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| LETTER TO EDITOR |
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| Year : 2021 | Volume
: 33
| Issue : 1 | Page : 98-99 |
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Reply to letter to editor: Choroidal thickness in pediatric population
Javad Heravian Shandiz1, Mohsen Heirani1, Ahmad Shojaei2, Foroozan Narooie-Noori3
1 Refractive Errors Research Center; Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
2 Basir Eye Health Research Center, Tehran, Iran
3 Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| Date of Submission | 14-Aug-2020 |
| Date of Decision | 29-Aug-2020 |
| Date of Acceptance | 29-Aug-2020 |
| Date of Web Publication | 26-Mar-2021 |
Correspondence Address:
Mohsen Heirani
Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad
Iran
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JOCO.JOCO_72_20
How to cite this article:
Heravian Shandiz J, Heirani M, Shojaei A, Narooie-Noori F. Reply to letter to editor: Choroidal thickness in pediatric population. J Curr Ophthalmol 2021;33:98-9 |
How to cite this URL:
Heravian Shandiz J, Heirani M, Shojaei A, Narooie-Noori F. Reply to letter to editor: Choroidal thickness in pediatric population. J Curr Ophthalmol [serial online] 2021 [cited 2021 Apr 18];33:98-9. Available from: http://www.jcurrophthalmol.org/text.asp?2021/33/1/98/312173 |
Dear Editor,
We thank Dr. Prousali Efthymia et al. for their perceptive comments on our research. Their letter concerned primarily regarding the trend of choroidal thickness changes during childhood. The main objective of our study was to characterize the distribution of choroidal thickness profile in healthy Iranian children and adults at different age groups from 4 to 60 years old.[1] The different kinds of refractive errors were labeled for each age group. The purpose of the study necessitated performing the examinations on a large sample of subjects from childhood to adulthood with different types of refractive errors. One limitation of our study was that we could not easily find a large number of children up to 10-year-old with different types of refractive errors to include in the study. However, considering the poor cooperation of children in the prolonged process of examinations and compared with previous studies, the number of pediatric subjects in the present study seems to be reasonable.[2],[3] By considering age as a factor, we inevitably included 45 cases under the age of 10 years as the children's group which was to some extent lower than the other age groups. Based on the present data, we found a decreasing trend in children that agree well with existing studies.[3],[4],[5] In line with our study, Nagasawa et al. found a significantly thicker choroidal profile in children compared with adults.[6] However, in the discussion part of the paper, we stated that there were conflicting results regarding the effect of age on choroidal thickness in children.[2],[7],[8] As an example, Bidaut-Garnier et al. found a positive correlation between choroidal thickness and age in the pediatric population (R[2] = 0.056, P = 0.0017).[2] In another study, Read et al. found a significantly thinner choroid (337 ± 65 μm, P < 0.05) in 4- to 6-year-old children compared with 7- to 9-year-old children (337 ± 65 μm, P < 0.05).[7] The discrepancies might be attributed to the different patient selection criteria, choroidal thickness measurement methods, and ethnicity variations. A key strength of the current research lies within the fact that we included both children and adult subjects, and hence, the sample size was much larger than was previously used in similar studies.
The second concern was that we did not include the exact numerical values of the choroidal thickness of each age group. We demonstrated the average horizontal, vertical, and total choroidal thicknesses (mean vertical and horizontal choroidal thickness profiles) in different age groups in [Figure 6]. The numerical values for the average horizontal, vertical, and total choroidal thickness of children under the age of 10 were 343.4 ± 62.96, 372.99 ± 59.69, and 356.44 ± 59.27, respectively. In addition, we considered 6 years of age groups and did not categorize children and young adults into narrower subgroups due to the goal of the study, which was a comparison in all age groups, and also in order to prevent excessive data presentation. In future work, it may be useful to study choroidal thickness in a large sample of pediatric population.
As acknowledged by Dr. Prousali Efthymia, we stated that we were limited to perform the method of cycloplegic refraction for evaluating the refractive error of the young subjects. This limitation was due to the large sample size and multiple examinations. Cycloplegic refraction is a time-consuming and aggressive procedure and might cause losing some subjects for our prolonged examinations. We reviewed the literature, and therefore, in line with previous studies, we administered most plus subjective refraction for analyzing refraction data.[3],[9],[10]
The final comment referred to incoherent reported data in [Table 5]. We do not disagree with their comment; however, it would be worth noting that the main reason for collecting previous findings was to demonstrate the differences in the values of choroidal thickness due to the variety of factors such as sample size, age of participants, ethnicity, and instrumentation. We acknowledge the importance of standardizing choroidal thickness data and that these different factors make it difficult to compare this study with other cross-sectional studies of the choroidal profile.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Heirani M, Shandiz JH, Shojaei A, Narooie-Noori F. Choroidal thickness profile in normal Iranian eyes with different refractive status by spectral-domain optical coherence tomography. J Curr Ophthalmol 2020;32:58-68.  [Full text] |
| 2. | Bidaut-Garnier M, Schwartz C, Puyraveau M, Montard M, Delbosc B, Saleh M. Choroidal thickness measurement in children using optical coherence tomography. Retina 2014;34:768-74. |
| 3. | Read SA, Collins MJ, Vincent SJ, Alonso-Caneiro D. Choroidal thickness in myopic and nonmyopic children assessed with enhanced depth imaging optical coherence tomography. Invest Ophthalmol Vis Sci 2013;54:7578-86. |
| 4. | Jin P, Zou H, Zhu J, Xu X, Jin J, Chang TC, et al. Choroidal and retinal thickness in children with different refractive status measured by swept-source optical coherence tomography. Am J Ophthalmol 2016;168:164-76. |
| 5. | Zhang JM, Wu JF, Chen JH, Wang L, Lu TL, Sun W, et al. Macular choroidal thickness in children: The shandong children eye study. Invest Ophthalmol Vis Sci 2015;56:7646-52. |
| 6. | Nagasawa T, Mitamura Y, Katome T, Shinomiya K, Naito T, Nagasato D, et al. Macular choroidal thickness and volume in healthy pediatric individuals measured by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci 2013;54:7068-74. |
| 7. | Read SA, Collins MJ, Vincent SJ, Alonso-Caneiro D. Choroidal thickness in childhood. Invest Ophthalmol Vis Sci 2013;54:3586-93. |
| 8. | Mori T, Sugano Y, Maruko I, Sekiryu T. Subfoveal choroidal thickness and axial length in preschool children with hyperopic anisometropic amblyopia. Curr Eye Res 2015;40:954-61. |
| 9. | Moussa M, Sabry D, Soliman W. Macular choroidal thickness in normal Egyptians measured by swept source optical coherence tomography. BMC Ophthalmol 2016;16:138. |
| 10. | Jirarattanasopa P, Panon N, Hiranyachattada S, Bhurayanontachai P. The normal choroidal thickness in southern Thailand. Clin Ophthalmol 2014;8:2209-13. |
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