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Comment
. 2023 Dec;37(18):3847-3853.
doi: 10.1038/s41433-023-02629-2. Epub 2023 Jun 27.

Association between choriocapillaris perfusion and axial elongation in children using defocus incorporated multiple segments (DIMS) spectacle lenses

Xuewei Li #  1   2   3   4   5 , Jie Hu #  2   3   4   5 , Zisu Peng  1   2   3   4   5 , Sitong Chen  1   2   3   4   5 , Liyuan Sun  1   2   3   4   5 , Kai Wang  6   7   8   9   10 , Yan Li  1   2   3   4   5 , Mingwei Zhao  1   2   3   4   5
Affiliations
Comment

Association between choriocapillaris perfusion and axial elongation in children using defocus incorporated multiple segments (DIMS) spectacle lenses

Xuewei Li et al. Eye (Lond). 2023 Dec.

Abstract

Purpose: To investigate choroidal and ocular biological variables that influence axial length (AL) elongation in children wearing defocused incorporated multiple segments (DIMS) spectacle lenses.

Methods: This cohort study included 106 myopic children aged 7-14 years with a 1-year follow-up. Participants were divided into two groups according to the increase in AL in one year: rapid (>0.2 mm) and slow (≤0.2 mm) axial elongation groups. Cycloplegic autorefraction and AL were measured at baseline and after 6 and 12 months. The area of choriocapillaris flow voids (FVs) and choroidal thickness (ChT) at baseline were measured.

Results: Univariate linear regression analysis showed that AL elongation were significantly associated with the FVs area (standardised β = 0.198, P < 0.05) and age (standardised β = -0.201, P < 0.05). Multiple linear regression showed that the FVs area, age, and average K reading were associated with AL elongation. Multiple logistic regression analyses showed that greater degrees of myopia and larger FVs areas were risk factors for rapid axial elongation, while older age, large pupil diameter and steeper cornea were protective factors. In estimating axial elongation, the FVs area alone demonstrated an area under the curve (AUC) of 0.672 (95% CI, 0.569-0.775, P < 0.01), and that of FVs area and other ocular variables was 0.788 (95% CI, 0.697-0.878, P < 0.001).

Conclusion: Larger choriocapillaris FVs area at baseline may help to predict axial elongation in myopic eyes. The association between FVs area and axial elongation should be taken into consideration in further myopic cohort studies.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Calculation of the flow void area.
A The image of the superficial retina was converted to 8-bit and B subjected to Yen threshold processing. C The choriocapillaris layer was converted into an 8-bit image and D subjected to auto-local thresholding (Plansalkar’s Method, radius = 2). E The particle area in a 3-mm centred on the fovea was analysed. FThe calculation focused on an area of central 3 mm circle surrounding, and the black particle area was analysed.
Fig. 2
Fig. 2. Linear regression analysis betwee axial elongation, age and flow void.
Scatter plots showing the correlation between A axial elongation and FVs and B axial elongation and age.
Fig. 3
Fig. 3. ROC Analysis to predict axial elongation.
ROC curve of FVs area alone and total equation (including FVs, age, SER, Ave-K and PD) to predict axial elongation in children wearing DIMS lenses.
See this image and copyright information in PMC

Comment on

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