Macular Microvasculature in High Myopia without Pathologic Changes: An Optical Coherence Tomography Angiography Study

Min, Chan Hong; Al-Qattan, Heba M.; Lee, Joo Yong; Kim, June Gone; Yoon, Young Hee; Kim, Yoon Jeon

doi:10.3341/kjo.2019.0113

Cited by 34 publications

(39 citation statements)

References 30 publications

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“…[18] and Min et al [19] found that the FAZ area of highly myopic eyes was larger than that of emmetropic eyes, and it was positively correlated with the eye axis, which is contrary to our research results.…”

Section: Discussioncontrasting

confidence: 99%

“…The deep central fovea blood ow density is most closely related to the loss of retinal capillaries related to myopia and can be used as a sensitive indicator for detecting capillary loss in high myopia. Min et al [19] found that parafoveal vessel density was decreased and the super cial capillary plexus was signi cantly reduced in patients with high myopia without pathological changes, while there was no signi cant difference in the deep parafoveal vessel density [7] . In a prospective study, Venkatesh et al [26] found that deep blood vessel density changes in the macular area of simple high myopia were positively correlated with AL and negatively correlated with myopic SE, while the super cial blood vessel density was not signi cantly correlated with AL or myopic SE.…”

Section: Discussionmentioning

confidence: 98%

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Application of Angio Optical Coherence Tomography and Flash Electroretinogram in the Study of Retinal Morphology and Function in High Myopia

Cao

Luo²,

Ouyang³

et al. 2021

Preprint

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Purpose: Using optical coherence tomography (OCTA) and flash electroretinography (F-ERG), we investigated changes to the retinal micromorphology and the overall function of the retina in eyes with different degrees of high myopia. Design: Case-control study. Participants: A total of 64 cases of 118 eyes with axial high myopia with diopters ranging from -−6.0 D to −15.0D were included in the study. The individuals were 18-40 years old.Methods: Subjects were divided into three groups according to the axial length (AL) of the eye and the spherical equivalent (SE)of the lens: the high myopia group (AL: ≤26 mm and SE: −6.0D to −9.0D) with 32 eyes, the ultra-high myopia group (AL: 26-28 mm and SE: -9.25D to -12.0D) with 43 eyes, and the extremely high myopia group (AL: ≥28 mm and SE: −12.25D to −15.0D) with 43 eyes. We used the OCTA measurements macular foveal retinal thickness (MRT), foveal avascular zone (FAZ), and superficial macular and deep retinal microvascular density, and the F-ERG measurements retinal dark-adaptation a-wave and b-wave, oscillation potential (OP) wave, light adaptation a-wave and b-wave, and 30-Hz flicker light amplitudes, which represent the functional state of the retina.Results: The differences in retinal thickness in the macular area between the three groups were only statistically significant within 1 mm of the fovea (P = 0.006). MRT was positively correlated with AL (r = 0.278, P = 0.002) and negatively correlated with SE (R = −0.200, P = 0.031). The difference in the FAZ area between the three groups was also statistically significant (P = 0.036), and FAZ was negatively correlated with AL (r = −0.377, p < 0.001) and positively correlated with SE (r = 0.192, P < 0.5). Both the superficial and deep blood flow density of the macular fovea were positively correlated with AL (p < 0.001). The superficial parafoveal blood flow density was negatively correlated with AL (r = −0.280, P = 0.002) but positively correlated with SE (R = 0.254, P = 0.006). The overall blood flow density of the deep retina, the parafoveal blood flow density, and the blood flow density around the fovea were negatively correlated with AL (p < 0.001) and positively correlated with myopic SE (p < 0.001). The dark-adaptation b-wave, maximum comprehensive response a-wave and b-wave, OP wave, bright-adaptation a-wave and b-wave, and 30-Hz flicker amplitudes of the retina were negatively correlated with AL and positively correlated with SE. The amplitudes of light adaptation a-wave and b-wave were[1] negatively correlated with the foveal avascular density (p < 0.001), and the average amplitude of the OP wave was positively correlated with the superficial retinal avascular density (p < 0.001).Conclusions: Before obvious pathological changes or central vision damage, the morphology and function of the macular area show subtle changes in patients with high myopia. As the degree of myopia increases and the axis of the eye increases, the activity of the cone cells in high myopia eyes decreases and the microvascular circulation in the inner retina and function of inner layer cells, such as non-proa cells, are affected. The changes of retinal dark adaptation are more sensitive than those of bright adaptation, which indicates that retinal rod cell damage may be earlier than cone cell damage in high myopia. Therefore, we believe that the combined use of OCTA and F-ERG can help in the early diagnosis and monitoring of patients at a high risk of myopia and to guide their clinical treatment.Because the p-value is clearly provided, the term “significantly” is not necessary (removed to reduce wordiness).

