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Changes of optic nerve head microcirculation in high myopia.

Wen-Quan Tang1, Yu-Lin Luo1, Xi-Lang Wang1

  • 1Department of Ophthalmology, Hunan Children's Hospital, Changsha 410007, Hunan Province, China.

International Journal of Ophthalmology
|January 20, 2023
PubMed
Summary

In high myopia, increasing axial length (AL) reduces optic nerve head (ONH) microcirculation, specifically peripapillary vascular density (PVD). Age and spherical equivalent (SE) showed no significant impact on ONH vascularity.

Keywords:
axial lengthhigh myopiaoptic nerve headoptical coherence tomography angiographyvascular density

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Vascular Biology

Background:

  • High myopia (HM) is associated with structural changes in the optic nerve head (ONH).
  • Understanding the microcirculation of the ONH is crucial for managing HM-related complications.
  • The relationship between demographic and refractive factors and ONH vascularity in HM requires further investigation.

Purpose of the Study:

  • To investigate the correlation between age, spherical equivalent (SE), and axial length (AL) and optic nerve head (ONH) microcirculation in individuals with high myopia (HM).
  • To determine the impact of these factors on intrapapillary vascular density (IVD) and peripapillary vascular density (PVD).

Main Methods:

  • A cross-sectional study included 164 right eyes of patients with high myopia.
  • Optical coherence tomography angiography (OCTA) was employed to quantify ONH vessel density.
  • Participants were categorized into groups based on age (<20, 20-29, ≥30 years), SE (-9 to -6 D, -12 to -9 D, <-12 D), and AL (<26 mm, 26-26.9 mm, 27-27.9 mm, ≥28 mm).

Main Results:

  • No significant differences in vessel density were found across age or SE groups.
  • Intrapapillary vascular density (IVD) showed a correlation with age (r=-0.190, P<0.05) but not with SE or AL.
  • Peripapillary vascular density (PVD) significantly decreased with increasing axial length (AL) (F=3.605, P=0.015), particularly in temporal sectors (IT, TI, TS).

Conclusions:

  • Axial length elongation in high myopia is associated with a reduction in peripapillary vascular density (PVD) of the optic nerve head.
  • Intrapapillary vascular density (IVD) remains stable with increasing AL but shows a slight correlation with age.
  • Axial length elongation, rather than age or spherical equivalent, appears to be the primary factor contributing to reduced ONH microcirculation in high myopia.