Li Su1,2, Yong-Sok Ji2,3, Nianting Tong2,4, David Sarraf5,6, Xiangui He7, Xiaodong Sun1, Xun Xu1, SriniVas R Sadda8. 1. Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of medicine, Shanghai, China. 2. Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, 1355 San Pablo St., Los Angeles, CA, 90033, USA. 3. Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea. 4. Department of Ophthalmology, Qingdao Municipal Hospital, Qingdao, Shandong, China. 5. Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. 6. Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA. 7. Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China. 8. Doheny Eye Institute, Department of Ophthalmology, David Geffen School of Medicine at UCLA, 1355 San Pablo St., Los Angeles, CA, 90033, USA. ssadda@doheny.org.
Abstract
PURPOSE: To study the retinal capillary microvasculature and the choriocapillaris (CC) in myopic eyes using swept-source optical coherence tomography angiography (SS-OCTA). METHODS: Patients with high myopia (≥ - 6D; axial length ≥ 26.5 mm), moderate myopia (≥ - 3D, < - 6D), and age-matched healthy subjects presenting to the Shanghai General Hospital and Doheny-UCLA Eye Centers were enrolled in this prospective, multicenter study. Any subjects with evidence of macular abnormalities suggestive of pathologic myopia were excluded. SS-OCTA at both sites was performed using a Zeiss PLEX Elite instrument with a 6 × 6 mm scan pattern centered on the fovea. Two repeated volume scans were acquired for image averaging. The instrument pre-defined en face slab of the superficial and deep retinal capillary microvasculature was used to isolate and display the superficial and deep retinal capillaries. A slab spanning from 21 to 31 μm deep to the RPE fit line was used to isolate and display the CC. The OCTA images were exported for averaging using Image J. Littmann's method and the Bennett formula were applied to adjust for the impact of magnification in the high and moderate myopia groups. The resultant images were then binarized. Though projection artifact removal software was used, regions below the large superficial retinal vessels were excluded for quantitative analyses of the deep retinal capillary plexus and the CC. Vessel density (VD) and vessel length density (VLD) of the superficial and deep retinal capillary plexus (SCP, DCP) and CC flow deficit (FD) were analyzed, quantified, and compared between different groups. RESULTS: Twenty-five eyes of 25 patients with high myopia, 25 eyes of 25 patients with moderate myopia, and 25 eyes of 25 normal age-matched controls were included in this study. The VD of the SCP was lower in the high myopia group compared with the emmetropic control groups (p < 0.05), but the VD of the DCP demonstrated no significant difference among the three groups (p > 0.05). The VLDs of the SCP were lower in the high and moderate myopia groups compared with the control group (p < 0.05), while the VLD of the DCP was lower in the high myopia group compared with the moderate myopia and emmetropic control group (p < 0.05). The CC FD% in the high myopia group was significantly greater than both the control and moderate myopia subjects (p < 0.05). Of note, the severity of the CC flow deficit was not correlated with choroidal thickness (p > 0.05). CONCLUSION: The retinal microvasculature may demonstrate alterations in highly myopia eyes. The CC in macular regions shows greater impairment in eyes with high myopia compared with eyes with lesser degrees of myopia, and these deficits are already present in the absence of features of pathologic or degenerative myopia. The threshold of CC FD leading to myopic maculopathy remains to be defined.
PURPOSE: To study the retinal capillary microvasculature and the choriocapillaris (CC) in myopic eyes using swept-source optical coherence tomography angiography (SS-OCTA). METHODS:Patients with high myopia (≥ - 6D; axial length ≥ 26.5 mm), moderate myopia (≥ - 3D, < - 6D), and age-matched healthy subjects presenting to the Shanghai General Hospital and Doheny-UCLA Eye Centers were enrolled in this prospective, multicenter study. Any subjects with evidence of macular abnormalities suggestive of pathologic myopia were excluded. SS-OCTA at both sites was performed using a Zeiss PLEX Elite instrument with a 6 × 6 mm scan pattern centered on the fovea. Two repeated volume scans were acquired for image averaging. The instrument pre-defined en face slab of the superficial and deep retinal capillary microvasculature was used to isolate and display the superficial and deep retinal capillaries. A slab spanning from 21 to 31 μm deep to the RPE fit line was used to isolate and display the CC. The OCTA images were exported for averaging using Image J. Littmann's method and the Bennett formula were applied to adjust for the impact of magnification in the high and moderate myopia groups. The resultant images were then binarized. Though projection artifact removal software was used, regions below the large superficial retinal vessels were excluded for quantitative analyses of the deep retinal capillary plexus and the CC. Vessel density (VD) and vessel length density (VLD) of the superficial and deep retinal capillary plexus (SCP, DCP) and CC flow deficit (FD) were analyzed, quantified, and compared between different groups. RESULTS: Twenty-five eyes of 25 patients with high myopia, 25 eyes of 25 patients with moderate myopia, and 25 eyes of 25 normal age-matched controls were included in this study. The VD of the SCP was lower in the high myopia group compared with the emmetropic control groups (p < 0.05), but the VD of the DCP demonstrated no significant difference among the three groups (p > 0.05). The VLDs of the SCP were lower in the high and moderate myopia groups compared with the control group (p < 0.05), while the VLD of the DCP was lower in the high myopia group compared with the moderate myopia and emmetropic control group (p < 0.05). The CC FD% in the high myopia group was significantly greater than both the control and moderate myopia subjects (p < 0.05). Of note, the severity of the CC flow deficit was not correlated with choroidal thickness (p > 0.05). CONCLUSION: The retinal microvasculature may demonstrate alterations in highly myopia eyes. The CC in macular regions shows greater impairment in eyes with high myopia compared with eyes with lesser degrees of myopia, and these deficits are already present in the absence of features of pathologic or degenerative myopia. The threshold of CC FD leading to myopic maculopathy remains to be defined.
Authors: Yong Li; Feihui Zheng; Li Lian Foo; Qiu Ying Wong; Daniel Ting; Quan V Hoang; Rachel Chong; Marcus Ang; Chee Wai Wong Journal: Diagnostics (Basel) Date: 2022-06-08
Authors: Li Su; Benjamin R Lin; Fei Lin; Ilene K Tsui; Stephanie L Gaw; Carla Janzen; SriniVas R Sadda; Irena Tsui Journal: Transl Vis Sci Technol Date: 2020-12-03 Impact factor: 3.283
Authors: Li Su; Wongsiri Taweebanjongsin; Stephanie L Gaw; Gilad Rabina; SriniVas R Sadda; Irena Tsui Journal: Transl Vis Sci Technol Date: 2020-08-13 Impact factor: 3.283