Myopia-related stepwise and quadrant retinal microvascular alteration and its correlation with axial length

Liu, Mingming; Wang, Peng; Hu, Xiaojun; Zhu, Chengcheng; Yuan, Ying; Ke, Bilian

doi:10.1038/s41433-020-01225-y

“…The reduction of IOP and the baseline RNFL thickness were independent factors associated with peripapillary RPC VD improvement, as shown in the multivariate linear regression model ( Figure 2 ; Table 4 ). Although the image quality ( 37 ) and myopic status ( 38 ) correlated with retinal VD, we did not find their correlation with VD improvement. Previous cross-sectional studies have demonstrated an insignificant prediction value of IOP on the measurements of peripapillary parameters ( 39 , 40 ).…”

Section: Discussioncontrasting

confidence: 86%

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Chen

¹

,

Hong

²

,

Di

³

et al. 2021

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Purpose: To investigate the relationship between retinal microvasculature changes and intraocular pressure (IOP) for ocular hypertension (OHT) patients and further assess the factors associated with retinal microcirculation changes.Methods: This was a single-center prospective study designed for OHT patients, which consisted of two visits. After collecting baseline data of those who met the eligibility criteria, these patients were treated with latanoprost 0.005% ophthalmic solution for 4 weeks. Peripapillary vessel density (VD) of radial peripapillary capillaries (RPC) layer, macular VD in both superficial and deep layers, and foveal avascular zone (FAZ) area were measured by optical coherence tomography angiography (OCTA) before and after the treatment. We compared the changes in IOP and VD among the two visits by paired-sample t-test. Bonferroni correction was applied. Factors associated with VD changes were analyzed by linear regression analysis.Results: Thirty-four eyes of thirty-four patients were included. The mean IOP decreased by 6.5 ± 2.2 mmHg (p < 0.001). The peripapillary RPC VD increased significantly from 51.8 ± 2.5 to 53.0 ± 3.1% (Adjusted-p = 0.012). We found no significant difference in detailed sectors of the peripapillary region after correction. In the macular area, both the superficial and deep layers in foveal (superficial: 0.2 ± 1.9%, p = 0.523; deep: 0.0 ± 2.3%, p = 0.969) and parafoveal (superficial: 0.3 ± 3.0%, p = 0.565; deep: 0.5 ± 3.1%, p = 0.423) VD remained unchanged. The decrease of the mean FAZ area was insignificant (p = 0.295). The percentage of IOP reduction (β = 0.330, p = 0.031) and the baseline RNFL thickness (β = 0.450, p = 0.004) significantly correlated with the percentage of peripapillary RPC VD improvement in the multivariate linear regression analysis.Conclusion: The peripapillary VD in OHT patients increased after the reduction of IOP. The mild change of IOP did not alter the microcirculation in the macula. In addition, the percentage of IOP change and the baseline RNFL thickness were independent factors for the peripapillary RPC VD improvement.

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“…Another study claimed that the peripheral DVD contributes as an indicator of capillary loss in high myopia [ 17 ]. However, Liu et al found that the inferior and nasal quadrants were not correlated to AL and stated that the two quadrants had the lowest susceptibility during the development of myopia [ 18 ], which is contradictory to our findings, and the contrasting results may be ascribed to the difference in inclusion criteria and the population. Based on the abovementioned paradoxical results, subsequent studies should focus on the quadrant variation of microstructural and microvascular alteration with myopia progression.…”

Section: Discussioncontrasting

confidence: 99%

Vessel Density and Retinal Thickness from Optical Coherence Tomography Angiography as New Indexes in Adolescent Myopia

Zhu

¹

,

Chen

²

,

Yao

³

2021

Journal of Ophthalmology

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Purpose. To evaluate and quantify blood perfusion and retinal thickness (RT) from the perspective of quadrants by optical coherence tomography angiography (OCTA) in adolescents with myopia and explore the relationship between axial elongation and related indexes of OCTA. Methods. A total of 88 subjects (149 eyes) with different degrees of myopia were included in this cross-sectional study. Vessel density (VD) and RT of quadrants in macular and peripheral regions were measured through OCTA. Results. The superficial VD (SVD) of the parainferior region was significantly correlated with axial length (AL) between the emmetropia (EM) group and high myopia (HI) group ( P = 0.012 ). There were significant differences in deep VD (DVD) in all quadrants, except for the foveal, perifoveal, and peri-inferior regions ( P > 0.05 ). However, there were significant alterations in the whole, parainferior, and perinasal regions ( P = 0.030 , 0.023, and 0.035) in the low-to-moderate myopia (L–M) group compared with those in the HI group. There were significant differences in the RT in all quadrants, except for the foveal, paratemporal, and paranasal regions ( P > 0.05 ) between the EM and L–M groups and the foveal region ( P > 0.05 ) between the EM and HI groups. Nevertheless, only RT in the peri-inferior region of the L–M and HI groups showed significant differences. AL was negatively correlated with SVD in the perifoveal and parainferior regions (r = −0.179, P = 0.029 ; r = −0.227, P = 0.005 ) and inversely correlated with DVD and RT in almost all quadrants, except for the foveal region (r = −0.020, P = 0.811 ; r = 0.135, P = 1.000 ). Conclusion. DVD and RT were closely associated with the severity of myopia and might be new indexes in assessing and detecting myopia development via OCTA.

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“…Besides the abnormality of macular structure such as posterior staphyloma, a long axial length may impair EZ recovery, as observed in the current study, resulting in lower functional visual outcomes. In addition to the thinner choroid, highly myopic eyes also have a lower microvascular density in superficial and deep retinal layers 25 . Thus, both inner and outer insufficiencies of the blood supply to the outer retina may impair EZ recovery.…”

Section: Discussionmentioning

confidence: 99%

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

Lee

¹

,

Kim

²

,

Song

³

et al. 2021

Sci Rep

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To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.

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Myopia-related stepwise and quadrant retinal microvascular alteration and its correlation with axial length

Cited by 39 publications

References 40 publications

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

Vessel Density and Retinal Thickness from Optical Coherence Tomography Angiography as New Indexes in Adolescent Myopia

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery

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