Optical Defocus Rapidly Changes Choroidal Thickness in Schoolchildren

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Abstract

The current study aimed to examine the short-term choroidal response to optical defocus in schoolchildren. Myopic schoolchildren aged 8–16 were randomly allocated to control group (CG), myopic defocus group (MDG) and hyperopic defocus group (HDG) (n = 17 per group). Children in MDG and HDG received additional +3D and -3D lenses, respectively, to their full corrections on the right eyes. Full correction was given to their left eyes, and on both eyes in the CG. Axial length (AXL) and subfoveal choroidal thickness (SFChT) were then measured by spectral domain optical coherence tomography. Children wore their group-specific correction for 2 hours after which any existing optical defocus was removed, and subjects wore full corrections for another 2 hours. Both the AXL and SFChT were recorded hourly for 4 hours. The mean refraction of all subjects was -3.41 ± 0.37D (± SEM). SFChT thinned when exposed to hyperopic defocus for 2 hours but less thinning was observed in response to myopic defocus compared to the control group (p < 0.05, two-way ANOVA). Removal of optical defocus significantly decreased SFChT in the MDG and significantly increased SFChT in the HDG after 1 and 2 hours (mean percentage change at 2-hour; control vs. hyperopic defocus vs. myopic defocus; -0.33 ± 0.59% vs. 3.04 ± 0.60% vs. -1.34 ± 0.74%, p < 0.01). Our results showed short-term exposure to myopic defocus induced relative choroidal thickening while hyperopic defocus led to choroidal thinning in children. This rapid and reversible choroidal response may be an important clinical parameter in gauging retinal response to optical defocus in human myopia.

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Most cited references 33

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Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography.

Colin Tan, Yanling Ouyang, Humberto Ruiz … (2012)

To describe the pattern and magnitude of diurnal variation of choroidal thickness (CT), its relation to systemic and ocular factors, and to determine the intervisit reproducibility of diurnal patterns. A prospective study was conducted on 12 healthy volunteers who each underwent sequential ocular imaging on two separate days at five fixed, 2-hour time intervals. Spectral domain optical coherence tomography (OCT) with enhanced depth imaging and image tracking was performed using a standardized protocol. Choroidal and retinal thicknesses were independently assessed by two masked graders. CT diurnal variation was assessed using repeated-measures ANOVA. A significant diurnal variation in CT was observed, with mean maximum CT of 372.2 μm, minimum of 340.6 μm (P < 0.001), and mean diurnal amplitude of 33.7 μm. Retinal thickness (mean, 235.0 μm) did not exhibit significant diurnal variation (P = 0.621). The amplitude of CT variation was significantly greater for subjects with thicker morning baseline CT compared with those with thin choroids (43.1 vs. 10.5 μm, P < 0.001). There were significant correlations between amplitude of CT and age (P = 0.032), axial length (P < 0.001), and spherical equivalent (P < 0.001). The change in CT also correlated with change in systolic blood pressure (P = 0.031). Comparing CT on two different days, a similar diurnal pattern was observed, with no significant difference between corresponding measurements at the same time points (P = 0.180). There is significant diurnal variation of CT, with good intervisit reproducibility of diurnal patterns on two different days. The amplitude of variation varies with morning baseline CT, and is correlated with age, axial length, refractive error, and change in systolic blood pressure.

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Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.

Pauline Cho, Sin-Wan Cheung (2012)

This single-masked randomized clinical trial aimed to evaluate the effectiveness of orthokeratology (ortho-k) for myopic control. A total of 102 eligible subjects, ranging in age from 6 to 10 years, with myopia between 0.50 and 4.00 diopters (D) and astigmatism not more than 1.25D, were randomly assigned to wear ortho-k lenses or single-vision glasses for a period of 2 years. Axial length was measured by intraocular lens calculation by a masked examiner and was performed at the baseline and every 6 months. This study was registered at ClinicalTrials.gov, number NCT00962208. In all, 78 subjects (37 in ortho-k group and 41 in control group) completed the study. The average axial elongation, at the end of 2 years, were 0.36 ± 0.24 and 0.63 ± 0.26 mm in the ortho-k and control groups, respectively, and were significantly slower in the ortho-k group (P 0.54) but was correlated with the initial age of the subjects (P 1.00D per year) were 65% and 13% in younger (age range: 7-8 years) and older (age range: 9-10 years) children, respectively, in the control group and were 20% and 9%, respectively, in the ortho-k group. Five subjects discontinued ortho-k treatment due to adverse events. On average, subjects wearing ortho-k lenses had a slower increase in axial elongation by 43% compared with that of subjects wearing single-vision glasses. Younger children tended to have faster axial elongation and may benefit from early ortho-k treatment. (ClinicalTrials.gov number, NCT00962208.).

