A prediction model and method for hypertrophic choroidal disease

Abstract

The present invention relates to the field of biomedicine, and more specifically, to a prediction model and method for hypertrophic choroidal disease. The prediction model is constructed by the following steps: S1) Data acquisition: selecting eyes with hypertrophic choroidal disease, eyes with normal hypertrophic choroids, and eyes with normal non-hypertrophic choroids as data collection objects, and collecting the choroidal thickness in the macular region, the thickness of the choroidal medium vascular layer, and the thickness of the choroidal large vascular layer; S2) Data processing: calculating the ratio of the Sattler layer thickness to the Haller layer thickness to obtain the S / H ratio; comparing and analyzing the choroidal thickness and S / H ratio across age groups and groups, and establishing a multivariate regression model; S3) Data output: drawing a receiver operating characteristic (ROC) curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio. This objectively reflects the comparison with healthy eyes in the normal population and those with hypertrophic choroidal disease.

Description

Technical Field

[0001] The present invention relates to the field of biomedicine, and in particular to a prediction model and method for hypertrophic choroidal disease. Background Art

[0002] (1) Introduction to basic academic concepts: Physiological structure of the choroid and definition of choroidal thickness: The wall of the eyeball is composed of three layers: outer, middle, and inner. The outer layer includes the cornea and sclera, the middle layer is the uveal tract, which includes the iris, ciliary body, and choroid, and the inner layer is the retina. The choroid is the rearmost part of the uveal tract, located between the retina and the sclera, and provides a rich blood supply to the outer layer of the retina. From the inside to the outside, it is divided into Bruch's membrane, choroidal capillary layer, middle vascular layer (Sattler layer), large vascular layer (Haller layer), and suprachoroidal space. The retinal pigment epithelium (RPE) is the outermost structure of the retina, and its base is closely connected to the Bruch's membrane of the choroid. Choroidal thickness refers to the distance between the high-reflection area of ​​Bruch's membrane under the retinal pigment epithelium and the outer boundary of the choroid and sclera when using coherent optical tomography. Because the choroid is mainly composed of blood vessels, under normal circumstances, its thickness will show physiological changes with the degree of vascular filling and the influence of other factors. Furthermore, because the suprachoroidal space is part of the ocular lymphatic system, its thickness can rapidly increase under stressful conditions and, under long-term pathological conditions, can develop a hyperpermeable state, causing a slow or acute increase in choroidal thickness. Therefore, choroidal thickness can intuitively demonstrate choroidal morphological changes and serve as an important imaging indicator for the diagnosis, evaluation of intervention effects, and follow-up monitoring of retinal and choroidal diseases. Furthermore, as the primary nutrient source for photoreceptor cells, alterations in choroidal structure and function also play a significant role in the pathogenesis of various retinal and choroidal diseases.

[0003] Pachychoroid spectrum disorders (PCD) are a group of diseases characterized by chronic choroidal thickening and choroidal vascular decompensation. This new concept was first introduced to China in 2015 by the teams of Professors Zhang Xinyuan and Timothy Lai. Currently, there are no reports internationally on diagnostic criteria for PCD and its predictive risk factors, and there are no precise quantitative standards for choroidal thickening.

[0004] (2) Non-invasive fundus imaging technology provides new ideas for the prediction and diagnosis of hypertrophic choroidal disease: Invasive imaging examinations (such as choroidography) are currently the main method for diagnosing hypertrophic choroidal disease, but they have many defects such as high trauma and inconvenient operation. The use of non-invasive OCT indicators has brought great convenience to the clinical prediction and diagnosis of hypertrophic choroidal disease. The team's research found that hypertrophic choroid also exists in the normal population, and the imaging differentiation between this population and hypertrophic choroidal disease will provide new ideas for the prediction and diagnosis of the disease. However, there are currently few observations on the choroidal structure, especially the imaging characteristics, of normal people, especially those with hypertrophic choroid. There is no research on the imaging differences between normal people with hypertrophic choroid and those with hypertrophic choroidal disease, and there is no clear OCT indicator to predict hypertrophic choroidal disease.

[0005] (3) Existing diagnostic thresholds for thick choroid: There is currently no unified gold standard in academia.

[0006] The diagnosis of hypertrophic choroidal disease requires two key elements: 1. Increased choroidal thickness and 2. Choroidal vascular dysfunction. Choroidal thickening is a crucial prerequisite for the diagnosis of hypertrophic choroidal disease. Currently, there is a lack of a standardized definition of the diagnostic value for hypertrophic choroidal disease, and no objective and reliable diagnostic value exists to distinguish choroidal thickening from normal individuals. Manual measurement and automated OCT measurement are the two primary methods for measuring choroidal thickness.

[0007] Currently, most studies use the mean value of the choroid in the population plus or minus the upper limit of the standard deviation as the diagnostic standard for thick choroid, that is, the mean ± standard deviation method: patients with hypertrophic choroidal spectrum disorder (PCD) are included, and the sample choroid mean and standard deviation are calculated. The population with a value < mean - standard deviation is defined as a thin choroid population, the population with a value between mean - standard deviation and mean + standard deviation is defined as a medium choroid population, and the population with a value > mean + standard deviation is defined as a thick choroid population.

[0008] A few studies, such as the bimodal model method, use the choroidal thickness interval as the X-axis and the frequency of the population as the Y-axis to produce a bimodal plot, using the mean of the trough as the dividing line to distinguish between hypertrophic and non-hypertrophic disease. Sara Touhami et al. define choroidal thickening as a choroidal thickness >395 μm, while Richard F. Spaide et al. define disease-free thick choroid as a subfoveal choroidal thickness ≥ the age-adjusted 95th percentile of the choroidal thickness of healthy eyes without a history of disease.

[0009] However, these methods fail to comprehensively consider the impact of age, gender, refraction, axial length, and other physiological factors on choroidal thickness. In particular, numerous studies have found that choroidal thickness gradually thins with age, requiring correction for all of these imaging factors. Therefore, diagnosing choroidal thickness solely based on measurement is subject to significant bias and objective limitations, making it unsuitable as an objective criterion for diagnosing pachychoroidiasis.

