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Jie Ye, YiLei Shao, Meixiao Shen, Fan Lu; Atrophy of choroid could be crucial in the development of myopic macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1539.
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© ARVO (1962-2015); The Authors (2016-present)
The relative contribution of retina and choroid to the pathogenesis of myopic macular degeneration (MMD) is unclear. In order to clarify it, the association of choroidal vasculature, retinal microstructure, and retinal microvascular network with MMD were investigated.
Prospective research. Thirty-two eyes of 23 patients with high myopia (≤ -6.0D or axial length ≥ 26.5mm) were included. MMD was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification. OCT system (Optovue RTVue XR Avanti; Optovue, Inc., Fremont, CA, USA) with a custom automated algorithm software was used to measure choroidal thickness (CT), retinal thickness (RT), vascular densities of superficial and deep retinal capillary layers (SRCL and DRCL), which presented the choroidal vasculature, retinal microstructure and retinal microvascular network, respectively.
There were 19 eyes in category 1, 8 eyes in category 2 and 5 eyes in category 3. Correlation of MMD severity was significantly strong for CT (r = -0.830, p < 0.001), and significant but less strong for RT (r = -0.576, p < 0.001). The vascular density of SRCL was correlated with the MMD severity (r = -0.362, p = 0.032), however no significant correlation was found between the vascular density of DRCL and MMD severity (r = -0.161, p = 0.211). A stepwise multiple linear regression analysis to determine the explanatory variables most strongly associated with MMD among CT, RT and SRCL. CT (β = -0.658, p < 0.001) and RT (β = -0.311, p = 0.019) were the variables associated significantly with MMD, and SRCL wasn’t a significant predictor of MMD.
Among choroidal vasculature, retinal microstructure and retinal microvascular network, we demonstrated that choroidal vasculature has the strongest correlation with MMD severity. This suggested progressive atrophy of choroid may play a more important role in the development of MMD. OCT system could be a useful tool to differentiate MMD severity and clarify the mechanism of MMD.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1. Comparison of CT, RT, vascular densities of SRCL and DRCL with different MMD severity. CT and RT in the category 2 and category 3 were both thinner than in category 1. Vascular densities of SRCL and DRCL in the category 2 and category 3 were not significant lower than in category 1. *p < 0.05, **p < 0.001.
Figure 2. Representative images from OCT system in different MMD groups. Scale bar = 300μm.
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