Retinal Artery Angles in High Axial Myopia and Its Relationship With Visual Function

PURPOSE: To evaluate the retinal artery angles in high axial myopia and assess the correlation with other morphometric and functional parameters. METHODS: This cross-sectional study included 112 eyes of 112 patients with high axial myopia. Based on axial length (AL), the participants were divided into three groups: group 1 (26 ≤ AL < 28 mm), group 2 (28 ≤ AL < 31 mm), and group 3 (≥31 mm). Scanning laser ophthalmoscopy imaging was used to analyze the retinal artery angle (Yugami correlated angle [YCA]). Retinal vascular densities (VDs) in both superficial capillary plexuses (SCPs) and deep capillary plexuses were evaluated. Fixation behavior, including retinal mean sensitivity (MS), macular fovea 2°, 4° fixation rate (P1, P2), and 68.2% bivariate contour ellipse area, were analyzed by microperimetry. Finally, the correlation between YCAs and AL, VDs, best-corrected visual acuity (BCVA), and fixation behavior was assessed. RESULTS: The YCAs showed significant differences among the three groups (all P < 0.001, respectively). Compared to group 1, the YCA decreased in group 2 (P < 0.001) and continued to decrease in group 3 (P = 0.043). The correlation analysis revealed that smaller YCAs (YCA, YCA(1/2), YCA(1/4)) were positively correlated with the longer AL (ρ = 0.580, 0.545, 0.448, P < 0.001) and lower VDs in any sector in SCPs (all P ≤ 0.05). Furthermore, smaller YCAs were positively correlated with decreased BCVA (ρ = 0.392, 0.387, 0.262; all P < 0.001) and reduced MS (ρ= 0.300, 0.269, 0.244; all P < 0.05). CONCLUSIONS: Smaller YCAs were correlated with longer AL, lower VD in SCP, decreased BCVA, and reduced MS. The YCAs might reflect vascular deformation caused by axial elongation and could potentially be useful in predicting visual function in high axial myopia. TRANSLATIONAL RELEVANCE: The quantitative analysis of YCAs in fundus photography holds potential clinical value in predicting visual function in high axial myopia.