[0010] (4) Distribution characteristics of hypertrophic choroid in normal people and risk factors for developing hypertrophic choroidal disease: After taking into account the influence of multiple factors such as age, refractive power, and axial length, the team found that people with thick choroid also exist in the normal population (for specific methods, please refer to the invention patent content below). According to the reliable and objective diagnostic threshold for hypertrophic choroid proposed by the team, in normal eyes, thick choroid accounts for 14%-41% in different age groups (our research data, not yet published). However, existing studies have rarely observed the choroid in normal people, and even less on the choroid in normal people with choroidal hypertrophy. In particular, whether thick choroid is associated with the development of hypertrophic choroidal disease and what are the predictive indicators are clinical questions that require close attention in clinical work and have not yet been answered for the following reasons: 1) Hypertrophic choroidal disease is a new concept proposed in recent years. It was first proposed and reported by our team in China in 2016. Research and understanding in this area are limited. 2) Our team is the most capable team conducting a series of studies in this area and is also the most influential research team internationally. Therefore, research results from other teams are relatively few, and this field is still "virgin territory." 3) Other researchers rarely focus on comparing the anatomical structure of the choroid in normal people with the pathological changes of related diseases. 4) It is still unknown whether thick choroid will progress to hypertrophic choroidal disease. 5) The current academic community lacks a standard definition of the "diagnostic value of hypertrophic choroidal disease" and there is no objective and reliable diagnostic value to distinguish thickened choroid in normal people.

[0011] Therefore, whether these eyes with hypertrophic choroid are risk factors for developing hypertrophic choroidal disease has not been studied, nor have long-term follow-up reports been conducted. All of the above-mentioned issues are currently blank in the international and domestic research and clinical fields.

[0012] (5) Limitations of existing imaging predictive indicators for hypertrophic choroidal disease: The current gold standard for diagnosing hypertrophic choroidal disease is still invasive ICGA and other examinations. There is currently no clear OCT indicator to predict hypertrophic choroidal disease. In the imaging observation of hypertrophic choroidal disease, the thickness of the capillary layer and Sattler layer is considered to be atrophic and thin, while the blood vessels in the Haller layer are dilated and thickened. In previous studies on the OCT imaging characteristics of hypertrophic choroidal disease, researchers proposed the ratio of capillary layer thickness or Sattler layer thickness to choroidal thickness (CC / SFCT ratio, S / SFCT ratio) as a predictive indicator for predicting the occurrence and development of the disease. This study used EDI-OCT and Spectralis OCT scanners to automatically measure the choriocapillaris layer thickness, Sattler layer thickness, and macular choroidal thickness in patients with PCV disease. Combining the bimodal pattern method and the mean ± standard deviation method, PCV was subjectively divided into <200μm and >200μm. Pairwise comparisons between hypertrophic and non-hypertrophic groups revealed a significant decrease in the ratio of capillary layer thickness, or Sattler's layer thickness, to choroidal thickness (CC / SFCT ratio, S / SFCT ratio) in PCV patients. However, this study had significant limitations in its results and design. First, the OCT instrument used to measure choroidal thickness was an older model. Furthermore, the study used cutoff values ​​with low sensitivity and specificity for stratification, and failed to consider the important role of medium and large choroidal vascular layers in the development and progression of the disease. The study also focused on a single hypertrophic choroidal disease (e.g., CSC or PCV) and did not include a control group of healthy controls with hypertrophic choroids. Furthermore, it did not consider the multiple factors that influence choroidal thickness. Therefore, this ratio cannot objectively represent changes in the medium and large choroidal vascular layers during disease development and progression. It does not comprehensively consider multiple pathological factors, such as choroidal vasodilation, physical compression, and neovascularization, and cannot serve as a comprehensive assessment indicator for disease prediction.

[0013] Therefore, the focus of the present invention is to find a scientific and objective method for diagnosing hypertrophic choroiditis (determining the cutoff value) and imaging prediction indicators for hypertrophic choroiditis. Summary of the Invention

[0014] The purpose of the present invention is to use the most advanced SS-OCT technology (the scanning depth can reach as deep as the sclera, allowing detailed observation of the choroid), taking into account multiple factors affecting the choroid, such as age, gender, and refractive power, combined with comprehensive changes in the Sattler layer and Haller layer, to predict hypertrophic choroidal disease using the S / H ratio.

[0015] The present invention provides a computer device, comprising a memory, a processor, and a computer program stored in the memory, wherein the processor executes the computer program to implement the following steps:

[0016] S1) Data collection: Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes with non-hypertrophic choroidal disease were selected as data collection objects, and the choroidal thickness, Sattler layer thickness, and Haller layer thickness of the macular area of ​​the data objects were collected respectively;

[0017] S2) Data processing: The ratio of Sattler's layer thickness to Haller's layer thickness was calculated to obtain the S / H ratio. Choroidal thickness and S / H ratio were compared and analyzed across age groups and groups. Age, gender, and refraction were corrected and a multivariate regression model was established.

[0018] S3) Data output: Draw an ROC curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio.

[0019] Furthermore, the hypertrophic choroidal disease in step S1) includes: polypoidal choroidal vasculopathy, central serous chorioretinopathy, and neovascular age-related macular degeneration;

[0020] In step S1), the critical value standard for judging whether the choroid is hypertrophic or non-hypertrophic is determined by the following steps:

[0021] S11) selecting eyes with hypertrophic choroidal disease and normal eyes as data collection objects;

[0022] S12) performing age, gender, and refractive power matching based on the data from step 1);

[0023] S13) For the matched data, swept-source OCT is used to measure the choroidal thickness in the macular area;

[0024] S14) Likelihood ratio analysis was used to determine the cutoff value for hypertrophic choroid.

[0025] Furthermore, in step 3), the judgment criteria of the prediction model of hypertrophic choroidal disease based on the S / H ratio are:

[0026] Eyes with an S / H ratio of <0.27 had a higher risk of CSC; eyes with an S / H ratio of <0.30 had a higher risk of PCV; and eyes with an S / H ratio of <0.29 had a higher risk of nAMD.

[0027] The present invention further provides a computer-readable storage medium having a computer program / instruction stored thereon. When the computer program / instruction is executed by a processor, the above steps are implemented, specifically:

[0028] S1) Data collection: Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes with non-hypertrophic choroidal disease were selected as data collection objects, and the choroidal thickness, Sattler layer thickness, and Haller layer thickness of the macular area of ​​the data objects were collected respectively;

[0029] S2) Data processing: The ratio of Sattler's layer thickness to Haller's layer thickness was calculated to obtain the S / H ratio. Choroidal thickness and S / H ratio were compared and analyzed across age groups and groups. Age, gender, and refraction were corrected and a multivariate regression model was established.

