Choroidal Thickness and Visual Acuity in Highly Myopic Eyes

Abstract

Choroidal thickness in high myopia is inversely correlated with increasing age and myopic refractive error and is an important predictor of visual acuity. Given that myopia is increasing worldwide, these findings may have epidemiologic significance.

Optical Coherence Tomography–based Correlation Between Choroidal Thickness and Drusen Load in Dry Age-Related Macular Degeneration

“…13,[19][20][21][22][23] Foveal choroidal flow and volume also decrease with age. 24 Grunwald et al 24 hypothesized that this was in response to age-related decrease in density and diameter of the choriocapillaris that was previously observed by Ramrattan et al 25 A more recent study found an inverse relationship between choroidal blood flow (and volume) and drusen extent.…”

“…This result could be expected with reasonable confidence because another group has also recently shown an inverse correlation between choroidal thickness and visual acuity in myopia. 13 It is important to note that their study showed that subfoveal choroidal thickness was the only significant predictor for visual acuity while other parameters, including retinal and foveal thickness, outer retinal hyporeflective layer thickness, and inner segment to RPE aggregate thickness, were not significant predictors. They ultimately concluded that OCT-measured retinal features are not correlated with visual acuity.…”

“…7 It has been demonstrated that enhanced depth imaging (EDI) SD-OCT, which produces an inverted image from 100 scans to improve signal-to-noise ratio, can be used to visualize the choroid even better. [8][9][10][11] The new technology has lead to better understanding of the role of choroid in various macular diseases, including central serious chorioretinopathy, 9-11 high myopia, 12,13 Vogt-Koyanagi-Harada disease, 14 and a variety of retinal dystrophies. 15 However, although SD-OCT has been used to assess choroidal thickness in various diseases, including AMD, it has not yet been used to correlate choroidal thickness with drusen load in dry AMD.…”

Advances of optical coherence tomography in myopia and pathologic myopia

“…[30][31][32][33][34] Furthermore, the diminution in choroidal thickness with age was approximately the same in absolute quantities in highly myopic eyes as in eyes without high myopia. 35 When highly myopic eyes grow with age, the choroid may become very thin and even completely absent. Chorioretinal atrophy (CRA) in high-myopic eyes appeared white in fundoscopy due to overlying RPE hypoplasia and the underlying sclera became readily visible.…”

“…[35][36][37] Studies evaluating the choroid in myopic eyes using ultrasonography and indocyanine green angiography (ICGA) demonstrated that the density of choroidal vasculature and circulation were reduced. [38][39][40] It is hypothesized that in the process of globe elongation in axial myopia, the choroid may well be stretched without development of additional vasculature.…”