We thank Drs Uzun and Pehlivan for the comments.

We have excluded individuals who have significant systemic diseases that could affect their visual performance, and this includes those with multiple comorbidities and on multiple medications. As this group of 749 participants are young (age range 19–25 years), it is highly unlikely that there is a considerable proportion of participants who have hypertension or who smoke. Unfortunately, we did not collect data on body mass index, blood pressure, exercise, sleep, smoking status, or consumption of alcohol or caffeinated beverages.

We agree that there is diurnal variation in choroidal thickness (CT), as shown by Tan and associates in a young group of 12 subjects. However, we note that the mean diurnal variation was only 33.7 μm, which is small compared to the mean CT (± SD) of 372.2 ± 100.4 μm. The mean variation is only 10.4 μm in the thin group (CT less than 300 μm), which is comparable to the myopic participants in our study (mean CT ± SD of 257.5 ± 77.5 μm). In addition, it was also reported that myopic individuals and eyes with longer axial length had significantly lower CT diurnal variation. As such, the amplitude of diurnal variation can be negligible in these young myopic eyes. In our study, the association between reduced choroidal thickness and myopic maculopathy is supported by both optical coherence tomography and histology-based studies in the literature.