Abstract:Objective: To use optical coherence tomography angiography (OCTA) to analyze the characteristics of the peripapillary nerve fiber layer thickness and vessel density and their correlation. Method: Ninety myopic patients (90 eyes) in the Eye Hospital, Wenzhou Medical University from October 2020 to December 2020 were enrolled in this case series study. Patients were divided into three groups based on spherical equivalent (SE): 27 eyes in the control group (-3.00 D SE +0.75 D), 34 eyes in the high myopia group (-9.00 D SE<-6.00 D) and 29 eyes in the extreme high myopia group (SE -9.00 D). The average peripapillary retinal nerve fiber layer and radial peripapillary capillary vessel density and the superior temporal, temporal superior, superior nasal, nasal superior, nasal inferior, inferior nasal, inferior temporal and temporal inferior quadrants around the optic disc were analyzed by OCTA before and after ocular magnification. The differences in the radial peripapillary capillary vessel density (RPC VD) and peripapillary retinal nerve fiber layer (pRNFL) among the 3 groups were compared by one-way analysis of variance or nonparametric analysis. The correlations among RPC VD, pRNFL, axial length, and SE were analyzed by Spearman or Pearson correlation analysis. Results: Before ocular magnification, the superior and inferior temporal pRNFL became thicker, while the inferior nasal pRNFL became thinner (H=14.75, P=0.001; H=11.20, P<0.001; F=11.30, P<0.001) and the nasal superior and nasal inferior RPC VD decreased in the high myopia group (H=6.82, P=0.033; H=10.90, P=0.004) compared with the control group. The average temporal superior, superior nasal, nasal superior, nasal inferior, inferior nasal and temporal inferior pRNFL are positively correlated with RPC VD (r=0.29, 0.25, 0.35, 0.44, 0.50, 0.40, 0.48, all P<0.05). After ocular magnification, the average pRNFL and RPC VD increased with an increase in axial length (r=0.40, P<0.001; r=0.63, P<0.001) and a decrease in SE (r=-0.29, P=0.006; r=-0.48, P<0.001). pRNFL and RPC VD showed a significant positive correlation on average, superior temporal, temporal superior, superior nasal, nasal superior, nasal inferior, inferior nasal, inferior temporal and temporal inferior quadrants (r=0.48, 0.40, 0.58, 0.38, 0.47, 0.57, 0.29, 0.43, 0.56, all P<0.05). Conclusion: In patients with high myopia, RPC VD and pRNFL increase in the superior and inferior temporal quadrants and decrease in the inferior nasal, nasal superior and nasal inferior quadrants before ocular magnification and increase on average after ocular magnification.
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