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The relationship between glaucoma and myopia: the Blue Mountains Eye Study.

P. Mitchell, F Hourihan, J Sandbach … (1999)

To quantify the relationship between myopia and open-angle glaucoma, ocular hypertension (OH), and intraocular pressure (IOP) in a representative older population. Cross-sectional population-based study of 3654 Australians 49 to 97 years of age. Subjects with any myopia (> or =-1.0 diopter [D]) were identified by a standardized subjective refraction and categorized into low myopia (> or =-1.0 D to or =-3.0 D). Glaucoma was diagnosed from characteristic visual field loss, combined with optic disc cupping and rim thinning, without reference to IOP. Ocular hypertension was diagnosed when applanation IOP was greater than 21 mmHg in either eye in the absence of glaucomatous visual field and optic disc changes. General estimating equation models were used to assess associations between eyes with myopia and either glaucoma or OH. Glaucoma was present in 4.2% of eyes with low myopia and 4.4% of eyes with moderate-to-high myopia compared to 1.5% of eyes without myopia. The relationship between glaucoma and myopia was maintained after adjusting for known glaucoma risk factors, odds ratio (OR) of 2.3, and 95% confidence intervals (CI) of 1.3 to 4.1 for low myopia. It was stronger for eyes with moderate-to-high myopia (OR, 3.3; CI, 1.7-6.4). Only a borderline relationship was found with OH, OR of 1.8 (CI, 1.2-2.9) for low myopia, and OR of 0.9 (CI, 0.4-2.0) for moderate-to-high myopia. Mean IOP was approximately 0.5 mmHg higher in myopic eyes compared to nonmyopic eyes. This study has confirmed a strong relationship between myopia and glaucoma. Myopic subjects had a twofold to threefold increased risk of glaucoma compared with that of nonmyopic subjects. The risk was independent of other glaucoma risk factors and IOP.

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Author and article information

Contributors

Andreas Wedrich: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 18 August 2016

Publication date Collection: 2016

Volume: 11

Issue: 8

Electronic Location Identifier: e0161535

Affiliations

[1 ]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, PR China

[2 ]Laboratory of Experimental Optometry, Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong, PR China

[3 ]Hainan Eye Hospital, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Haikou, PR China

Medizinische Universitat Graz, AUSTRIA

Author notes

Competing Interests: The authors have declared that no competing interests exist.

Conceptualization: DW RC QL CL CT.
Data curation: DW RC.
Formal analysis: DW RC RL.
Funding acquisition: QL CT.
Investigation: DW RC RL ML YS TZ.
Methodology: DW RC CT.
Project administration: DW RC.
Resources: QL CT.
Supervision: CL QL CT.
Validation: RC CL CT.
Visualization: DW RC RL.
Writing - original draft: DW RC.
Writing - review & editing: DW RC QL CT.

* E-mail: drliuquan@ 123456163.com (QL); chi-ho.to@ 123456polyu.edu.hk (CHT)

Article

Publisher ID: PONE-D-16-11156

DOI: 10.1371/journal.pone.0161535

PMC ID: 4990278

PubMed ID: 27537606

SO-VID: ae42fba5-eec0-4b8e-896f-091d5c864c4d

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 17 March 2016

Date accepted : 8 August 2016

Page count

Figures: 3, Tables: 2, Pages: 12

Funding

Funded by: The Hong Kong Polytechnic University

Award ID: GUA32, GYZ29

Award Recipient : Chi Ho To

Funded by: funder-id http://dx.doi.org/10.13039/501100005847, Health and Medical Research Fund;

Award ID: K-ZJHZ

Award Recipient : Chi Ho To

Funded by: Henry G Leong Professorship in E

Award ID: N/A

Award Recipient : Chi Ho To

The work was supported by The Hong Kong Polytechnic University (GUA32, GYZ29), Health and Medical Research Fund(HMRF, K-ZJHZ) and Henry G Leong Professorship in Elderly Vision Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Data Availability All relevant data are within the paper and its Supporting Information files.

Optical Defocus Rapidly Changes Choroidal Thickness in Schoolchildren

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PLOS: COVID-19 pandemic

Most cited references 33

Diurnal variation of choroidal thickness in normal, healthy subjects measured by spectral domain optical coherence tomography.

Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.

The relationship between glaucoma and myopia: the Blue Mountains Eye Study.

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