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Corneal morphology correlates with choriocapillaris perfusion in myopic children

  • Pediatrics
  • Published:
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Abstract

Aims

The present study investigated the difference in choriocapillaris (CC) perfusion between different AL/K ratio groups with similar spherical equivalent refraction (SER) and analyzed factors affecting CC perfusion.

Methods

This cross-sectional study included 129 children with low-to-moderate myopia. Axial length (AL), average K-reading (Ave-K), and SER were measured. Choroidal vascularity, including the total choroidal area (TA), choroidal luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), CC flow voids (FVs), and FVs%, was obtained using optical coherence tomography angiography.

Results

Participants with similar SER were divided into two groups (high AL/K ratio, n = 57; low AL/K ratio, n = 72). The high AL/K group had lower LA, TA, and CVI (P < 0.01) and lower FVs (inner ring and fovea, P < 0.05) and FVs% (outer ring, inner ring, and fovea, P < 0.05). The AL/K ratio and FVs% were negatively correlated in the outer ring (r =  − 0.174, P < 0.05) and inner ring (r =  − 0.174, P < 0.05). The Ave-K and inner FVs (r = 0.178, P < 0.05), outer FVs% (r = 0.175, P < 0.05), and inner FVs% (r = 0.196, P < 0.05) were positively correlated. In stepwise multiple regression for the outer ring, the horizontal CVI was related to FVs (β = 0.175, P < 0.05), and the vertical CVI was related to FVs% (β = 0.232, P < 0.01). Independent risk factors associated with inner FVs area were vertical CVI (β = 0.329; P < 0.001) and SER (β =  − 0.196, P < 0.05); FVs% was also associated with vertical CVI (β = 0.360, P < 0.01) and SER (β =  − 0.196, P < 0.05).

Conclusion

With a similar SER, myopic eyes with a higher AL/K ratio maintained more CC perfusion and lower CVI, which may indicate rapid myopic progression. Low K-reading eyes had more CC perfusion and less CVI, which may explain the relatively poor myopia control efficacy in the clinic.

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Abbreviations

AL:

Axial length

CCT:

Central corneal thickness

ACD:

Anterior chamber depth

LT:

Lens thickness

VCD:

Vitreous chamber depth

Ave-K:

Average cornea K-reading

SER:

Spherical equivalent refraction

ChBF:

Choroidal blood flow

FVs:

Blood flow voids

FVs%:

Percentage of blood flow voids

CVI:

Choroidal vascular index

H-CVI-3 mm:

CVI in horizontal scan within 3 mm

H-CVI-6 mm:

CVI in horizontal scan within 6 mm

V-CVI-3 mm:

CVI in vertical scan within 3 mm

V-CVI-6 mm:

CVI in vertical scan within 6 mm

SFChT:

Subfoveal choroidal thickness

SA:

Stromal area

LA:

Luminal area

TA:

Total choroidal area

NO:

Nasal region of the outer ring in ETDRS

TO:

Temporal region of the outer ring in ETDRS

IO:

Inferior region of the outer ring in ETDRS

SO :

Superior region of the outer ring in ETDRS

NI:

Nasal region of the inner ring in ETDRS

TI:

Temporal region of the inner ring in ETDRS

II:

Inferior region of the inner ring in ETDRS

SI:

Superior region of the inner ring in ETDRS

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 82171092, 81870684) and the National Key R&D Program of China (Grant No.2020YFC2008200).

Author information

Authors and Affiliations

  1. Institute of Medical Technology, Peking University Health Science Center, Beijing, China

    Xuewei Li, Lu Ma, Kai Wang, Yan Li & Mingwei Zhao

  2. Department of Ophthalmology & Clinical Centre of Optometry, Peking University People’s Hospital, Beijing , 100044, China

    Xuewei Li, Lu Ma, Jie Hu, Qiong Xu, Kai Wang, Yan Li & Mingwei Zhao

  3. College of Optometry, Peking University Health Science Center, Beijing, China

    Xuewei Li, Lu Ma, Jie Hu, Qiong Xu, Kai Wang, Yan Li, Jia Qu & Mingwei Zhao

  4. Eye Disease and Optometry Institute, Peking University People’s Hospital, Beijing, China

    Xuewei Li, Lu Ma, Jie Hu, Qiong Xu, Kai Wang, Yan Li & Mingwei Zhao

  5. Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China

    Xuewei Li, Lu Ma, Jie Hu, Qiong Xu, Kai Wang, Yan Li & Mingwei Zhao

  6. School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China

    Jia Qu

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Contributions

X. Li participated in conception and design of this work, data acquisition and analysis, and in literature search and manuscript writing. M. Lu and J. Hu contributed to data collection and the acquisition of fundus photograph and picture processing of the datasets. Q. Xu contributed to data collection and data analysis. Y. Li, J. Qu, and M. Zhao contributed to the interpretation of data, and revision of the manuscript for this study. K. Wang contributed to design of the work, interpretation of data, and revision of the manuscript for this study. All authors read and approved the final version of the manuscript.

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Correspondence to Kai Wang.

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This study design adhered to the principles of the Helsinki Declaration and was approved by the Ethics Committee of Peking University People’s Hospital. Study approval number is 2020PHB276.

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Li, X., Ma, L., Hu, J. et al. Corneal morphology correlates with choriocapillaris perfusion in myopic children. Graefes Arch Clin Exp Ophthalmol 260, 3375–3385 (2022). https://doi.org/10.1007/s00417-022-05675-w

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