Microvascular alterations of peripapillary choriocapillaris in young adult high myopia detected by optical coherence tomography angiography

Abstract

Abstract Objectives. To characterize the microstructural alterations of peripapillary choriocapillaris in young adult high myopes using optical coherence tomography angiography (OCTA) and to explore factors involved in the alterations. Methods. This cross-sectional control study included 205 eyes (95 with high myopia and 110 with mild-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 PPA-β zone, spherical equivalent (SE), and axial length (AL) were collected and compared across groups. Results. The MvD was identified in 195 eyes (95.1%). Highly myopic eyes exhibited significantly greater area of 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-moderately myopic eyes, and lower average density in the choriocapillaris. Linear regression analysis showed that MvD area correlated age, SE, AL, and PPA-β area (all P < 0.05). Conclusions. MvDs represent choroidal microvascular alterations in young adult high myopes, which were correlated with age, SE, AL, and PPA-β zone. In this disorder, OCTA matters for characterizing the underlying pathophysiological adaptations.