Optical coherence tomography angiography of superficial retinal vessel density and foveal avascular zone in myopic children

PURPOSE: To assess the superficial retinal vessel density (SRVD) and foveal avascular zone (FAZ) in myopic children using optical coherence tomography angiography (OCTA). METHODS: 174 eyes of 89 subjects with myopia and 101 eyes of 54 age-matched, emmetropic volunteers (control group) were enrolled in this study. The mean age of the subjects and controls was 13.9 (SD ± 2.3) and 13.1 (SD ± 2.4), respectively. Myopia was defined as spherical equivalent <– 1.0 diopter. Emmetropic subjects were defined as having spherical equivalent from + 0.5 to − 0.5 diopter. The mean axial length (AL) in myopic patients was 24.58 mm (SD ± 1.22) and 22.88 mm (SD ± 0.65) in the controls. Every patient underwent a complete ophthalmological examination and OCTA, using AngioVue (Optovue). The FAZ area and superficial retinal vessel density, including whole SRVD, fovea SRVD and parafovea SRVD, were analyzed. Foveal thickness (FT) and parafoveal thickness (PFT) were also taken into consideration. RESULTS: Whole SRVD, parafovea SRVD and PFT were significantly higher in controls than in the myopic subjects (p < 0.001, p = 0.007, p < 0.01, respectively). The FAZ area was significantly larger in the myopic group compared to the controls (p = 0.010). Fovea SRVD and FT did not differ significantly between the groups (p = 0.740, p = 0.795 respectively). In overall subjects we found significant correlation between axial length and all the investigative parameters: age, FAZ area, whole SRVD, parafovea SRVD, fovea SRVD, PFT, FT (p < 0.001, p = 0.014, p = 0.008, p < 0.005, p = 0.014, p = 0.010, p = 0.024, respectively). Analyzing only myopic group we confirmed that AL was significantly correlated with age, whole SRVD and parafovea SRVD (p < 0.001, p = 0.014, p = 0.009, respectively). Similarly, in this group the spherical equivalent also correlated with age, whole SRVD and parafovea SRVD (p < 0.001, p = 0.007, p = 0.005, respectively). Such correlations were not confirmed in the non–myopic group. CONCLUSIONS: Our results suggest that superficial retinal vessel density is decreased and FAZ area is enlarged in the entire group of the myopic children compared to emmetropic subjects. Longitudinal observation of these young patients is needed to determine the relevance of the microvascular alterations in future.