The purpose of this study was to measure alterations of inner retinal microvascular density and outer retinal sublayer thicknesses in pathological myopia, and to correlate the measured parameters with best corrected visual acuity (BCVA). METHODS. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of 21 control, 48 simple high myopia, and 22 pathological myopia eyes were analyzed to quantify the thicknesses of the outer retinal sublayers and the density of the inner retinal microvascular network that includes the superficial retinal capillary plexus (SRCP) and deep retinal capillary plexus (DRCP). Retinal sublayer thicknesses and microvascular densities were compared among the three groups, and correlations of sublayer thicknesses and microvascular densities with BCVA were determined. RESULTS. In pathological myopia, density of the DRCP, thicknesses of myoid and ellipsoid zone (MEZ), interdigitation zone and retinal pigment epithelium/Bruch complex (IZ + RPE), and choroid were lower than in simple high myopia (P < 0.05). The decreased DRCP density was correlated with thinner MEZ and IZ+RPE in pathological myopia (P < 0.05), but not in simple high myopia (P > 0.05). Simple linear regression showed that axial length, female, thicknesses of outer plexiform layer (OPL), MEZ, IZ + RPE, choroid, and density of the SRCP and DRCP were correlated with BCVA. In multiple regression analysis, worse BCVA was associated only with thinner MEZ, thinner choroid, and decreased DRCP (P < 0.05). CONCLUSIONS. Alteration of inner retinal microvascular density and outer retinal sublayer thicknesses occurred in pathological myopia, especially decreased DRCP and thinner MEZ, which were significantly associated with worse BCVA.

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PurposeTo quantify the radial peripapillary capillary (RPC) density and the peripapillary retinal nerve fiber layer (pRNFL) thickness in pathological myopia and examine associations among these factors and best-corrected visual acuity (BCVA).MethodsThe cohort was composed of 41 eyes as control and 79 eyes with high myopia (59 simple high myopia, 20 pathological myopia). Optical coherence tomography angiography was done to obtain RPC density and pRNFL thickness, superficial retinal capillary plexus (SRCP), and deep retinal capillary plexus (DRCP) density. The axial length (AL) was measured. Correlations among BCVA, RPC density, pRNFL thickness, AL, and other parameters were determined.ResultsFor pathological myopia, the densities of RPC, SRCP, and DRCP were significantly less than those of the control and simple high myopia groups (p ≤ 0.005). There was no statistical difference in pRNFL thickness between pathological myopia and simple high myopia (p = 0.063), whereas there was significant difference in global pRNFL thickness between pathological myopia and control (p = 0.008). The global RPC density showed the greatest area under the curve (AUC = 0.962, sensitivity = 94.74%, specificity = 90.00%, cutoff value = 47.8%) for pathological myopia, whereas the AUC of pRNFL thickness, SRCP, and DRCP were only 0.675, 0.824, and 0.865, respectively. The univariate and multiple linear regression models showed that RPC density, SRCP density, and AL were correlated with BCVA (All p &lt; 0.05). In the final BCVA model with multiple generalized estimating equation analysis, AL, RPC density and interaction between RPC and AL were shown (all p &lt; 0.03). For an eye with AL ≥ 27.94 mm, global RPC density was predicted to be less than 48.77% with a high risk of visual impairment.ConclusionPeripapillary alterations, both the decreasing RPC density and pRNFL thickness, occurred in pathological myopia compared with the control. The RPC density was associated with BCVA, and this relationship was affected by AL.

Purpose To investigate the change of diabetic macular edema (DME) post vitrectomy and its risk factors.Methods Retrospective study design. This study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy with gradable optical coherence tomography imaging from January 2018 to March 2022. The incidence of post vitrectomy DME (PV-DME) was defined as patients with a central retinal thickness (CRT) > 300 µm by optical coherence tomography among patients without preoperative DME.Results The cumulative incidence of PV-DME at 3 months was 40.1% (89/222), with its majority subtype of single diffused retinal thickening (66.2%) followed by single cystoid macular edema (27.0%). Multivariate Cox regression analysis indicated that a thicker preoperative CRT (HR = 1.01, 95% CI 1.00–1.02) and intraoperative internal limiting membrane peeling (HR = 3.18, 95% CI 1.85–5.47) were associated with the presence of PV-DME, while intraoperative intravitreal injection of triamcinolone acetonide (HR = 0.28, 95% CI 0.13–0.57) was protective against PV-DME. In eyes with preoperative DME (n = 143), the CRT decreased gradually from 468.3 ± 177.7 µm preoperatively to 409.5 ± 151.0 µm (P = 0.027), 377.4 ± 141.9 µm (P < 0.001), and 368.0 ± 157.6 µm (P < 0.001) at 7 days, 1 month, and 3 months postoperatively, respectively. Multivariate linear regression analysis indicated that only a thicker preoperative CRT (β = 0.77, 95% CI 0.63–0.92) was associated with a decreasing postoperative CRT.Conclusion PV-DME is a very common postoperative complication in patients with proliferative diabetic retinopathy. Triamcinolone acetonide could prevent its formation. Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.