Two-Year Choroidal Thickness Attenuation and Its Associations in Healthy Chinese Adults

Abstract

Purpose Identifying clinical associations causing attenuation in choroidal thickness (CT) among healthy Chinese adults. Methods A 2-year longitudinal study was conducted in volunteers aged over 30 years from China. All participants had no history of eye disease or surgery. All subjects underwent swept-source optical coherence tomography to measure the CT in the macular region at baseline and at 2-year follow-up. The regression models were based on the generalized estimating equation. Results A total of 603 eyes of 336 healthy participants were included in the final analysis (mean [SD] age, 58.88 [8.82] years; 74.70% female). Mean (SD) choroidal thickness (MCT) was reduced significantly from 206.62 (72.42) to 194.02 (72.08) µm (difference, −12.60 µm; 95% confidence interval [CI], −13.62 to −11.57). Among the Early Treatment of Diabetic Retinopathy Study (ETDRS) grid, CT at the subfoveal sector showed the greatest 2-year reduction (difference, −14.55 µm; 95% CI, −15.87 to −13.22). The largest 2-year change was observed in the 50 to 59 years group (difference, −14.51 µm; 95% CI, −16.71 to −12.32). Multivariate regression showed female gender (β = −2.85; 95% CI, −5.65 to −0.56) and baseline MCT (β = −0.040; 95% CI, −0.056 to −0.024) were significantly and independently associated with greater 2-year CT decrease. Conclusions These results indicated that CT among Chinese healthy adults decreased during the 2-year follow-up, and the greater choroidal thinning rate was significantly associated with female gender and larger baseline MCT. Translational Relevance Longitudinal CT data of healthy adults provide a reference range when evaluating pathologic variations, especially for the age-related retinal-choroidal disorders.

New findings on choroidal features in healthy people by ultra-widefield swept-source optical coherence tomography angiography

“…Due to the limitation of observation scope, few studies compared the decline of MCT with age in the macular region with other regions. In 2018, Wenjia Cai et al conducted a 2-year longitudinal study on healthy volunteers over 30 years old 29 . They discovered that the greatest 2-year change in MCT was in the group aged 50–59 within a 6 mm × 6 mm area centered on the macula.…”

“…The decrease in CT generally indicated a reduction in choroidal blood density and blood supply, and the loss of choroidal vasculature weakened the ability of the choroid to supply oxygen and metabolites to the RPE and retina 30 . The high metabolic demand for nutrient supply to the macula requires rapid and intensive filling of choroidal capillaries and choroidal arteries 29 , 31 . In summary, it is hypothesized in our study that the accelerated loss of choroidal vasculature in people aged > 50 leads to a decrease in the ability of the choroid to supply oxygen and metabolites to the RPE and retina 30 .…”