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Randomized Controlled Trial
. 2015 Jul;160(1):62-71.e2.
doi: 10.1016/j.ajo.2015.04.018. Epub 2015 Apr 18.

Choroidal Thickness Profiles in Myopic Eyes of Young Adults in the Correction of Myopia Evaluation Trial Cohort

Elise Harb  1 , Leslie Hyman  2 , Jane Gwiazda  3 , Wendy Marsh-Tootle  4 , Qinghua Zhang  2 , Wei Hou  2 , Thomas T Norton  4 , Katherine Weise  4 , Keri Dirkes  5 , Linda M Zangwill  5 ; COMET Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Choroidal Thickness Profiles in Myopic Eyes of Young Adults in the Correction of Myopia Evaluation Trial Cohort

Elise Harb et al. Am J Ophthalmol. 2015 Jul.

Abstract

Purpose: To examine the relationship of choroidal thickness with axial length (AL) and myopia in young adult eyes in the ethnically diverse Correction of Myopia Evaluation Trial (COMET) cohort.

Design: Cross-sectional, multicenter study.

Methods: In addition to measures of myopia by cycloplegic autorefraction and AL by A-scan ultrasonography, participants underwent optical coherence tomography imaging of the choroid in both eyes at their last visit (14 years after baseline). Using digital calipers, 2 independent readers measured choroidal thickness in the right eye (left eye if poor quality; n = 37) at 7 locations: fovea and 750, 1500, and 2250 μm nasal (N) and temporal (T) to the fovea.

Results: Choroidal thickness measurements were available from 294 of 346 (85%) imaged participants (mean age: 24.3 ± 1.4 years; 44.9% male) with mean myopia of -5.3 ± 2.0 diopters and mean AL of 25.5 ± 1.0 mm. Overall, choroidal thickness varied by location (P < .0001) and was thickest at the fovea (273.8 ± 70.9 μm) and thinnest nasally (N2250, 191.5 ± 69.3 μm). Multivariable analyses showed significantly thinner choroids in eyes with more myopia and longer AL at all locations except T2250 (P ≤ .001) and presence of peripapillary crescent at all locations except T1500 and T2250 (P ≤ .0001). Choroidal thickness varied by ethnicity at N2250 (P < .0001), with Asians having the thinnest and African Americans the thickest choroids.

Conclusion: Choroids are thinner in longer, more myopic young adult eyes. The thinning was most prominent nasally and in eyes with a crescent. In the furthest nasal location, ethnicity was associated with choroidal thickness. The findings suggest that choroidal thickness should be evaluated, especially in the nasal regions where myopic degenerations are most commonly seen clinically.

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Figures

Figure 1
Figure 1. Measurement of choroidal thickness in myopic eyes
Digital calipers (yellow lines) were used to measure the choroidal thickness from the posterior edge of the retinal pigment epithelium to the chorio-scleral junction at seven locations surrounding the fovea (subfoveal and 750, 1500 and 2250 μm temporal and nasal to the fovea). The image and mean choroidal thickness at each location shown here is from a typical myopic participant.
Figure 2
Figure 2. Nasal-temporal asymmetries in choroidal thickness in myopic eyes
Mean (SD) choroidal thickness at each of the seven measured locations surrounding the fovea (subfoveal and 750, 1500 and 2250 μm temporal (T) and nasal (N) to the fovea) in the myopic participants of the Correction of Myopia Evaluation Trial demonstrates nasal-temporal asymmetries.
Figure 3
Figure 3. Ethnic variations in choroidal thickness in myopic eyes
Mean choroidal thickness, by ethnic group, in the myopic participants of the Correction of Myopia Evaluation Trial cohort at each of the seven measured locations (N=nasal, T=temporal). Error bars represent SE. At N1500 and N2250, African Americans (white bars) had the thickest choroids and Asians (black bars) had the thinnest choroids.
Figure 4
Figure 4. Choroidal thickness in longer or highly myopic eyes
Top: Mean choroidal thickness of myopic eyes with shorter (black bars) and longer (grey bars) axial length, based on a median split of 25.5 mm, at each of the seven measured locations (N=nasal, T=temporal). Error bars represent SE. Bottom: Mean choroidal thickness of eyes with high myopia (worse than -6.0 D, grey bars) and without high myopia (black bars) at each of the seven measured locations (N=nasal, T=temporal). Error bars represent SE.
Figure 4
Figure 4. Choroidal thickness in longer or highly myopic eyes
Top: Mean choroidal thickness of myopic eyes with shorter (black bars) and longer (grey bars) axial length, based on a median split of 25.5 mm, at each of the seven measured locations (N=nasal, T=temporal). Error bars represent SE. Bottom: Mean choroidal thickness of eyes with high myopia (worse than -6.0 D, grey bars) and without high myopia (black bars) at each of the seven measured locations (N=nasal, T=temporal). Error bars represent SE.
Figure 5
Figure 5. Choroidal thickness in eyes with and without crescent
Mean choroidal thickness of myopic eyes with crescent (grey bars) and without crescent (black bars) at each of the seven measured locations (N=nasal, T=temporal). Error bars represent SE.
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