{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T01:53:28Z","timestamp":1781315608055,"version":"3.54.1"},"reference-count":45,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Chinese Natural Science Foundation for Young Staff","award":["81800881"],"award-info":[{"award-number":["81800881"]}]},{"name":"Chinese National key research and development program","award":["2021YFC2702100"],"award-info":[{"award-number":["2021YFC2702100"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2023,1,26]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Background\/aims<\/jats:title><jats:p>We aim to explore the effect of sympathetic nervous system (SNS) on choroid thickness (ChT) and axial length (AL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Students of grade 2 and 3 from a primary school were included and followed for 1\u2009year. Visual acuity, refraction, AL and ChT were measured. Morning urine samples were collected for determining SNS activity by analysing concentrations of epinephrine, norepinephrine and dopamine using the liquid chromatography-tandem mass spectrometry. The most important factor (factor 1) was calculated using factor analysis to comprehensively indicate the SNS activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 273 students were included, with an average age of 7.77\u00b10.69 years, and 150 (54.95%) were boys. Every 1\u2009\u00b5g\/L increase in epinephrine is associated with 1.60\u2009\u00b5m (95%\u2009CI 0.30 to 2.90, p=0.02) decrease in average ChT. Every 1\u2009\u00b5g\/L increase in norepinephrine is associated with 0.53\u2009\u00b5m (95%\u2009CI 0.08 to 0.98, p=0.02) decrease in the ChT in inner-superior region. The factor 1 was negatively correlated with the ChT in the superior regions. Every 1\u2009\u00b5g\/L increase in norepinephrine was associated with 0.002\u2009mm (95%\u2009CI 0.0004 to 0.004, p=0.016) quicker AL elongation. The factor 1 was positively correlated with AL elongation (coefficient=0.037, 95%\u2009CI 0.005 to 0.070, p=0.023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We hypothesised that chronic stress characterised by elevated level of the SNS, was associated with significant increase in AL elongation, probably through thinning of the choroid.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2022-322165","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T18:20:20Z","timestamp":1676398820000},"page":"405-410","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Sympathetic nervous system activity is associated with choroidal thickness and axial length in school-aged children"],"prefix":"10.1136","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0166-1308","authenticated-orcid":false,"given":"Senlin","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijun","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5845-107X","authenticated-orcid":false,"given":"Xian","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoyu","family":"Xiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6629-1272","authenticated-orcid":false,"given":"Lipu","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haidong","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-1879","authenticated-orcid":false,"given":"Xiangui","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4453-611X","authenticated-orcid":false,"given":"Jianfeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4250-0356","authenticated-orcid":false,"given":"Yingyan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"2024022109050588000_108.3.405.1","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2015-307724"},{"key":"2024022109050588000_108.3.405.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2013.08.010"},{"key":"2024022109050588000_108.3.405.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2018.10.029"},{"key":"2024022109050588000_108.3.405.4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1167\/iovs.62.5.3","article-title":"IMI risk factors for myopia","volume":"62","author":"Morgan","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.405.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.k2022","article-title":"Education and myopia: a mendelian randomisation study","volume":"361","author":"Mountjoy","year":"2018","journal-title":"BMJ"},{"key":"2024022109050588000_108.3.405.6","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.16-20243"},{"key":"2024022109050588000_108.3.405.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2009.08.008"},{"key":"2024022109050588000_108.3.405.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199801153380307"},{"key":"2024022109050588000_108.3.405.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1681.2007.04590.x"},{"key":"2024022109050588000_108.3.405.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2016.02.027"},{"key":"2024022109050588000_108.3.405.11","first-page":"1","article-title":"Peripheral and central effects of circulating catecholamines","volume":"5","author":"Tank","year":"2015","journal-title":"Compr Physiol"},{"key":"2024022109050588000_108.3.405.12","first-page":"439","article-title":"Autonomic control of the eye","volume":"5","author":"McDougal","year":"2015","journal-title":"Compr Physiol"},{"key":"2024022109050588000_108.3.405.13","doi-asserted-by":"publisher","DOI":"10.1006\/exer.2002.1182"},{"key":"2024022109050588000_108.3.405.14","doi-asserted-by":"crossref","first-page":"5032","DOI":"10.1167\/iovs.18-24954","article-title":"Defective choroidal blood flow baroregulation and retinal dysfunction and pathology following sympathetic denervation of choroid","volume":"59","author":"Li","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.405.15","first-page":"63","article-title":"The acute effect of pseudoephedrine on choroidal thickness","volume":"167","author":"Ovet","year":"2016","journal-title":"Clin Ter"},{"key":"2024022109050588000_108.3.405.16","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.3109\/02713683.2014.971935","article-title":"The effect of systemic tamsulosin hydrochloride on choroidal thickness measured by enhanced depth imaging spectral domain optical coherence tomography","volume":"40","author":"Sari","year":"2015","journal-title":"Curr Eye Res"},{"key":"2024022109050588000_108.3.405.17","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.3389\/fphys.2019.01146","article-title":"Functional-optical coherence tomography: a non-invasive approach to assess the sympathetic nervous system and intrinsic vascular regulation","volume":"10","author":"Jendzjowsky","year":"2019","journal-title":"Front Physiol"},{"key":"2024022109050588000_108.3.405.