Macular Choroidal Thickness in Children: The Shandong Children Eye Study.

Purpose: To examine the thickness of the macular choroid and its associations in school children aged 6 to 18 years.

Methods: The school-based cross-sectional Shandong Children Eye Study included 6026 (94.7%) of 6364 eligible children fulfilling the inclusion criterion of an age from 4 to 18 years. Spectral-domain optical coherence tomography (SD-OCT) was performed for a subgroup of 972 school children aged 6+ years. All participants underwent ocular examinations, including measurement of visual acuity, cycloplegic refractometry, biometry, and SD-OCT (enhanced depth imaging mode) for measurement of choroidal thickness.

Results: The study included 972 children (501 girls) with a mean age of 11.3 ± 3.3 years (range, 6-18 years) and mean axial length of 24.10 ± 1.56 mm (range, 16.57-28.82 mm). Mean choroidal thickness was thicker (P < 0.001) at 500 μm temporal to the foveola (290 ± 67 μm) than in the subfoveal region (283 ± 67 μm; range, 113-507 μm) and the region 500 μm superior to the fovea (283 ± 66 μm), where it was thicker (P < 0.001) than at 500 μm inferior of the foveola (281 ± 66 μm), and it was thinnest (P < 0.001) at 500 μm nasal of the foveola (268 ± 67 μm). In multivariate analysis, thicker SFCT was (overall correlation coefficient r: 0.51) associated with shorter axial length (P < 0.001; standardized correlation coefficient β: -0.48; B: -23.7; 95% confidence interval [CI]: -27.2 to -20.3), male sex (P = 0.006; β: -0.08; B: -10.7; 95% CI: -18.3 to -3.11), and younger age (P = 0.04; β: -0.07; B: -1.46; 95% CI: -2.85 to -0.07).

Conclusions: As in adults, thicker SFCT in children and teenagers was markedly associated with shorter axial length, and to a lesser degree with male sex and older age. As in adults, increasing axial myopia in teenagers is associated with choroidal thinning and development of a leptochoroid.