[0030] S3) Data output: Draw an ROC curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio.

[0031] Furthermore, the hypertrophic choroidal disease in step S1) includes: polypoidal choroidal vasculopathy, central serous chorioretinopathy, and neovascular age-related macular degeneration.

[0032] Furthermore, in step S1), the critical value standard for judging whether the choroid is hypertrophic or non-hypertrophic is determined by the following steps:

[0033] S11) selecting eyes with hypertrophic choroidal disease and normal eyes as data collection objects;

[0034] S12) performing age, gender, and refractive power matching based on the data from step 1);

[0035] S13) For the matched data, swept-source OCT is used to measure the choroidal thickness in the macular area;

[0036] S14) Likelihood ratio analysis was used to determine the cutoff value for hypertrophic choroid.

[0037] Furthermore, in step 3), the judgment criteria of the prediction model of hypertrophic choroidal disease based on the S / H ratio are:

[0038] Eyes with an S / H ratio of <0.27 had a higher risk of CSC; eyes with an S / H ratio of <0.30 had a higher risk of PCV; and eyes with an S / H ratio of <0.29 had a higher risk of nAMD.

[0039] Furthermore, the computer-readable storage medium refers to a carrier for storing data, which may be a floppy disk, an optical disk, a DVD, a hard disk, a flash memory, a USB flash drive, a CF card, an SD card, an MMC card, an SM card, a memory stick (Memory Stick) or an xD card.

[0040] The present invention provides a computer program product, comprising a computer program, which, when executed by a processor, implements the above steps:

[0041] S1) Data collection: Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes with non-hypertrophic choroidal disease were selected as data collection objects, and the choroidal thickness, Sattler layer thickness, and Haller layer thickness of the macular area of ​​the data objects were collected respectively;

[0042] S2) Data processing: The ratio of Sattler's layer thickness to Haller's layer thickness was calculated to obtain the S / H ratio. Choroidal thickness and S / H ratio were compared and analyzed across age groups and groups. Age, gender, and refraction were corrected and a multivariate regression model was established.

[0043] S3) Data output: Draw an ROC curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio.

[0044] The present invention provides a method for constructing a hypertrophic choroidal critical value model, comprising the following steps:

[0045] 1) Select eyes with hypertrophic choroidal disease and normal eyes as data collection objects;

[0046] 2) performing age, gender, and refractive index matching based on the data from step 1);

[0047] 3) For the matched data, swept-source OCT was used to measure the choroidal thickness in the macular area;

[0048] 4) Likelihood ratio analysis was used to determine the critical value of hypertrophic choroid.

[0049] The present invention provides a method for constructing a prediction model for hypertrophic choroidal disease, comprising the following steps:

[0050] 1) Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes without hypertrophic choroidal disease were selected as data collection objects;

[0051] 2) Collect the choroidal thickness, Sattler layer thickness, and Haller layer thickness of the macular area of ​​the data object respectively, and calculate the ratio of the Sattler layer thickness to the Haller layer thickness to obtain the S / H ratio;

[0052] 3) Compare and analyze choroidal thickness and S / H ratio among different age groups and groups, and establish a multivariate regression model after correcting for age, gender, and refraction;

[0053] 4) Draw the ROC curve and obtain the prediction model of hypertrophic choroidal disease based on the S / H ratio.

[0054] 9. The construction method according to claim 1, characterized in that the hypertrophic choroidal disease includes: polypoidal choroidal vasculopathy, central serous chorioretinopathy, and neovascular age-related macular degeneration;

[0055] In step S1), the hypertrophic choroidal critical value obtained in claim 7 is used as the critical value standard for judging whether the choroid is hypertrophic or non-hypertrophic.

[0056] Furthermore, in step 3), the prediction model for hypertrophic choroidal disease based on the S / H ratio is:

[0057] Eyes with an S / H ratio of <0.27 had a higher risk of CSC; eyes with an S / H ratio of <0.30 had a higher risk of PCV; and eyes with an S / H ratio of <0.29 had a higher risk of nAMD.

[0058] This study uses state-of-the-art SS-OCT technology to predict hypertrophic choroidal disease using the S / H ratio, taking into account multiple factors affecting the choroid, such as age, gender, and diopter. This method combines changes in the Sattler and Haller layers to more objectively reflect the pathological changes in the large vascular layer of the choroid in eyes with hypertrophic choroidal disease, compared to healthy eyes and those with hypertrophic choroidal disease. BRIEF DESCRIPTION OF THE DRAWINGS

[0059] Figure 1 Flowchart for determining diagnostic cutoffs for hypertrophic choroidopathy; PCD: hypertrophic choroidal spectrum disorder; PCV: polypoidal choroidal vasculopathy; CSC: central serous chorioretinopathy; nAMD: neovascular age-related macular degeneration.

[0060] Figure 2 Correlation analysis between SFCT and age in normal subjects (Pearson linear correlation analysis, n=382)A: SFCT was negatively correlated with age (r=-0.34, P<0.001)B: SFCT was negatively correlated with age in males (r=-0.43, P<0.001)C: SFCT was negatively correlated with age in females (r=-0.38, P<0.001)SFCT: subfoveal choroidal thickness.

[0061] Figure 3 The correlation between SFCT and refraction in normal subjects (Spearman rank correlation analysis, n=382) SFCT was weakly positively correlated with refraction (rs=0.19, P<0.001) SFCT: subfoveal choroidal thickness.

[0062] Figure 4The figure shows the distribution of hypertrophic choroid in normal people of different age groups.

[0063] Figure 5 Distribution of hypertrophic choroid in the normal population.

[0064] Figure 6 Comparison of S / H values ​​across different age groups in the normal population. (A) Differences in S / H values ​​among healthy individuals with hypertrophic choroids at age groups 20-39, 40-59, and ≥60 years; (B) Differences in S / H values ​​among healthy individuals with non-hypertrophic choroids at age groups 20-39, 40-59, and ≥60 years; (C) Differences in S / H values ​​among all healthy individuals at age groups 20-39, 40-59, and ≥60 years. S / H value: ratio of the thickness of the Satter layer to the Haller layer of the choroid.

[0065] Figure 7 To compare the differences in subfoveal choroidal thickness (SFCT) and S / H ratio among the three groups.