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Application of Angio Optical Coherence Tomography and Flash Electroretinogram in the Study of Retinal Morphology and Function in High Myopia

Cao

Luo²,

Ouyang³

et al. 2021

Preprint

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“…Previous studies showed no significant difference in the foveal avascular zone (FAZ) area between myopic and control groups, consistent with our results 14 , 15 . Min et al, in contrast, concluded that the FAZ area was significantly larger in the myopic eyes 16 . Since different OCTA devices use different technologies and patients are of different ages, sexes, and ethnicities, it is not possible to standardize measurements.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of retinal vascular density and related factors in youth myopia without maculopathy using OCTA

Wang

Zhang

et al. 2021

Sci Rep

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To evaluate the retinal vascular flow density changes of myopic eyes of young adults using optical coherence tomography angiography and the factors affecting these changes. In this cross-sectional study, 90 eyes of 45 participants were analyzed and divided into three groups: mild, moderate, and high myopia (without pathological changes). Macular and radial peripapillary capillary flow densities were measured using optical coherence tomography angiography. Their relationships with the axial length, the spherical equivalent of the refractive error, and age were analyzed using analysis of variance, Pearson’s correlation coefficient, and multivariate linear regression analysis. Superficial and deep macular vascular densities were significantly decreased in the high myopia group compared to the other groups. In the high myopia group, the nasal peripapillary flow density decreased, whereas the flow density inside the disc increased. The axial length negatively correlated with the superficial and deep macular vascular density, but positively correlated with the vascular density inside the disc. The spherical equivalent of the refractive error negatively correlated with the macular vascular density. The retinal vascular density decreased in the high myopia group. Hence, the microvascular network inside the disc may have a compensatory action in the hypoxic setting of high myopia.

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“…Multiple studies have demonstrated decreasing macular VD being associated with increasing myopia [ 21 , 22 ]. Some studies have demonstrated only differences in certain regions and layers [ 23 , 24 ], whilst others have not demonstrated any differences between high myopic and non-high myopic patients [ 25 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

High myopia and macular vascular density: an optical coherence tomography angiography study

et al. 2021

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Objective To investigate whether there are differences inmacular vascular density (VD) between patients with high-myopia (HM) and those with non-high myopia (NHM) using Optical Coherence Tomography Angiography (OCTA). Method OCTA was performed on 35 eyes with HM with spherical equivalence (SE) > − 6.00D and 35 eyes with NHM with SE ≤ -6.00D. Vascular densities of the macula (overall macula, fovea, parafovea, superior hemi and inferior hemi) were measured in each of the superficial, deep and choriocapillaris layers of the retina. Results In the superficial retinal layer, overall macular VFD was significantly higher in the NHM compared to the HM group (51.27 ± 3.74 vs. 48.07 ± 5.69, p < 0.05). There were significant differences between the NHM and HM in parafovea (52.58 ± 5.78 vs. 49.4 ± 6.43, p < 0.05), superior-hemi (53.38 ± 4.03 vs 49.78 ± 6.84, p < 0.05) and inferior-hemi regions (53.49 ± 4.61 vs 49.05 ± 6.41, p < 0.05), but not in the fovea region. Similarly, in the deep retinal layer, overall macular VFD was significantly higher in the NHM group compared to the HM group (58.69 ± 2.46 vs. 56.90 ± 4.08, p < 0.05). There was significant differences between the HM and NHM in superior-hemi region (61.97 ± 2.68 vs. 60.08 ± 3.98, p < 0.05), but not in the fovea, parafovea, and inferior-hemi region. In the choriocapillaris, there was no difference in the overall macular VFD, nor any of the individual sectors between the HM and the NHM groups. Conclusion VFD in the superficial and deep retinal layers of the macula are significantly increased in the NHM compared to HM eyes. This is not the case in the choroidal capillary layers of the retina.

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Macular Microvasculature in High Myopia without Pathologic Changes: An Optical Coherence Tomography Angiography Study

Cited by 34 publications

References 30 publications

Application of Angio Optical Coherence Tomography and Flash Electroretinogram in the Study of Retinal Morphology and Function in High Myopia

Application of Angio Optical Coherence Tomography and Flash Electroretinogram in the Study of Retinal Morphology and Function in High Myopia

Evaluation of retinal vascular density and related factors in youth myopia without maculopathy using OCTA

High myopia and macular vascular density: an optical coherence tomography angiography study

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