Is the Retinal Vasculature Related to β-Peripapillary Atrophy in Nonpathological High Myopia? An Optical Coherence Tomography Angiography Study in Chinese Adults

PURPOSE: The association between β-peripapillary atrophy and the retinal vasculature in nonpathological high myopia is unclear. The aim of this study is to investigate whether β-peripapillary atrophy contribute to the changes of the retinal vasculature using optical coherence tomography angiography. METHODS: In a cross-sectional study, one hundred and thirty eyes with nonpathological high myopia were included. β-peripapillary atrophy was analysed using Image J software based on fundus photographs. A 3.0 × 3.0 mm(2) grid and a 4.5 × 4.5 mm(2) grid were used to scan parafoveal and peripapillary regions using optical coherence tomography angiography, respectively. Vessel density and fractal dimensions of the retina and foveal avascular zone were analysed and quantified using en face projection images. Correlations between the vascular density, foveal avascular zone, and β-peripapillary atrophy were determined. RESULTS: Using multivariate analysis, β-peripapillary atrophy was negatively correlated with the vessel density in radial peripapillary capillaries (p=0.002) even after adjusting for other variables. This relationship was also confirmed in the macula (superficial retinal plexus: p < 0.05; deep retinal plexus: p < 0.05). The vessel densities in the nasal and inferior sectors were more strongly correlated with β-peripapillary atrophy. CONCLUSIONS: There was a negative correlation between β-peripapillary atrophy and the retinal vasculature in highly myopic eyes, especially in radial peripapillary capillaries and deep retinal plexus. β-peripapillary atrophy can be visualized and is a convenient structural feature that can benefit the early diagnosis and detection of chorioretinal atrophy in high myopia.