Microvascular Alterations of Peripapillary Choriocapillaris in Young Adult High Myopia Detected by Optical Coherence Tomography Angiography

Abstract

(1) Background: The microstructural alterations of the peripapillary choriocapillaris in high myopes remain elusive. Here, we used optical coherence tomography angiography (OCTA) to explore factors involved in these alterations. (2) Methods: This cross-sectional control study included 205 young adults’ eyes (95 with high myopia and 110 with mild to moderate myopia). The choroidal vascular network was imaged using OCTA, and the images underwent manual adjustments to determine the peripapillary atrophy (PPA)-β zone and microvascular dropout (MvD). The area of MvD and the PPA-β zone, spherical equivalent (SE), and axial length (AL) were collected and compared across groups. (3) Results: The MvD was identified in 195 eyes (95.1%). Highly myopic eyes exhibited a significantly greater area for the PPA-β zone (1.221 ± 0.073 vs. 0.562 ± 0.383 mm2, p = 0.001) and MvD (0.248 ± 0.191 vs. 0.089 ± 0.082 mm2, p < 0.001) compared with mildly to moderately myopic eyes, and a lower average density in the choriocapillaris. Linear regression analysis showed that the MvD area correlated with age, SE, AL, and the PPA-β area (all p < 0.05). (4) Conclusions: This study found that MvDs represent choroidal microvascular alterations in young-adult high myopes, which were correlated with age, SE, AL, and the PPA-β zone. In this disorder, OCTA is important for characterizing the underlying pathophysiological adaptations.

Optic Disc Microvasculature Dropout in Preperimetric Glaucoma

“…40,43 Also, a considerable number of myopic eyes (average AXL 25.0 mm) were included in this study, thus limiting the applicability of those 2 parameters. Given that both MvD and focal LC defects can be observed in eyes the myopia, 44,45 further studies on the development of vascular and structural changes of the deep ONH tissue in myopic glaucomatous eyes are warranted. Fourth, eyes with diabetes, hypertension, and various glaucoma medications were included in this study, and this may be the potentially confounding factor related to the vascular parameters.…”