Fundus vascular arcades angle reflects choroidal thickness in highly myopic children and adolescents

To identify the role of fundus vascular arcades angle (VAA) in reflecting choroidal thickness (ChT) of highly myopic children and adolescents. Participants aged 5 to 18 yrs with high myopia (spherical equivalent, SE ≤ -5.0 D) were enrolled and followed up for one year from the Shanghai Child and Adolescent Large-scale Eye Study. The VAA in the range of one papillary diameter (PD) as well as 2PD away from the central point of optic disc was recognized and measured by artificial intelligence from fundus photographs. Finally, 277 highly myopic participants were included in the analysis. The mean VAA (1PD) was 128.38 ± 9.56°, and the mean VAA (2PD) was 110.25 ± 11.97°. For those with larger VAA, the choroidal thickness around macula (mChT) or papillary (pChT) was thicker (P for trend < 0.05). After adjusting for age and gender, thinner ChT was independently associated with smaller VAA (P < 0.001). For those with more decrease of VAA, the thinning of ChT was more remarkable (P < 0.05). In the regression analysis, more change of pChT was independently associated with more change of VAA (P < 0.01). After adjusting for other related parameters, 1°change of VAA (1PD) or VAA (2PD) accounted for 0.855 mm or 0.719 mm change of pChT. Fundus VAA was closely associated with choroidal thickness in highly myopic paediatric population. It could serve as an alternative indicator of choroid thickness in the fundus screening for evaluating the risk of pathological changes of high myopia.