Korean J Ophthalmol.  2016 Feb;30(1):32-39. 10.3341/kjo.2016.30.1.32.

Macular Choroidal Thickness and Volume Measured by Swept-source Optical Coherence Tomography in Healthy Korean Children

• Lee JW
• Song IS
• Lee JH
• Shin YU
• Lim HW
• Lee WJ
• Lee BR

• KMID: 2363888
• DOI: http://doi.org/10.3341/kjo.2016.30.1.32

Abstract

PURPOSE
To evaluate the thickness and volume of the choroid in healthy Korean children using swept-source optical coherence tomography.
METHODS
We examined 80 eyes of 40 healthy children and teenagers (<18 years) using swept-source optical coherence tomography with a tunable long-wavelength laser source. A volumetric macular scan protocol using the Early Treatment Diabetic Retinopathy Study grid was used to construct a choroidal thickness map. We also examined 44 eyes of 35 healthy adult volunteers (> or =18 years) and compared adult measurements with the findings in children.
RESULTS
The mean age of the children and teenagers was 9.47 +/- 3.80 (4 to 17) vs. 55.04 +/- 12.63 years (36 to 70 years) in the adult group (p < 0.001, Student's t-test). Regarding the Early Treatment Diabetic Retinopathy Study subfields, the inner temporal subfield was the thickest (247.96 microm). The inner and outer nasal choroid were thinner (p = 0.004, p = 0.002, respectively) than the surrounding areas. The mean choroidal volumes of the inner and outer nasal areas were smaller (p = 0.004, p = 0.003, respectively) than those of all the other areas in each circle. Among the nine subfields, all areas in the children, except the outer nasal subfield, were thicker than those in adults (p < 0.05). Regression analysis showed that age, axial length, and refractive error correlated with subfoveal choroidal thickness (p < 0.05).
CONCLUSIONS
Overall macular choroidal thickness and volume in children and teenagers were significantly greater than in adults. The nasal choroid was significantly thinner than the surrounding areas. The pediatric subfoveal choroid is prone to thinning with increasing age, axial length, and refractive error. These differences should be considered when choroidal thickness is evaluated in children with chorioretinal diseases.

Keyword

Choroidal thickness; Choroidal volume; Pediatrics; Swept source optical coherence tomography

MeSH Terms

Adolescent
Adult
Aged
Aging/physiology
Asian Continental Ancestry Group
Axial Length, Eye/anatomy & histology
Child
Child, Preschool
Choroid/*anatomy & histology
Female
Healthy Volunteers
Humans
Macula Lutea/anatomy & histology
Male
Middle Aged
Republic of Korea
*Tomography, Optical Coherence

Figure

• 

  Fig. 1 Choroidal thickness map obtained using swept-source optical coherence tomography in a healthy 9-year-old girl. The 3-dimensional (D) volumetric macular scan protocol with 512 A-scans × 256 B-scans was used to obtain 3D imaging data of a 6 × 6 mm area. (A) Autosegmentation of the chorioscleral border in the B-scan image. (B) Choroidal thickness map of a 6 × 6 mm area centered on the fovea obtained from analysis of the B-scan images in the 3D data set. Mean choroidal thickness for each sector was obtained by applying the Early Treatment Diabetic Retinopathy Study grid to the map.

• 

  Fig. 2 Pediatric and adult choroidal thinning with increasing age in each (A) horizontal and (B) vertical segment of the Early Treatment Diabetic Retinopathy Study grid. OT = outer temporal; IT = inner temporal; SF = subfoveal; IN = inner nasal; ON = outer nasal; OS = outer superior; IS = inner superior; II = inner inferior; OI = outer inferior.

• 

  Fig. 3 Scatterplots show the relationship between central choroidal thickness and (A) age, (B) axial length, and (C) refractive error. As age and axial length increased, central choroidal thickness (A,B) decreased. In contrast, as the spherical equivalent increased, central choroidal thickness (C) tended to increase.

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