Mapping Regional Choroidal Thickness Changes During Myopia Control in Children: A 24-Month Secondary Analysis of the ASPECT Randomized Trial

Background/Objectives: Choroidal thickness (ChT) changes have been proposed as biomarkers of myopia-control response, but their regional pattern and relationship with axial elongation remain uncertain. We evaluated regional choroidal responses to adding. Defocus Incorporated Multiple Segments (DIMS) spectacles to 0.025% atropine, and asessed biomarker potential of regional and baseline ChT.

Methods

This secondary analysis included ASPECT participants with enhanced-depth imaging OCT scans. In ASPECT, 111 myopic children aged 4–16 years were randomized to nightly 0.025% atropine plus DIMS or single-vision spectacles. ChT was measured subfoveally and 1000 µm nasally and temporally at baseline and 6, 12, 18, and 24 months using a validated automated segmentation pipeline. Linear mixed-effects models assessed longitudinal and between-group differences, associations with axial elongation, and effect modification by baseline ChT.