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. 2024 Feb 18;17(2):317-323.
doi: 10.18240/ijo.2024.02.14. eCollection 2024.

Using choroidal thickness to detect myopic macular degeneration

Ran Liu  1   2 , Meng Xuan  1 , De-Cai Wang  1 , Ou Xiao  1 , Xin-Xing Guo  3 , Jian Zhang  1 , Wei Wang  1 , Monica Jong  4   5 , Padmaja Sankaridurg  4   5 , Kyoko Ohno-Matsui  6 , Qiu-Xia Yin  1 , Ming-Guang He  1   7   8   9 , Zhi-Xi Li  1
Affiliations

Using choroidal thickness to detect myopic macular degeneration

Ran Liu et al. Int J Ophthalmol. .

Abstract

Aim: To explore the usage of choroidal thickness measured by swept-source optical coherence tomography (SS-OCT) to detect myopic macular degeneration (MMD) in high myopic participants.

Methods: Participants with bilateral high myopia (≤-6 diopters) were recruited from a subset of the Guangzhou Zhongshan Ophthalmic Center-Brien Holden Vision Institute High Myopia Cohort Study. SS-OCT was performed to determine the choroidal thickness, and myopic maculopathy was graded by the International Meta-Analysis for Pathologic Myopia (META-PM) Classification. Presence of MMD was defined as META-PM category 2 or above.

Results: A total of 568 right eyes were included for analysis. Eyes with MMD (n=106, 18.7%) were found to have older age, longer axial lengths (AL), higher myopic spherical equivalents (SE), and reduced choroidal thickness in each Early Treatment Diabetic Retinopathy Study (ETDRS) grid sector (P<0.001). The area under the receiver operating characteristic (ROC) curves (AUC) for subfoveal choroidal thickness (0.907) was greater than that of the model, including age, AL, and SE at 0.6249, 0.8208, and 0.8205, respectively. The choroidal thickness of the inner and outer nasal sectors was the most accurate indicator of MMD (AUC of 0.928 and 0.923, respectively). An outer nasal sector choroidal thickness of less than 74 µm demonstrated the highest odds of predicting MMD (OR=33.8).

Conclusion: Choroidal thickness detects the presence of MMD with high agreement, particularly of the inner and outer nasal sectors of the posterior pole, which appears to be a biometric parameter more precise than age, AL, or SE.

Keywords: choroidal thickness; high myopia; myopic macular degeneration; swept-source optical coherence tomography.

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Conflict of interest statement

Conflicts of Interest: Liu R, None; Xuan M, None; Wang DC, None; Xiao O, None; Guo XX, None; Zhang J, None; Wang W, None; Jong M, None; Sankaridurg P, None; Ohno-Matsui K, None; Yin QX, None; He MG, None; Li ZX, None.

Figures

Figure 1
Figure 1. Swept-source optical coherence tomography scans showing the boundary of the choroid in a highly myopic eye and demonstrating how the Early Treatment Diabetic Retinopathy Study (ETDRS) grid was applied for the choroidal thickness map
A: The boundary of choroidal thickness, from the outer surface of Bruch's membrane to the inner surface of the sclera, was automatically detected in the radical scan. B: Fundus image showing 12 scan lines running through the fovea. The ETDRS grid was applied, and the mean choroidal thickness was obtained in each sector. C: Diagram of the ETDRS grid. The central, middle, and outer circles, which represent, respectively, 1000, 3000, and 6000 µm in diameter, divided the posterior pole into nine sectors: subfoveal, outer nasal, outer temporal, outer superior, outer inferior, inner nasal, inner temporal, inner superior, and inner inferior sectors.
Figure 2
Figure 2. Receiver operating characteristic (ROC) curves of four biometrics for the detection of myopic macular degeneration
The area under the curve (AUC) from the highest to lowest; subfoveal macular choroidal thickness (SFCT, 0.907), axial length (AL, 0.8208), spherical equivalent (SE, 0.8205), and age (0.6249).
See this image and copyright information in PMC

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