Abstract
Purpose :
To investigate the association of myopia progression with retinal microvasculature among school children.
Methods :
This prospective study included a total of 952 children with 1106 eyes. All participants underwent thorough physical and ophthalmic examinations at baseline and follow-up for 3 years. Macular images of the superficial (SCP) and deep capillary plexus (DCP) were acquired by optical coherence tomography angiography (OCT-A) and then quantified by a customized automated image analysis program. Rapid myopia progression was defined as spherical equivalent (SE) progression ≥ -0.5 Diopter per year or as axial length (AL) elongation ≥ 0.36 mm per year. Logistic regression analysis estimated the impacts of baseline OCT-A metrics on rapid myopia progression. Univariate and multivariate linear regression analyses evaluated the association of the annual myopia progression with baseline OCT-A metrics. Generalized estimating equation (GEE) adjusted for eye correlation to allow the analysis of both eyes of a subject.
Results :
The included subjects had a mean SE of 0.11±1.51 D and mean AL of 23.17±0.93 mm at baseline. During follow-up, 19.3% of eyes had rapid AL elongation and 29.5% had rapid SE progression. After adjusting for covariates, logistic regression analysis showed rapid AL elongation was associated with lower baseline foveal avascular zone (FAZ) circularity (OR=0.42 [95% CI 0.18 to 0.97]; P<0.05). In multivariate linear regression analysis, decreased annual SE progression was associated with higher baseline FAZ circularity (β=0.19 [95% CI 0.05 to 0.32]; P<0.01). Increased annual AL elongation was associated with a larger baseline FAZ area (β=0.03 [95% CI 0.01 to 0.06]; P<0.05), larger baseline non-perfusion area (NPA) (β=0.06 [95% CI 0.01 to 0.10]; P<0.01), and larger baseline top 10 inter-capillary areas including FAZ (ICA10_IncFAZ) (β=0.03 [95% CI 0.01 to 0.05]; P<0.001) and excluding FAZ (ICA10_ExcFAZ) (β=0.03 [95% CI 0.01 to 0.04]; P<0.01), as well as a lower baseline FAZ circularity (β=-0.06 [95% CI -0.10 to -0.01]; P<0.05) and lower baseline vessel density(VD) (β=-0.13 [95% CI -0.24 to -0.03]; P<0.05) in the SCP.
Conclusions :
A larger FAZ area, larger NPA, lower VD and less FAZ circularity in the SCP are associated with faster myopia progression in children. These findings may help identify children at risk of rapid myopia progression and facilitate early intervention.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.