Korean J Ophthalmol.  2020 Apr;34(2):106-112. 10.3341/kjo.2019.0113.

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

Affiliations
  • 1Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 2College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Abstract

Purpose
To investigate macular microvasculature changes using optical coherence tomography angiography (OCTA) and analyze their correlation with the structural parameters in highly myopic eyes.
Methods
We measured the area of the foveal avascular zone (FAZ) and the parafoveal vessel density in the superficial and deep retinal plexuses using OCTA. The magnification effect of the FAZ area was corrected using Bennett's formula. Retinal thickness measured at each corresponding area of the OCTA parameters, subfoveal choroidal thickness, and ocular characteristics were reviewed, and the relationships between the microvasculature measurements and the ocular structural characteristics were explored.
Results
Fifty-two eyes with high myopia and 52 normal sex- and age-matched controls were included in the analysis. The FAZ area was significantly larger in the myopic eyes (p = 0.023). The superficial parafoveal vascular density was significantly decreased (p= 0.007) in the myopic eyes compared with the normal eyes, whereas there was no significant difference in the deep parafoveal vascular density (p = 0.226). Regarding the retinal thickness, only the parafoveal inner retinal thickness was significantly smaller in the myopic eyes than in the normal eyes (p = 0.023). The FAZ and subfoveal choroidal thickness were significantly correlated with the axial length, and the parafoveal inner retinal thickness was significantly correlated with the superficial parafoveal vascular density (all p < 0.05).
Conclusions
The FAZ was enlarged and the parafoveal vascular density was reduced in the highly myopic eyes. The decrease was prominent in the superficial capillary plexuses and well-correlated with the retinal thickness profiles. The macular microvascular network alteration may be attributed to the ocular axial elongation that occurs with myopia.

Keyword

Foveal avascular zone; Macular microvasculature; Myopia; Optical coherence tomography angiography

Figure

  • Fig. 1 Correlations between the microvasculature and structural profiles. (A) Axial length and the superficial capillary plexus (SCP) foveal avascular zone (FAZ) area showed a positive correlation. (B) Axial length and the SCP vessel density showed a negative correlation. (C) SCP vessel density and the parafoveal inner retinal thickness showed a positive correlation. (D) Axial length and the choriocapillaris flow void area showed a positive correlation. (E) Axial length and subfoveal choroidal thickness (SFCT) showed a negative correlation. (F) SFCT and the choriocapillaris flow void area showed no significant correlation.


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