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

Association between retinal microvasculature and optic disc alterations in high myopia

Purpose

This study aimed to explore the characteristics of retinal perfusion and its associations with high myopia.

Methods

A total of 760 participants were included. Peripapillary radial peripapillary capillary perfusion, foveal avascular zone, and parafoveal perfusion were measured using optical coherence tomography angiography (OCTA). Tilted disc ratio and parapapillary atrophy were determined using swept-source optical coherence tomography.

Results

A total of 760 young healthy participants with myopic eyes were included in the analysis. The mean axial length and titled disc ratio were 26.43 ± 1.14 and 0.76 ± 0.08 mm in the high-myopia group and 24.79 ± 0.75 and 0.80 ± 0.09 mm in the control group, respectively. The high-myopia group exhibited significantly larger parapapillary atrophy, lower tilted disc ratio, lower radial peripapillary capillary vessel density, larger area of foveal avascular zone, and lower deep parafoveal vessel density. In the multivariate analysis, titled disc ratio significantly correlated with radial peripapillary capillary vessel density (P = 0.0134), larger foveal avascular zone (P = 0.0062), and lower deep parafoveal vessel density (P < 0.0001).

Conclusions

Reduced radial peripapillary capillary and deep parafoveal vessel density and enlarged area of foveal avascular zone were observed in high myopia. Tilted disc ratio correlated with retinal perfusion.

Optical Coherence Tomography Angiography in Glaucoma

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.