reduced if compared to healthy subjects (p < 0.01). No difference was found when compared to choroidal thickness from nonsyndromic RP patients (p = 0.2138). Conclusions. Our study demonstrated in vivo choroidal thickness reduction in patients with Usher Syndrome type 2. These data are important for the comprehension of mechanisms of disease and for the evaluation of therapeutic approaches.

Distribution of Choroidal Thickness and Choroidal Vessel Dilation in Healthy Japanese Individuals: The Nagahama Study.

Choroidal changes in lens-induced myopia in guinea pigs

BackgroundThe aim was to investigate the correlation of serum cortisol level with choroidal thickness.MethodsSixty‐six healthy volunteers had no visual complaints or history of ocular disease. Subfoveal choroidal thickness at the foveal centre was measured with spectral domain optical coherence tomography (SD‐OCT). Morning serum cortisol levels were obtained at 8:00 am immediately following the SD‐OCT measurement. Measurements of only the right eyes were included in the study. Age, gender, axial length and spherical equivalent were noted. Correlation of choroidal thickness with age, gender, axial length, spherical equivalent and serum cortisol level were investigated with linear and multiple regression analysis.ResultsSixty‐six eyes of 66 patients were evaluated. Mean age was 43.4 ± 3.6 years (range: 40 to 53 years), mean spherical equivalent was ‐0.15-D (range: ‐1.25 to +1.50-D), mean axial length was 23.2-mm (range; 22.0 to 23.7-mm), mean choroidal thickness was 317.9 ± 45.1 μm (range: 206 to 394 μm). Age and spherical equivalent were not significantly correlated with choroidal thickness. Axial length had a strong negative correlation with choroidal thickness (R2: 0.488, p = 0.000). There was no significant correlation between serum cortisol level and choroidal thickness (R2: 0.034, p = 0.139).ConclusionOur results did not reveal any correlation between serum cortisol level and choroidal thickness. We believe that more prospective studies are needed to determine the relationship of cortisol and other hormones with choroidal thickness.

Background: The axial length (AL) elongation of the eyeball is the characteristc of myopia. If this is the result of general growth, one might expect the cornea to have grown to be thicker than normal. If instead the myopic eye is larger due to a mechanism of stretching, one would expect the cornea to be thinner than normal. Several studies to determine the relationship of central corneal thickness (CCT) and the AL have reported different results. This study aims to investigate the association between AL with CCT and degree of myopia. Methods: It was a cross sectional study, involved 60 eyes of 32 myopic subjects. Axial length was measured using an A-scan ultrasound, CCT was measured with an ultrasonic pachymeter, and refractive errors was measured with trial and error method.Results: Thirty-two patients (60 eyes) were recruited for the study. The age of patients ranged from 21 to 47 years old, with a mean of 27.6±7.58 years. The mean axial length was 23.98±0.81 mm and the mean CCT was 535.98±26.95 μm. There were 44 eyes with low myopia, 13 eyes with moderate myopia, and 3 eyes with high myopia. The analysis of covariance (Ancova) was used to verified correlation between AL and CCT (p=0.704). The Spearman’s correlation analysis was used to verified correlation between AL and degree of myopia (p=0.001). Conclusion: There was no correlation between AL and CCT. There was a significant positive correlation between AL and degree of myopia.  Keywords: AL, CCT, degree of myopia  Â

BackgroundHigh myopia, a cause of serious visual impairment, is a significant global public health concern. We investigate longitudinal changes in macular choroidal thickness (CT) during pregnancy and 6-months postpartum in women with high myopia (HM).MethodsA prospective longitudinal study was conducted in HM-pregnant women during the course of pregnancy (n = 42 eyes, 42 patients) and 6 months postpartum (n = 40 eyes, 40 patients, two cases lost).Macular CT was measured via enhanced-depth imaging (EDI)-optical coherence tomography (OCT) (EDI-OCT). Intraocular pressure (IOP), axial length (AL), refractive error, mean arterial pressure (MAP), mean ocular perfusion pressure (MOPP), and body mass index (BMI) were also measured.ResultsMacular CTs of HM pregnant women (214.3 ± 52.3 μm) had increased significantly during the third trimester of pregnancy compared with postpartum women (192.7 ± 51.9 μm, p = 0.014). No significant differences in AL, refractive error, or MAP were found between pregnant and postpartum groups (p > 0.05 for all parameters).During pregnancy, macular CT was negatively correlated with AL (first trimester: p = 0.010; second trimester: p = 0.013; and third trimester: p = 0.008) and positively correlated with refractive error (first trimester: p = 0.038; second trimester: p = 0.024; and third trimester: p = 0.010). No correlations between macular CT and age, IOP, MOPP, MAP, or BMI were found.ConclusionsOur study revealed the presence of a significantly thicker choroid during the third trimester of pregnancy compared with 6-mo postpartum in HM women. Macular CT positively correlated with refractive error and negatively correlated with AL during pregnancy, but did not correlate with gestational age, MOPP, IOP, MAP, or BMI.

