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Myopia, Axial Length, and OCT Characteristics of the Macula in Singaporean Children

¹From the Singapore Eye Research Institute, Republic of Singapore; the ²Department of Community, Occupational and Family Medicine, National University of Singapore, Republic of Singapore; ³The Institute of Ophthalmology, London, United Kingdom; the ⁴Singapore National Eye Center, Republic of Singapore; the ⁵Department of Ophthalmology, National University Hospital, Republic of Singapore; the ⁶University of Sydney, Center for Vision Research, Westmead Millennium Institute, Westmead, New South Wales, Australia; and the ⁷Center for Eye Research Australia, University of Melbourne, Melbourne, Australia.

PURPOSE. The purpose of this study was to evaluate the associations between macular volume and thickness, as assessed by optic coherence tomography (OCT), with refraction and axial length (AL) in children.

METHODS. A total of 104 Chinese school children (51 girls and 53 boys) 11 to 12 years of age were randomly selected from one school during the 2005 examination in the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Cycloplegic autorefraction was performed to obtain refraction (defined as spherical equivalent [SE]) and ultrasound biometry performed to obtain the AL. Macular volume and thickness were then measured (StratusOCT3; Carl Zeiss Meditec, Dublin, CA).

RESULTS. Children with moderate myopia (SE at least –3.0 D) tended to have smaller total macular volume and thinner quadrant-specific macular thickness (except in the inferior and superior inner quadrants), followed by children with low myopia (–0.5 SE < –3.0 D), compared with children with no myopia (SE > –0.5 D). Total macular volume was positively associated with SE (ß = 1.58, 95% CI, 0.84 to 2.32, standardized ß = 0.14, P < 0.001) and negatively associated with AL (ß = –1.20, 95% CI, –1.62 to –0.79, standardized ß = 0.45, P < 0.001) in multiple linear regression models controlling for age and gender.

CONCLUSIONS. In children, increasing axial myopia was associated with reduced macular volume and thickness. These findings suggest that early anatomic changes may be present in the retinas of children with axial myopia.

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