[0066] Figure 8 To compare the differences in S / H values ​​between three groups of people at different age stages: normal subjects with hypertrophic choroid, normal subjects with non-hypertrophic choroid and subjects with hypertrophic choroidal disease.

[0067] Figure 9 After adjusting for age, gender, and refraction, the multivariate regression model showed that a decreased S / H value was a risk factor for hypertrophic choroidal disease.

[0068] Figure 10 Receiver operating characteristic curve (ROC curve) prediction of diagnostic cutoff values ​​for PCV, nAMD, and CSC

[0069] (A) ROC curve of PCV; (B) ROC curve of nAMD; (C) ROC curve of CSC; PCV: polypoidal choroidal vasculopathy; nAMD: neovascular age-related macular degeneration; CSC: central serous chorioretinopathy; AUC: area under the ROC curve and the coordinate axes.

[0070] Figure 11 Flowchart for identifying predictors of hypertrophic choroidal disease; PCV: polypoidal choroidal vasculopathy; CSC: central serous chorioretinopathy; nAMD: neovascular age-related macular degeneration; S / H: ratio of Sattler's layer to Haller's layer thickness; OCT: optical coherence tomography. DETAILED DESCRIPTION

[0071] The present invention will be further described in detail below in conjunction with specific embodiments. The examples provided are only for illustrating the present invention and are not intended to limit the scope of the present invention. The examples provided below can serve as a guide for further improvements by those skilled in the art and are not intended to limit the present invention in any way.

[0072] Unless otherwise specified, the experimental methods in the following examples are conventional methods and were performed according to the techniques or conditions described in the literature in the field or according to the product instructions. The materials and reagents used in the following examples, unless otherwise specified, were all commercially available.

[0073] This invention adheres to the Declaration of Helsinki and was approved by the Ethics Committee of Beijing Tongren Hospital (approval number: TRECKY2016-054). All subjects understood the purpose and methods of this study and voluntarily signed an informed consent before entering the study cohort.

[0074] In the following embodiments, the diagnosis of hypertrophic choroidal disease requires an ophthalmic clinical diagnosis. The ophthalmic clinical examination confirms that the patient has polyposis choroiditis (PCV), age-related maculopathy (nAMD), or central serous chorioretinopathy (CSC). The PCV diagnostic criteria are based on the expert consensus of the PCV Working Group of the Asia-Pacific Society of Ophthalmic Imaging in 2020, EVEREST study II, and modified EVEREST criteria; the diagnosis of CSC is based on typical clinical manifestations, fluorescein fundus angiography and choroidal angiography, and typical imaging features of OCT; the diagnosis of nAMD is based on the "Expert Consensus on Neovascular Age-Related Macular Degeneration" published by Spaide et al. in 2019.

[0075] Example 1 Determination of the diagnostic cutoff value for hypertrophic choroid

[0076] 1. Data Analysis of Database

[0077] 1. A total of 504 individuals (760 eyes) were included in the database. Gender and age information was recorded for each individual. The relevant data were measured according to the following method, and the SFCT diagnostic cutoff value for PCD was estimated based on the likelihood ratio. The data are shown in Table 1:

[0078]

[0079] Note: (a: independent sample t test; b: χ 2 test; c: Mann-Whitney U test) SFCT: subfoveal choroidal thickness; PCD: hypertrophic choroidal spectrum disease

[0080] The specific operation process is as follows Figure 1 As shown, the following steps are included:

[0081] 1) Routine eye examination:

[0082] All subjects underwent a comprehensive ophthalmological examination. The naked eye visual acuity and best-corrected visual acuity of the examined eye were tested using the Snellen visual acuity chart. The intraocular pressure of the examined eye was measured using a fully automatic non-contact tonometer (TX20, Santen Pharmaceutical Co., Ltd., Japan). The anterior segment of the examined eye, including the external eye, cornea, anterior chamber, and lens, was examined using a slit lamp microscope (SL-IE, Topcon, Japan). The pupil was fully dilated with compound tropicamide eye drops (Santen Pharmaceutical Co., Ltd., Japan), and the fundus was examined with a 12500 binocular indirect ophthalmoscope (Keeler, USA). The fundus was photographed using a CR-1 non-mydriatic color fundus camera (Canon Inc., Japan).

[0083] 2) Measurement of choroidal thickness in the macular area:

[0084] All eyes were fully dilated with tropicamide compound eye drops. SS-OCT (DRIOCT-1 Atlantis scanner, Topcon, Japan) was used to examine the macula. The scan area was 9 mm × 9 mm, and 12 high-resolution B-scan images of the choroid were obtained through the fovea. Topcon Advanced Boundary Segmentation (TABS) software automatically analyzed these 12 B-scan images and generated Early Treatment Diabetic Retinopathy Study (ETDRS) rings around the fovea, with radii of 1, 3, and 6 mm. Choroidal thickness in the central area of ​​the macula was automatically measured by the instrument. Images were acquired and manually measured by two experienced physicians to correct for errors in the automatic measurement software. The ETDRS zoning system divides the scan area into the central zone (C), superior inner ring zone (S1), superior outer ring zone (S2), nasal inner ring zone (N1), nasal outer ring zone (N2), inferior inner ring zone (I1), inferior outer ring zone (I2), temporal inner ring zone (T1), and temporal outer ring zone (T2). The choroidal thickness of each ETDRS zone was measured. According to the internationally accepted method, the SFCT mean value, i.e., the measurement value of zone C, was mainly analyzed.

[0085] 3) Quantitative diagnosis of hypertrophic choroid by likelihood ratio test:

[0086] The subjects were divided into 20-year age groups (20-39, 40-59, 60-79, and ≥80 years). All subjects were then stratified by SFCT measurement intervals from the minimum to the maximum in 100-μm intervals. Positive likelihood ratios (PLRs) were calculated based on the number of eyes in the normal and disease groups at each measurement interval. The PLR ​​= (number of eyes in the disease group within the target measurement interval / total number of eyes in the disease group) / (number of eyes in the normal group within the target measurement interval / total number of eyes in the normal group). SFCT measurement intervals with a positive likelihood ratio close to 1 represented the critical SFCT value for distinguishing between the normal and disease groups. Within this range, SFCT was further stratified into intervals of 50, 25, and 10 μm to establish diagnostic criteria for hypertrophic choroiditis based on SFCT in different age groups.

