Prospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2023; 11(23): 5479-5493
Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5479
Evaluation of childhood developing via optical coherence tomography-angiography in Qamdo, Tibet, China: A prospective cross-sectional, school-based study
Ke-Xin Sun, Yong-Guo Xiang, Tong Zhang, Sheng-Lan Yi, Jiu-Yi Xia, Xin Yang, Shi-Jie Zheng, Yan Ji, Wen-Juan Wan, Ke Hu
Ke-Xin Sun, Yong-Guo Xiang, Sheng-Lan Yi, Jiu-Yi Xia, Xin Yang, Shi-Jie Zheng, Yan Ji, Wen-Juan Wan, Ke Hu, Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Tong Zhang, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400016, China
Author contributions: Sun KX and Hu K involved in design and conduct of the study, and preparation of the manuscript; Sun KX, Xiang YG, Zhang T, Yi SL, Xia JY, Yang X, Zheng SJ, Wan WJ, Ji Y, and Shi K participated in the collection of the data; Hu K and Wan WJ participated in the management of this program; all authors review and approval of the final manuscript.
Supported by the National Natural Science Foundation of China, No. 81870650, No. 81570832, and No. 81300794; and Science and Technology Program Chongqing, China, No. 2018GDRC008.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Chongqing Medical University Institutional Review Board (Approval No. 2020-376).
Clinical trial registration statement: This study is registered at https://www.chictr.org.cn/showproj.html?proj=37553. The registration identification number is No. ChiCTR2000039065.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None of the authors have any financial/conflicting interests to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Ke Hu (42222@qq.com).
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke Hu, MD, Adjunct Associate Professor, Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Medical College Road, Yuzhong District, Chongqing 400016, China. 42222@qq.com
Received: April 14, 2023
Peer-review started: April 14, 2023
First decision: July 3, 2023
Revised: July 11, 2023
Accepted: July 27, 2023
Article in press: July 27, 2023
Published online: August 16, 2023
Processing time: 123 Days and 14.7 Hours
Abstract
BACKGROUND

Optical coherence tomography angiography (OCTA) is a new and reliable machine used to evaluate retinal structure and macular perfusion in children. The use of OCTA under bad condition such as high altitude, low atmospheric oxygen, and low humidity, in children is rarely.

AIM

To quantify the macular micro-vasculature in healthy children of various ages using OCTA in Qamdo.

METHODS

Design: Prospective cross-sectional, school-based study. Three hundred and forty-seven normal students from 9 schools in 4 different areas in Qamdo were included. OCTA was performed on a 3 mm × 3 mm area centered on the macular region and macular cube 512 × 128 showed details in macular. Early treatment of diabetic retinopathy study Vessel Flow Density (VD) of the macular central vascular plexus density (CVD), inner vascular plexus density (IVD), full vascular plexus density (FVD), and the size of the foveal avascular zone (FAZ) were measured. All these results corrected by t/s = 3.382 × 0.01306 × (axial length-1.82). The differences were compared among various ages, sexes and living environments.

RESULTS

The mean FAZ area in all eyes was 0.27 mm2 ± 0.12 mm2. The mean foveal thickness (MFT) in the macular cube was 227.64 μm ± 23.51 μm. Compared with girls, boys had a lager FAZ (P = 0.0029). Among the different age groups, MFT (P < 0.001) and FVD (P < 0.0001), IVD (P < 0.0001), and CVD (P = 0.0050) increased with age. FAZ areas were not correlated with age (P = 0.8853) or others (MFT, area).

CONCLUSION

OCTA can use to evaluate macular perfusion in children. Our data bridge the gap between structural OCT and perfusion density in children in high altitude. Even though these were not a longitudinal study, it may provide us with hints about retina development during puberty and clinical implications of OCTA in children.

Keywords: Optical coherence tomography-angiography; Qamdo; Foveal avascular zone area; Vessel flow density; Teenager

Core Tip: Optical coherence tomography-angiography (OCTA) is practical as well as stable available in clinical ophthalmology. Our findings might conduce to diagnose and follow-up of children’s macular diseases. We obtain data from 5 to 18 years old children by OCTA images to describe the baseline of children retina growth and microcirculation in Qamdo, averages altitude above 3000 m. We now know the mean foveal thickness (MFT) was thinner in girls than in boys, and age effect in MFT (the macular cube), full vascular plexus density, inner vascular plexus density (linear increased). High altitude might cause difference in MFT but we don’t have enough data. Further studies will explain mechanisms and clinical significance of these changes.