Choroidal thickness, myopia, and myopia control interventions in children: a Meta-analysis and systemic review
Authors:   Department of Ophthalmology &amp; Clinical Centre of Optometry, Peking University People&#x2019;s Hospital, Beijing 100044, China; Eye Disease and Optometry Institute, Peking University People&#x2019;s Hospital, Beijing 100044, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing 100044, China, Meng Qing-Yu , Liang Shu-Ting ,   Department of Ophthalmology &amp; Clinical Centre of Optometry, Peking University People&#x2019;s Hospital, Beijing 100044, China; Eye Disease and Optometry Institute, Peking University People&#x2019;s Hospital, Beijing 100044, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing 100044, China, Wu Xi ,   Department of Ophthalmology &amp; Clinical Centre of Optometry, Peking University People&#x2019;s Hospital, Beijing 100044, China; Eye Disease and Optometry Institute, Peking University People&#x2019;s Hospital, Beijing 100044, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing 100044, China, Wang Le-Jin ,   Department of Ophthalmology &amp; Clinical Centre of Optometry, Peking University People&#x2019;s Hospital, Beijing 100044, China; Eye Disease and Optometry Institute, Peking University People&#x2019;s Hospital, Beijing 100044, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing 100044, China, Zhao Ming-Wei ,   Department of Ophthalmology &amp; Clinical Centre of Optometry, Peking University People&#x2019;s Hospital, Beijing 100044, China; Eye Disease and Optometry Institute, Peking University People&#x2019;s Hospital, Beijing 100044, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing 100044, China, Guo Li-Li ,   Department of Ophthalmology &amp; Clinical Centre of Optometry, Peking University People&#x2019;s Hospital, Beijing 100044, China; Eye Disease and Optometry Institute, Peking University People&#x2019;s Hospital, Beijing 100044, China; Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing 100044, China
Published: March 2023

AIM: To investigate changes of choroidal thickness (ChT) in children with myopia and the effect of current myopia control interventions on ChT.
METHODS: Major literature databases were searched for studies relevant to myopia in children. All studies used swept-source optical coherence tomography (SS-OCT) or enhanced depth imaging optical coherence tomography (EDI-OCT) to measure the ChT value. The weighted mean difference (WMD) and 95% confidence interval (CI) were pooled to evaluate ChT in myopia children.
RESULTS: A total of 11 eligible articles, including 1693 myopic and 1132 non-myopic eyes, were included in the first Meta-analysis. The sub-foveal choroidal thickness (SFCT; WMD=-40.06, 95%CI, -59.36 to -20.75, P<0.001) and ChT at other sectors were significantly thinner in myopic eyes compared with the non-myopic eyes. The Meta-analysis revealed that the ChT decreased horizontally from the temporal sector toward the nasal sector in the pediatric myopia population. Another 11 studies reporting the effect of myopia control interventions were included in the second Meta-analysis for the relationship between myopia control treatments and ChT. SFCT significantly increased after orthokeratology (OK) treatment and OK combined with 0.01% atropine (OKA) treatment (WMD=19.47, 95%CI, 15.96 to 22.98, P<0.001; WMD=21.81, 95%CI, 12.92 to 29.70, P<0.001, respectively). The forest plots showed that SFCT changed little in myopic children receiving 0.01% atropine (P=0.30). Furthermore, the Meta-analysis showed that OK treatment had a stronger effect on the value of SFCT in myopic children as compared with 0.01% atropine (WMD=9.86; 95%CI, -0.21 to 19.93, P=0.05). There is no difference between the treatment with OK and OKA treatment in ChT in myopic children (P=0.37).
CONCLUSION: The ChT in myopic eyes is thinner than that in non-myopic eyes in pediatric population. Myopia control interventions including OK and OKA lead to ChT thickening, but other treatments such as 0.01% atropine did not show an increase in ChT.