Comment on the Article: Choroidal Thickness in Pediatric Populations

We read with great interest the article entitled “Choroidal thickness profile in normal Iranian eyes with different refractive status by spectral‑domain optical coherence tomography” by Heirani et al.1 and would like to congratulate the authors on their informative study. This is the largest study so far reporting on choroidal thickness (ChT) profile of an Iranian population sample and the first one exhibiting outcomes on Iranian children. It has been well‑established in the literature that ChT progressively decreases during adult life. With regard to childhood populations, however, conflicting evidence exists about the impact of age on ChT, as both physiologic ocular growth and potential development of refractive errors should be accounted for.2 In particular, a thinner choroid in 4‑ to 6‑year‑olds compared to older pediatric groups has been reported,3 while data from both a longitudinal and another cross‑sectional population‑based study also showed increased ChT with age in children.4,5 On the contrary, Heirani et al. describe a decreasing pattern of ChT with age, while other studies have found no significant association. In their Figures 3 and 6, the data are stratified into six age groups, each covering 10 years; however, the exact numerical values of ChT of each group are not reported. Presentation of these data would be of interest, especially in subgroups of pediatric subjects within a narrower age range and categorized according to their refractive condition, so as to assess whether findings of previous studies are confirmed or not.