[0087] 2. The correlation between age and SFCT in normal subjects and the comparison of SFCT in different genders. Figure 2 As shown in the figure: SFCT of normal subjects gradually decreases with age, and SFCT is negatively correlated with age (r=-0.34, P<0.001). SFCT of normal subjects in both males and females is negatively correlated with age (r=-0.43, P<0.001; r=-0.38, P<0.001) ( Figure 2 ).

[0088] 3. The correlation between normal refraction and SFCT, the results are as follows Figure 3 As shown in the figure, SFCT of normal eyes was weakly positively correlated with diopter. As diopter increased, SFCT gradually increased (rs=0.19, P<0.001) ( Figure 3 ).

[0089] 4. Analysis of factors influencing SFCT. The results are shown in Table 2. A multiple linear regression model was constructed with SFCT as the dependent variable and age, gender, and refraction as independent variables. The results showed that age (t = -12.01, P < 0.001; 95% CI: -3.37 to -2.42) and refraction (t = 8.19, P < 0.001; 95% CI: 10.43 to 17.02) were independent influencing factors of SFCT. After controlling for age and refraction, gender was not an independent influencing factor of SFCT (β = -11.76, 95% CI: -25.49 to 1.98, P = 0.093) (Table 2).

[0090]

[0091] 5. Diagnostic cutoffs for hypertrophic choroiditis: The likelihood ratio test results showed that the SFCT diagnostic measurement value gradually decreased with increasing age. The SFCT diagnostic likelihood ratios for different age groups are shown in Table 3.

[0092]

[0093] 6. Based on the diagnostic values ​​determined in this study, the likelihood ratio test was evaluated by receiver operating characteristic curve (ROC) and the area under the curve (AUC) of the mean ± SD, a mainstream method currently used in research. The sensitivity and specificity of the likelihood ratio test were significantly higher than those of the latter, especially in the comparisons between PCD and normal subjects, CSC and normal subjects, and PCV and normal subjects (PPCD < 0.001, PCSC < 0.001, PPCV = 0.044) (Table 4).

[0094]

[0095] 7. Comparison of the distribution of hypertrophic choroid and non-hypertrophic choroid in normal subjects of different age groups. The results are shown in Table 5. Figure 4 Results: The incidence of hypertrophic choroid in normal eyes gradually increased with age. The proportions of eyes with hypertrophic choroid in patients aged 20-39 years, 40-59 years, and 60 years or older were 14.29% (10 / 70), 24.48% (47 / 192), and 29.89% (55 / 184), respectively. Significant differences were observed between the groups (χ² = 6.170, P = 0.046; LR = 6.579, P = 0.037). The proportion of hypertrophic choroid in the 60 years or older group was significantly higher than that in the 20-39 years group (χ² = 5.982, P = 0.014; LR = 6.479, P = 0.011).

[0096]

[0097] Based on the results of the above examples, it was concluded that the pachychoroid disease spectrum (PCD) is a group of diseases characterized by chronic choroidal thickening and choroidal vascular decompensation. It is a new concept that has emerged in recent years with the tremendous advances in fundus imaging technology, particularly optical coherent tomography (OCT). Accurate measurement of choroidal thickness and the definition of diagnostic values ​​for pachychoroidal thickening are undoubtedly important for understanding the pathogenesis of PCD and for the diagnosis and prevention of related diseases. However, there is no international method for standardizing and accurately quantifying choroidal thickness parameters. Currently, methods for measuring choroidal thickness with OCT are mainly divided into manual single-point or multi-point measurement and automatic segmentation. Due to different measurement methods, various studies have different definitions of pachychoroidal thickening. To reduce measurement errors, this study adopted a more objective automatic segmentation method, using the Topcon SS-OCT built-in software to automatically segment the choroid layer according to the ETDRS standard. The ETDRS zoning system divides the macula into a central zone, inner ring, and outer ring based on radii of 1, 3, and 6 mm from the fovea, and further divides the inner and outer rings into four quadrants (superior, inferior, nasal, and temporal). Manual correction can effectively reduce errors caused by single-point measurement. This study analyzed the internationally commonly used central zone SFCT mean under this zoning method. The likelihood ratio test was used to diagnose PCD and normal eyes, adjusting for the effects of factors such as age and refraction. Furthermore, the likelihood ratio calculation incorporated both sensitivity and specificity, which enhances clinical application value.

[0098] Example 2

[0099] Study population:

[0100] 1) Total database: A prospective cohort study database of hypertrophic choroidal disease (outpatients at Beijing Tongren Eye Center from 2016 to 2022) was established: a total of 468 subjects (691 eyes), including 82 patients with PCV (97 eyes), 58 patients with nAMD (66 eyes), 51 patients with CSC (61 eyes), and 277 healthy subjects (467 eyes);

[0101] 2) Matching database: 55 patients (61 eyes) with PCV, 38 subjects (43 eyes) with nAMD, and 45 subjects (50 eyes) with CSC were extracted from the above database according to the proportion of case numbers and matched with 100 healthy subjects (120 eyes) by sex and refraction (control for sex and match for refraction);

[0102] 3) Validation database: 300 eyes were randomly selected from the total database to form the validation data set, including 157 normal subjects (179 eyes), 42 PCV patients (44 eyes), 26 nAMD patients (28 eyes), and 27 CSC patients (31 eyes).

[0103] like Figure 11 As shown, the present invention provides a method for determining the diagnostic cutoff value of S / H in various disease groups, comprising the following steps: 1) using normal subjects with choroidal hypertrophy, normal subjects without choroidal hypertrophy, and subjects with hypertrophic choroidal disease as research subjects; 2) measuring macular choroidal thickness, Sattler layer thickness, and Haller layer thickness in each subject; 3) comparing and analyzing choroidal thickness and S / H ratio across age groups and groups; 4) matching subjects with hypertrophic choroidal disease and normal subjects based on age, gender, and refractive power to establish a multivariate regression model; and 5) plotting a receiver operating characteristic (ROC) curve to determine the diagnostic cutoff value of S / H in each disease group. This method, for the first time, uses imaging analysis with hypertrophic normal subjects as a control group (capable of incorporating a large number of samples), utilizes state-of-the-art swept-source optical coherence tomography (OCT), and accurately measures the S and H layers. Taking into account the three major factors influencing choroidal thickness, the results are more objective. Using the ROC curve, a highly specific and sensitive indicator is identified, and the S / H ratio is proposed for the first time as a predictor of hypertrophic choroidal disease.