PurposeThe purpose of this study was to investigate the focal relationship between choroidal thickness and retinal sensitivity in myopic eyes.MethodsParticipants underwent swept-source optical coherence tomography (SS-OCT) imaging and microperimetry testing. Choroidal thicknesses were obtained by segmenting the SS-OCT scans using a deep-learning approach. Retinal sensitivity was measured at 33 locations using scotopic microperimetry, and corresponding focal choroidal thickness at these locations were computed. Focal structure-function associations between retinal sensitivity and choroidal thickness across 15 retinal eccentricities were evaluated, and adjusted for retinal thickness, signal strength, age, axial length, and gender.ResultsThe analysis included 280 eyes from 155 participants (mean age = 25.8 ± 3.0 years) with myopia with a mean axial length of 26.56 ± 0.99 mm and refractive error of −6.87 ± 2.05 diopters (D). Mean retinal sensitivity was 27.68 ± 1.28 decibels (dB). Mean choroid thickness was 217.85 ± 66.66 µm, with choroidal thickness in the nasal quadrant significantly thinner than in the other quadrants. Choroidal thicknesses were correlated with retinal sensitivity in 14 of 15 retinal regions, including the global eccentricity zone (r = 0.261, P < 0.001). Significant associations were similarly found with retinal thickness (r = 0.305, P < 0.001), age (r = 0.182, P < 0.05), and axial length (r = −0.402, P < 0.001). Focal structure-function models further substantiated these relationships, demonstrating a significant effect size (β = 0.78, 95% confidence interval [CI] = 0.39–1.16, P < 0.001) after adjusting for retinal thickness and other demographic factors.ConclusionsSignificant associations between choroidal thickness measurements and microperimetry were observed in a cross-sectional cohort of myopic eyes, suggesting a structure-function relationship with retinal sensitivity at the choroid. Further studies will be required to evaluate this in other cohorts and in progression.

Background/Objectives: Preceding studies have reported the efficacy of multifocal contact lenses (MFCLs) in slowing myopia progression. Recently, a novel type of MFCL, i.e., extended depth-of-focus (EDOF) contact lens (CL), was designed. Here, we retrospectively investigated myopia progression associated with EDOF CL wear. Methods: Twenty-four consecutive myopic children (24 eyes; mean age, 13.9 years) received EDOF CLs to control myopia progression and participated in the study. We measured the axial length (AL), spherical equivalent (SE), and choroidal thickness (CT) at baseline and after 1 year of lens wear and compared the changes. Results: The mean baseline AL, SE, and CT were, respectively, 26.31 mm, -6.38 diopter (D), and 235 μm, and at 1 year 26.40 mm (p = 0.03), -6.61 D (p = 0.05), and 244 μm (p = 0.18). The AL decreased in 20.8% of cases (≧-0.05 mm/year), whereas 20.8% and 58.4% of cases had stabilization of the AL or an increased AL (≧+0.05 mm/year), respectively. The patients with a decreased AL engaged in a mean outdoor activity time of 200.6 min/day, the patients with an increased AL (≧+0.05 mm/year) engaged in a mean outdoor activity time of 126.7 min/day. The change in the AL was correlated significantly with the change in the CT (β = -0.46, p < 0.05), and 80% of patients with a shortened AL had increased CT (≧+20 μm/year). Conclusions: Our data showed that the AL stabilized or decreased in over 40% of myopic patients wearing EDOF CLs.

The relative contribution of mechanical and vascular factors to the pathogenesis of myopic macular degeneration (MMD) is unclear. To address this gap, we examined the association of choroidal thickness (CT) and scleral thickness (ST) with MMD. Prospective, clinic-based case series of 62 eyes of 41 patients with high myopia (≤-6 diopters or axial length ≥26.5 mm). Swept-source optical coherence tomography (SSOCT) was performed to measure subfoveal CT and ST. Myopic macular degeneration was graded from fundus photographs according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification. Presence of MMD was defined as META-PM category ≥ 2 and severe MMD was defined as category ≥ 3. The distribution of MMD severity was 15 (24.2%) in category 1, 28 (45.2%) in category 2, 10 (16.1%) in category 3, and 9 (14.5%) in category 4. Correlation of MMD severity was strong for subfoveal CT (r = -0.70, P < 0.001) but weak for subfoveal ST (r = -0.31, P = 0.01). Subfoveal CT, but not ST, was independently associated with presence of MMD (age and gender adjusted odds ratio [OR] per 10 μm decrease in CT 1.41, P = 0.002), and subfoveal CT, but not subfoveal ST, was significantly thinner in eyes with severe MMD (≥ category 3) than in eyes with mild MMD (CT: 31.5 ± 40.5 μm versus 82.0 ± 57.1 μm, P < 0.001; ST: 261.6 ± 78.5 μm versus 297.0 ± 73.8 μm, P = 0.09). We demonstrated significant thinning of the choroid with increasing MMD severity. In contrast, ST was weakly correlated with MMD. These data suggest progressive loss of choroid may be important in the pathogenesis of MMD.