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2009.12.002"},{"key":"2024022109050588000_108.3.405.19","doi-asserted-by":"crossref","first-page":"3074","DOI":"10.1167\/iovs.18-26397","article-title":"Changes in choroidal thickness and choroidal blood perfusion in guinea pig myopia","volume":"60","author":"Zhang","year":"2019","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.405.20","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ajo.2020.01.003","article-title":"Changes in choroidal thickness varied by age and refraction in children and adolescents: a 1-year longitudinal study","volume":"213","author":"Xiong","year":"2020","journal-title":"Am J Ophthalmol"},{"key":"2024022109050588000_108.3.405.21","unstructured":"Lesson 12: factor analysis.applied multivariate statistical analysis. Available: https:\/\/online.stat.psu.edu\/stat505\/lesson\/12 [Accessed 6 Oct 2022]."},{"key":"2024022109050588000_108.3.405.22","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.exer.2014.10.003","article-title":"The effect of topical adrenergic and anticholinergic agents on the choroidal thickness of young healthy adults","volume":"128","author":"Sander","year":"2014","journal-title":"Exp Eye Res"},{"key":"2024022109050588000_108.3.405.23","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000000043"},{"key":"2024022109050588000_108.3.405.24","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.62.14.30"},{"key":"2024022109050588000_108.3.405.25","first-page":"1249","article-title":"Choroidal thickness changes during altered eye growth and refractive state in a primate","volume":"41","author":"Troilo","year":"2000","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.405.26","first-page":"II36","article-title":"What do plasma and urinary measures of catecholamines tell us about human response to stressors?","volume":"83","author":"Dimsdale","year":"1991","journal-title":"Circulation"},{"key":"2024022109050588000_108.3.405.27","doi-asserted-by":"publisher","DOI":"10.1007\/BF00920935"},{"key":"2024022109050588000_108.3.405.28","doi-asserted-by":"crossref","first-page":"774237","DOI":"10.3389\/fpubh.2021.774237","article-title":"Relationship between myopia and other risk factors with anxiety and depression among Chinese university freshmen during the COVID-19 pandemic","volume":"9","author":"Zhang","year":"2021","journal-title":"Front Public Health"},{"key":"2024022109050588000_108.3.405.29","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/s12886-016-0382-2","article-title":"The differences in level of trait anxiety among girls and boys aged 13-17 years with myopia and emmetropia","volume":"16","author":"\u0141azarczyk","year":"2016","journal-title":"BMC Ophthalmol"},{"key":"2024022109050588000_108.3.405.30","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.1594","article-title":"Investigation of the psychological health of first-year high school students with myopia in Guangzhou","volume":"10","author":"Li","year":"2020","journal-title":"Brain Behav"},{"key":"2024022109050588000_108.3.405.31","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv047"},{"key":"2024022109050588000_108.3.405.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2018.01.015"},{"key":"2024022109050588000_108.3.405.33","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1097\/JCN.0b013e3182a477d5","article-title":"Effects of Internet addiction on heart rate variability in school-aged children","volume":"29","author":"Lin","year":"2014","journal-title":"J Cardiovasc Nurs"},{"key":"2024022109050588000_108.3.405.34","doi-asserted-by":"crossref","first-page":"107050","DOI":"10.1016\/j.envint.2021.107050","article-title":"Personal ozone exposure and stress hormones in the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes","volume":"159","author":"Xia","year":"2022","journal-title":"Environ Int"},{"key":"2024022109050588000_108.3.405.35","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1097\/OPX.0000000000000095","article-title":"Myopia screening: combining visual acuity and noncycloplegic autorefraction","volume":"90","author":"Ma","year":"2013","journal-title":"Optom Vis Sci"},{"key":"2024022109050588000_108.3.405.36","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-2606"},{"key":"2024022109050588000_108.3.405.37","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)00127-C"},{"key":"2024022109050588000_108.3.405.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2011.10.003"},{"key":"2024022109050588000_108.3.405.39","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1097\/HJH.0000000000000843","article-title":"Urinary catecholamines and the relationship with blood pressure and pharmacological therapy","volume":"34","author":"Missouris","year":"2016","journal-title":"J Hypertens"},{"key":"2024022109050588000_108.3.405.40","doi-asserted-by":"crossref","first-page":"730","DOI":"10.5301\/ejo.5000965","article-title":"Choroidal thickness and ametropia in children: a longitudinal study","volume":"27","author":"Fontaine","year":"2017","journal-title":"Eur J Ophthalmol"},{"key":"2024022109050588000_108.3.405.41","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.62.9.26","article-title":"Choroidal and retinal thickness and axial eye elongation in Chinese junior students","volume":"62","author":"Tian","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2024022109050588000_108.3.405.42","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.survophthal.2020.06.008","article-title":"Choroidal thickness and ocular growth in childhood","volume":"66","author":"Prousali","year":"2021","journal-title":"Surv Ophthalmol"},{"key":"2024022109050588000_108.3.405.43","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1111\/aos.14773","article-title":"The influence of the choroid on the onset and development of myopia: from perspectives of choroidal thickness and blood flow","volume":"99","author":"Liu","year":"2021","journal-title":"Acta Ophthalmol"},{"key":"2024022109050588000_108.3.405.44","doi-asserted-by":"publisher","DOI":"10.1016\/S0042-6989(02)00300-0"},{"key":"2024022109050588000_108.3.405.45","doi-asserted-by":"publisher","DOI":"10.1076\/ceyr.27.6.371.18188"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2022-322165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T17:07:18Z","timestamp":1708535238000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2022-322165"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,14]]},"references-count":45,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2,21]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bjo-2022-322165"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2022-322165","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,14]]}}}