Association Between Optic Nerve Head Deformation and Retinal Microvasculature in High Myopia

Sung, Mi Sun; Lee, Tae Hee; Heo, Hwan; Park, Sang Woo

doi:10.1016/j.ajo.2018.01.033

Cited by 60 publications

(65 citation statements)

References 45 publications

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“…A significantly reduced retinal vessel density also was found in myopic eyes compared to healthy controls by several other groups. [26][27][28] These findings are consistent with our observation in this study in that the superficial and deep retinal vessel density decreases with AL, even after adjusting for age, sex, and inner retinal thickness. The impact of AL could be partially explained by the transverse magnification effect.…”

Section: Discussionsupporting

confidence: 91%

Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

You

Chan

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Citation: You QS, Chan JCH, Ng ALK, et al. Macular vessel density measured with optical coherence tomography angiography and its associations in a large population-based study. Invest Ophthalmol Vis Sci. 2019;60:4830-4837. https://doi.org/10.1167/ iovs.19-28137PURPOSE. We investigate macular perfusion and the systemic and ocular associations in a population-based setting. METHODS.In this cross-sectional study, 2018 adults residing in Hong Kong underwent detailed ophthalmic examinations after consenting to participate. Macular perfusion was measured with optical coherence tomography angiography (OCTA) using the split-spectrum amplitude decorrelation angiography algorithm. The parafoveal flow index and vessel area density were quantified using automated custom-built software. RESULTS.Of the 2018 participants, the OCTA measurements were available for 1940, and 1631 (84.1%) had good quality scans. The right eyes of these 1631 participants (43.1% men) were included for final analysis. Mean age was 49.8 years (range, 18-92 years). Mean global macular vessel density was 47.3% and 55.1% for the superficial and deep retinal layers, respectively. In multivariate analysis, lower superficial vessel density remained significantly associated with lower signal strength index (SSI; P < 0.001, standardized b ¼ 0.607) and male sex (P < 0.001, b ¼ 0.162), and borderline associated with older age (P ¼ 0.09, b ¼ À0.045) and longer axial length (AL; P ¼ 0.09, b ¼ À0.037), while lower deep layer vessel density was significantly associated with lower SSI (P < 0.001, standardized b ¼ 0.667), longer AL (P < 0.001, b ¼ À0.097), and higher creatinine (P < 0.001, b ¼ À0.072).CONCLUSIONS. This large population-based study provided normative OCTA data of macular vessel density and demonstrated that a lower superficial retinal vessel density was significantly associated with lower SSI and male sex, while a lower deep layer retinal vessel density was significantly associated with lower SSI, longer AL, and higher level of creatinine. These associations must be considered when interpreting clinical quantitative OCTA data.

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Section: Discussionsupporting

confidence: 91%

Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

You

Chan

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Recently, several studies have reported the FAZ area in high myopia patients. Sung et al [10] reported that areas of superficial and deep FAZs were larger in highly myopic eyes. Superficial FAZ areas were significantly smaller than deep FAZ areas in both the control and high myopia groups.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, OCTA allows detection and measurement of foveal avascular zone (FAZ) area, which can be affected by several retinal diseases [9]. Since the FAZ is surrounded by interconnected capillaries, it is affected by changes in the retinal microvasculature of the macula, which is one of the most important parameters in central retinal circulation [10]. Balaratnasingam et al [11] reported that the FAZ possesses significant diagnostic and prognostic value in various retinal diseases, especially for grading of functional severity of maculopathy due to diabetic retinopathy and retinal vein occlusion.…”

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confidence: 99%

Repeatability of Manual Measurement of Foveal Avascular Zone Area in Optical Coherence Tomography Angiography Images in High Myopia

Lee

Baek

et al. 2020

Korean J Ophthalmol

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses /by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 113 Original ArticleHigh myopia is one of the most common causes of visual loss and is especially common in Asia. The prevalence of myopia is as high as 80% in Asia and 25% in other regions [1][2][3]. Severe myopia can increase the risk of glaucoma, retinal detachment, chorioretinal atrophy, and lacquer cracks. Therefore, high myopia patients, even those without other ophthalmic diseases, should not be overlooked [4]. In myopia, the sclera and chorioretina are enlarged to reduce the thickness of the macular choroid, which may result in delayed choroidal circulation to induce an ischemic state of Purpose: To analyze the repeatability of manual measurement of foveal avascular zone (FAZ) area in an optical coherence tomography angiography (OCTA) image in high myopia. Methods: This study comprised patients with high myopia and controls. Two consecutive FAZ areas of the superficial and deep capillary plexus were obtained using OCTA. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were assessed, and univariate and multivariate generalized linear mixed models were conducted to identify factors related to repeatability. Results: Thirty eyes with high myopia and 34 eyes of healthy subjects were included in the study. The mean age in high myopia and control subjects was 55.5 and 60.8 years, respectively, the mean spherical equivalent was -9.98 and -0.55 diopters, and the mean axial length was 28.0 and 23.9 mm. The ICCs of FAZ area of the superficial capillary plexus (SCP) were 0.891 and 0.919, while the CVs were 8.8% and 8.5%. In measurement of the deep capillary plexus, the ICCs were 0.788 and 0.907, while the CVs were 11.2% and 11.0%, which were acceptable but exhibited lower repeatability than those of SCP. Multivariate analyses showed that older age (p = 0.030) and greater axial length (p = 0.005) were significantly associated with lower repeatability of SCP FAZ area measurements. In addition, greater axial length (p = 0.044) was a significant factor for lower repeatability of deep capillary plexus FAZ area measurements. Conclusions: Manual measurement of FAZ area using OCTA exhibited relatively good repeatability for high myopia. Age and axial length affected repeatability and should be considered when analyzing FAZ areas in high myopia patients.

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“…25,26,27 Few studies to date have addressed this problem. In glaucoma with high myopia, the regional relationship of visual field and peripapillary vessel density is significantly greater than that with the corresponding RNFL thickness.…”

Section: Myopia and Peripapillary Vessel Densitymentioning

confidence: 99%

“…26 Similarly to RNLF thickness, perifoveal perfusion is altered in myopia with disc torsion. 27 Thus, in myopic glaucoma we cannot expect considerably better diagnostic accuracy from OCTA than from structural OCT parameters.…”

Section: Myopia and Peripapillary Vessel Densitymentioning

confidence: 99%

Optical Coherence Tomography Angiography in Glaucoma

Holló

2018

tjo

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Optical coherence tomography angiography (OCTA) comprises different OCT-based technologies developed for non-invasive assessment and measurement of optic nerve head and retinal perfusion. Currently the most clinically established approach is based on the split spectrum amplitude decorrelation algorithm, which detects moving red blood cells and eliminates all other information. The two main clinical fields in which OCTA offers clinically useful information are investigation of the macular retina (e.g. in macular degeneration and diabetic macular disease) and glaucoma. For glaucoma, the optic nerve head and the peripapillary retinal perfusion in the retinal nerve fiber layer, and the superficial perifoveal macular vasculature are the areas of interest. This review provides a comprehensive summary of the most important current and potential future applications of OCTA in glaucoma, but it does not address the nonglaucomatous optic nerve head or peripapillary and macular diseases.

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Association Between Optic Nerve Head Deformation and Retinal Microvasculature in High Myopia

Cited by 60 publications

References 45 publications

Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

Macular Vessel Density Measured With Optical Coherence Tomography Angiography and Its Associations in a Large Population-Based Study

Repeatability of Manual Measurement of Foveal Avascular Zone Area in Optical Coherence Tomography Angiography Images in High Myopia

Optical Coherence Tomography Angiography in Glaucoma

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