Aim To prospectively determine the impact of choroidal thickness (CT) on the myopic maculopathy progression. Methods This is a prospective, longitudinal, observational study. In total, 434 participants aged 7–70 years with bilateral high myopia (≤-6 D spherical error, range, −6 to −27.0 D) completed follow-up visits for 2 years. The baseline CT centred on the fovea was measured using a swept-source optical coherence tomography (OCT). Myopic maculopathy progression was determined by fundus photography. Logistic model was used to examine the impact of CT at baseline on the myopic maculopathy progression. Likelihood ratio test was adopted for model comparison. Results The mean baseline age, spherical equivalence and subfoveal CT (SFCT) of the participants were 23.2±12.5 years, −10.50±3.18 D and 153.20±72.76 μm, respectively. Over 2-year’s follow-up, 74 of 434 eyes (17.1%) had myopic maculopathy progression. Baseline SFCT was thinner in eyes with myopic maculopathy progression than those without (67.26±37.67 μm vs 170.95±65.45 μm; mean difference, 99.31 μm; 95% CI 83.61 to 115.01 μm; p<0.001). The same patterns of differences were observed in 7–18 years, 19–39 years and 40–70 years. In multivariate logistic regression model, SFCT was a significant risk factor (adjusted OR=0.97, p<0.005) when age, gender, axial length and baseline myopic maculopathy category were adjusted for. The addition of SFCT significantly improved the predictive discrimination of myopic maculopathy progression in comparison with that included established risk factors alone (area under the receiver operating characteristic curve, 0.899 vs 0.942, p<0.001). Conclusion CT is an independent predictor for myopic maculopathy progression.

中文翻译：

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脉络膜厚度可预测高度近视患者近视黄斑病变的进展：一项为期 2 年的纵向研究

目的 前瞻性地确定脉络膜厚度 (CT) 对近视黄斑病变进展的影响。方法 这是一项前瞻性、纵向、观察性研究。总共有 434 名年龄在 7-70 岁的双侧高度近视（≤-6 D 球面误差，范围，-6 至 -27.0 D）的参与者完成了为期 2 年的随访。使用扫描源光学相干断层扫描 (OCT) 测量以中央凹为中心的基线 CT。通过眼底照相确定近视黄斑病变的进展。Logistic 模型用于检查基线 CT 对近视黄斑病变进展的影响。模型比较采用似然比检验。结果参与者的平均基线年龄、球面等效性和中心凹下CT（SFCT）分别为23.2±12.5岁、-10.50±3.18 D和153.20±72.76 μm。经过2年多的随访，434 只眼中有 74 只（17.1%）出现近视黄斑病变进展。有近视黄斑病变进展的眼睛的基线 SFCT 比没有进展的眼睛更薄（67.26±37.67 μm vs 170.95±65.45 μm；平均差，99.31 μm；95% CI 83.61 至 115.01 μm；p<0.001）。在 7-18 岁、19-39 岁和 40-70 岁观察到相同的差异模式。在多变量逻辑回归模型中，当调整年龄、性别、眼轴长度和基线近视黄斑病变类别时，SFCT 是一个重要的危险因素（调整后的 OR=0.97，p<0.005）。与仅包括既定风险因素的情况相比，SFCT 的加入显着提高了对近视黄斑病变进展的预测辨别力（受试者工作特征曲线下面积，0.899 对 0.942，p<0.001）。