[0104] 1. Data analysis of the total database

[0105] 1. For a total of 468 people (691 eyes) in the database, the gender and age information of each person was recorded. The relevant data were measured according to the following method. Some of the data results are shown in Table 6:

[0106] 1) Routine eye examination:

[0107] All subjects underwent a comprehensive ophthalmological examination. The naked eye visual acuity and best-corrected visual acuity of the examined eye were tested using the Snellen visual acuity chart. The intraocular pressure of the examined eye was measured using a fully automatic non-contact tonometer (TX20, Santen Pharmaceutical Co., Ltd., Japan). The anterior segment of the examined eye, including the external eye, cornea, anterior chamber, and lens, was examined using a slit lamp microscope (SL-IE, Topcon, Japan). The pupil was fully dilated with compound tropicamide eye drops (Santen Pharmaceutical Co., Ltd., Japan), and the fundus was examined with a 12500 binocular indirect ophthalmoscope (Keeler, USA). The fundus was photographed using a CR-1 non-mydriatic color fundus camera (Canon Inc., Japan).

[0108] 2) Measurement of the thickness of each layer of the choroid in the macular area

[0109] All subjects underwent SS-OCT (DRIOCT1 Atlantis scanner, Topcon Co., Ltd., Tokyo, Japan). Twelve high-resolution B-segmentation ultrasound images spanning the fovea were acquired using radial mode through the macula, with a scanning area of ​​9 x 9 mm. Choroidal thickness was automatically determined in nine macular zones using TOPCON Advanced Boundary Segmentation (TABS) software. The Early Treatment Diabetic Retinopathy Study (ETDRS) zonal classification divides the macula into nine zones: a central circle with a diameter of 1 mm, four inner quarter circles with diameters ranging from 1 mm to 3 mm, and four outer quarter circles with diameters ranging from 3 mm to 6 mm. The thickness of the choriocapillaris (10.4 μm) was automatically defined by the OCT software; the boundaries of the Satter and Haller layers were determined by TABS software and then manually adjusted based on the morphological magnification of the choroidal vessels, such as the size of the vascular lumen. Two independent ophthalmologists (QW with 4 years of field experience and BQ with 6 years of field experience) performed the measurements, manually adjusted the stratification, and acquired the images. Calculate the thickness ratio of the Satter layer to the Haller layer.

[0110]

[0111] Furthermore, the subjects in the total database can be divided equally into hypertrophic choroid and non-hypertrophic choroid (according to the criteria of Table 3 in Example 1), where the normal subjects include 92 normal subjects with hypertrophic choroid (140 eyes) and 185 normal subjects with non-hypertrophic choroid (327 eyes), PCV subjects include 40 subjects with hypertrophic choroid PCV (45 eyes) and 42 subjects with non-hypertrophic choroid PCV (52 eyes), nAMD subjects include 12 subjects with hypertrophic choroid nAMD (14 eyes) and 46 subjects with non-hypertrophic choroid nAMD (52 eyes), and CSC subjects include 39 subjects with hypertrophic choroid CSC (46 eyes) and 12 subjects with non-hypertrophic choroid CSC (15 eyes).

[0112] 2. Analyze the proportion of choroidal thickening in normal population at different age groups in the total database. The results are as follows: Figure 5 As shown. Figure 5 It can be seen that the proportion of choroidal thickening in the normal population at different age groups is: 14%-41% of the normal population has choroidal thickening.

[0113] 3. Analyze the differences in S / H values ​​between hypertrophic and non-hypertrophic subgroups of the normal population in the total database. The results are as follows Figure 6 As shown, Figure 6(A) Differences in S / H values ​​of normal subjects with hypertrophic choroid at three age groups: 20-39 years, 40-59 years, and ≥60 years; (B) Differences in S / H values ​​of normal subjects with non-hypertrophic choroid at three age groups: 20-39 years, 40-59 years, and ≥60 years; (C) Differences in S / H values ​​of all normal subjects at three age groups: 20-39 years, 40-59 years, and ≥60 years; S / H value: ratio of the thickness of the Satter layer to the Haller layer of the choroid. Figure 6 It can be seen that there was no statistical difference between the normal group with hypertrophic choroid and the total normal group in the age range of 20-39, 40-59, and ≥60 years (p>0.05); there was a statistical difference between the normal group with non-hypertrophic choroid in the age range of 40-59 and ≥60 years (p<0.05).

[0114] 2. Data Analysis of Matching Database

[0115] 1. 55 PCV patients (61 eyes), 38 nAMD subjects (43 eyes), and 45 CSC subjects (50 eyes) from the matching database were compared with 100 healthy subjects (120 eyes). The gender and age information of each individual was recorded and the relevant data were measured according to the following method. Some of the data results are shown in Table 7:

[0116]

[0117] Based on the data of each tester in the matching database obtained in the above steps, the differences in subfoveal choroidal thickness (SFCT) and S / H ratio between the groups were compared. The results are as follows: Figure 7 As shown, from Figure 7 As can be seen from the results, there was no statistical difference between hypertrophic normal subjects and hypertrophic PCV and hypertrophic nAMD (p>0.05). The S / H value was statistically different between the hypertrophic normal subjects and the hypertrophic choroidal disease group (p<0.05).

[0118] 3. Based on the test data of the total database, the differences in S / H values ​​between hypertrophic and non-hypertrophic normal people in various age groups were compared. The results are as follows Figure 8 As shown in A; Based on the test data of the matching database, the differences in S / H values ​​between the hypertrophic and non-hypertrophic normal population and the hypertrophic choroidal disease population in each age group were compared. The results are shown in Figure 4As shown in B and C, (A) the difference in S / H value between normal subjects with hypertrophic choroid and normal subjects with non-hypertrophic choroid at the age of 20-39 years, 40-59 years and ≥60 years; (B) the difference in S / H value between normal subjects with hypertrophic choroid and subjects with hypertrophic choroidal disease at the age of 20-39 years, 40-59 years and ≥60 years; (C) the difference in S / H value between normal subjects with non-hypertrophic choroid and normal subjects with hypertrophic choroid at the age of 20-39 years, 40-59 years and ≥60 years; S / H value: the ratio of the thickness of the Satter layer of the choroid to the Haller layer of the choroid. Figure 8 It can be seen that the differences in S / H values ​​between the hypertrophic and non-hypertrophic subgroups of normal subjects and the hypertrophic choroidal disease (PCD) group in various age groups: there was no statistical difference between the hypertrophic normal subjects and the non-hypertrophic normal subjects groups (p>0.05), while there were statistical differences between the total normal subject group and the hypertrophic normal subject group and the hypertrophic choroidal disease group in the age groups of 40-59 years and ≥60 years (p>0.05).

[0119] 2. Model establishment (please carefully confirm whether the statement in this part is correct)

[0120] 1. Establishment of multiple regression model

[0121] Multivariate regression analysis was performed to adjust for the effects of age, sex, and refractive error. A matched database was generated, with a hypertrophic normal control group and a normal control group serving as reference groups. The impact of S / H values ​​on PCV, nAMD, and CSC was assessed. If normal controls were used as the reference analysis group, an odds ratio (OR) > 1 indicated that the independent variable was an independent risk factor for the dependent variable (disease), while an OR < 1 indicated that the independent variable was a protective factor.

[0122] SPSS statistical software (SPSS, Inc. 22.0, Chicago, IL, USA) was used to correct for the effects of age, gender, and refractive power. It was found that a decrease in the S / H value was a risk factor for hypertrophic choroidal disease (i.e., the S / H value was a protective factor for hypertrophic choroidal disease). The ROC curve was drawn to find the cut-off value of the S / H value, which had high sensitivity and specificity.

[0123] Results of the multivariate regression model: After adjusting for age, sex, and refractive error, the regression model showed that the S / H ratio was a protective factor for nAMD (OR 0.43, 95% CI 0.30-0.62, p < 0.001), PCV (OR 0.53, 95% CI 0.40-0.71, p < 0.001), and CSC (OR 0.34, 95% CI 0.22-0.52, p < 0.001) compared with normal healthy subjects. Compared with normal subjects with hypertrophic disease, the S / H ratio was also a protective factor for nAMD (OR = 0.41, 95% CI 0.26-0.63, p < 0.001), PCV (OR 0.52, 95% CI 0.36-0.75, p < 0.001) and CSC (OR = 0.36, 95% CI 0.23-0.57, p < 0.001).

[0124] The results are as follows Figure 9 As shown, Figure 9 After adjusting for age, sex, and refraction in the multivariate regression model, a decreased S / H ratio was found to be a risk factor for hypertrophic choroidal disease. Using normal subjects as a reference, a decreased S / H ratio was a risk factor for PCV (A), nAMD (B), and CSC (C); using normal subjects with hypertrophic choroid as a reference, a decreased S / H ratio was a risk factor for PCV (D), nAMD (E), and CSC (F). PCV: polypoidal choroidal vasculopathy; nAMD: neovascular age-related macular degeneration; CSC: central serous chorioretinopathy; S / H ratio: ratio of the thickness of the Satter layer to the Haller layer of the choroid.

[0125] 2. Drawing of ROC curve and determination of cut-off value

[0126] Receiver operating characteristic (ROC) curves were used to determine the cutoff values ​​of the S / H ratio for diagnosing different phenotypes of hypertrophic choroidal disease, including CSC, PCV, and nAMD. Highly sensitive and specific indices were selected as cutoff values ​​on the ROC curves. The S / H ratio cutoff value for CSC was 0.27 (AUC: 0.79, sensitivity = 0.77, specificity = 0.73); the S / H ratio cutoff value for PCV was 0.30 (AUC: 0.72, sensitivity = 0.71, specificity = 0.64); and the S / H ratio cutoff value for nAMD was 0.29 (AUC: 0.76, sensitivity = 0.72, specificity = 0.69).

[0127] ROC curve results: eyes with S / H < 0.27 (AUC: 0.79, sensitivity = 0.77, specificity = 0.73) had a higher risk of CSC, eyes with S / H < 0.30 had a higher risk of PCV (AUC: 0.72, sensitivity = 0.71, specificity = 0.64), and eyes with S / H < 0.29 had a higher risk of nAMD (AUC: 0.76, sensitivity = 0.72, specificity = 0.69).

[0128] like Figure 10 As shown, Figure 10 Receiver operating characteristic (ROC) curves were used to predict the diagnostic cutoff values ​​for PCV, nAMD, and CSC. (A) ROC curve for PCV; (B) ROC curve for nAMD; (C) ROC curve for CSC. PCV: polypoidal choroidal vasculopathy; nAMD: neovascular age-related macular degeneration; CSC: central serous chorioretinopathy; AUC: area under the ROC curve and the coordinate axes.

[0129] Based on the above results, it can be concluded that: people with an S / H ratio <0.27 have a higher risk of CSC than people with an S / H ratio >0.27; people with an S / H ratio <0.30 have a higher risk of PCV than people with an S / H ratio >0.30; people with an S / H ratio <0.29 have a higher risk of nAMD than people with an S / H ratio >0.29.

[0130] 3. Model Validation

[0131] A validation dataset of 300 eyes was randomly selected from the total database, including 157 normal subjects (179 eyes), 42 patients with PCV (44 eyes), 26 patients with nAMD (28 eyes), and 27 patients with CSC (31 eyes). The gender and age information of each patient were recorded. The relevant data were measured according to the following method (baseline data are shown in Table 8): the sensitivity and specificity of PCV were 70.45% and 66.50%, the sensitivity and specificity of nAMD were 67.86% and 69.54%, and the sensitivity and specificity of CSC were 77.42% and 74.11%.

[0132]

[0133] Based on the results of the above embodiments, it can be seen that invasive imaging examinations are currently the main method for diagnosing hypertrophic choroidal disease, but they have many defects such as high trauma and inconvenient operation. The use of non-invasive OCT indicators brings great convenience to the clinical prediction and diagnosis of hypertrophic choroidal disease. Since choroidal thickening exists in the normal population, the imaging differentiation of this population and hypertrophic choroidal disease will provide ideas for the prediction and diagnosis of the disease. However, there are currently few observations on the choroidal structure and imaging characteristics of normal people, especially normal people with hypertrophic choroid. No one has studied the imaging differences between normal people with hypertrophic choroid and people with hypertrophic choroidal disease, and there is no clear OCT indicator to predict hypertrophic choroidal disease. The present invention emphasizes the effects of gender and refraction on the imaging of choroidal structure, and proposes that the S / H value is a more stable predictive indicator for PCD disease than choroidal thickness.

[0134] The present invention has been described in detail above. It will be apparent to those skilled in the art that the present invention may be practiced over a wide range of parameters, concentrations, and conditions without departing from the spirit and scope of the present invention and without unnecessary experimentation. Although specific embodiments have been given herein, it should be understood that further modifications may be made to the present invention. In summary, this application is intended to encompass any variations, uses, or improvements to the present invention, including those made by conventional techniques known in the art that depart from the scope of the present invention. Applications of the essential features may be made within the scope of the following claims.

Claims

1. A computer device comprising a memory, a processor, and a computer program stored in the memory, wherein: The processor executes the computer program to implement the following steps: S1) Data Collection: Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes without hypertrophic choroidal disease were selected as data collection subjects. The choroidal thickness in the macular region, the thickness of the choroidal middle vascular layer, and the thickness of the choroidal great vascular layer were collected from the data subjects. The thickness of the choroidal middle vascular layer and the thickness of the choroidal great vascular layer were measured using optical coherence tomography. S2) Data processing: The ratio of the thickness of the choroidal medium vessels layer (Sattler) to the thickness of the choroidal great vessels layer (Haller) was calculated to obtain the S / H ratio. Choroidal thickness and S / H ratio were compared and analyzed across age groups and groups. The values ​​were corrected for age, sex, and refraction, and a multivariate regression model was constructed. S3) Data output: draw the receiver operating characteristic (ROC) curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio; The judgment criteria of the prediction model of hypertrophic choroidal disease based on the S / H ratio are: Patients with an S / H ratio of < 0.27 have a higher risk of developing CSC; patients with an S / H ratio of < 0.30 have a higher risk of developing PCV; and patients with an S / H ratio of < 0.29 have a higher risk of developing nAMD.

2. The computer device according to claim 1, wherein: The hypertrophic choroidal diseases mentioned in step S1) include: polypoidal choroidal vasculopathy, central serous chorioretinopathy, and neovascular age-related macular degeneration; In step S1), the critical value standard for judging whether the choroid is hypertrophic or non-hypertrophic is determined by the following steps: S11) Select eyes with hypertrophic choroidal disease and normal eyes as data collection objects; S12) performing age, gender, and refractive power matching based on the data from step 1); S13) For the matched data, swept-source OCT was used to measure the choroidal thickness in the macular area; S14) Likelihood ratio analysis was used to determine the cutoff value for hypertrophic choroid.

3. A computer-readable storage medium having a computer program / instruction stored thereon, characterized in that: When the computer program / instructions are executed by a processor, the steps described in any one of claims 1-2 are implemented.

4. The computer-readable storage medium according to claim 3, wherein: The computer-readable storage medium refers to a carrier for storing data, which is a floppy disk, CD, DVD, hard disk, flash memory, USB flash drive, CF card, SD card, MMC card, SM card, memory stick or xD card.

5. A computer program product comprising a computer program, characterized in that When the computer program is executed by a processor, the steps described in any one of claims 1 to 2 are implemented by the processor executing the computer program: S1) Data Collection: Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes without hypertrophic choroidal disease were selected as data collection subjects. The choroidal thickness in the macular region, the thickness of the choroidal middle vascular layer, and the thickness of the choroidal great vascular layer were collected from the data subjects. The thickness of the choroidal middle vascular layer and the thickness of the choroidal great vascular layer were measured using optical coherence tomography. S2) Data processing: The ratio of the thickness of the choroidal medium vessels layer (Sattler) to the thickness of the choroidal great vessels layer (Haller) was calculated to obtain the S / H ratio. Choroidal thickness and S / H ratio were compared and analyzed across age groups and groups. The values ​​were corrected for age, sex, and refraction, and a multivariate regression model was constructed. S3) Data output: draw the receiver operating characteristic (ROC) curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio; The judgment criteria of the prediction model of hypertrophic choroidal disease based on the S / H ratio are: Patients with an S / H ratio of < 0.27 have a higher risk of developing CSC; patients with an S / H ratio of < 0.30 have a higher risk of developing PCV; and patients with an S / H ratio of < 0.29 have a higher risk of developing nAMD.

6. A method for constructing a prediction model for hypertrophic choroidal disease, characterized in that: The steps include: S1) Data Collection: Eyes with hypertrophic choroidal disease, normal eyes with hypertrophic choroidal disease, and normal eyes without hypertrophic choroidal disease were selected as data collection subjects. The choroidal thickness in the macular region, the thickness of the choroidal middle vascular layer, and the thickness of the choroidal great vascular layer were collected from the data subjects. The thickness of the choroidal middle vascular layer and the thickness of the choroidal great vascular layer were measured using optical coherence tomography. S2) Data processing: The ratio of the thickness of the choroidal medium vessels layer (Sattler) to the thickness of the choroidal great vessels layer (Haller) was calculated to obtain the S / H ratio. Choroidal thickness and S / H ratio were compared and analyzed across age groups and groups. The values ​​were corrected for age, sex, and refraction, and a multivariate regression model was constructed. S3) Data output: draw the receiver operating characteristic (ROC) curve to obtain a prediction model for hypertrophic choroidal disease based on the S / H ratio; The judgment criteria of the prediction model of hypertrophic choroidal disease based on the S / H ratio are: Patients with an S / H ratio of < 0.27 have a higher risk of developing CSC; patients with an S / H ratio of < 0.30 have a higher risk of developing PCV; and patients with an S / H ratio of < 0.29 have a higher risk of developing nAMD.

7. The construction method according to claim 6, characterized in that: The hypertrophic choroidal diseases include: polypoidal choroidal vasculopathy, central serous chorioretinopathy, and neovascular age-related macular degeneration; In step S1), the hypertrophic choroidal critical value is used as the critical value standard for judging whether the choroid is hypertrophic or non-hypertrophic; the critical value standard for judging whether the choroid is hypertrophic or non-hypertrophic is determined by the following steps: S11) Select eyes with hypertrophic choroidal disease and normal eyes as data collection objects; S12) performing age, gender, and refractive power matching based on the data from step 1); S13) For the matched data, swept-source OCT was used to measure the choroidal thickness in the macular area; S14) Likelihood ratio analysis was used to determine the cutoff value for hypertrophic choroid.

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