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Correlation of the macular microvasculature to the axial length in pediatric patients with high axial refractive errors

Eye volume 38, pages 507–513 (2024)Cite this article

Subjects

Abstract

Aims

To compare the vascular density (VD) of the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC), and the foveal avascular zone (FAZ) among high hyperopic, high myopic, and emmetropic children using optical coherence tomography angiography (OCTA).

Methods

This was a cross sectional comparative study of otherwise healthy children with different refractive errors. Patients were recruited from Cairo University Children’s Hospital. OCTA imaging was performed using the RTVue XR Avanti device with AngioVue software. Both the 3 × 3 and 6 × 6 mm macular scans were utilized. Automated measurements were obtained from the built-in machine software. Axial length (AL) measurements were done using Lenstar LS 900 optical biometer.

Results

Ninety eyes from 51 healthy children were included. Among high myopes, there was significant thinning of the parafovea (p < 0.001). SCP-VD was also lower in high myopes in all areas except the fovea (all p < 0.001). The DCP-VD was significantly lower in high myopes in the parafovea and perifovea. High hyperopes had lower subfoveal CC-VD. Despite high myopes showing a significantly lower OCTA signal strength, linear regression analysis revealed that AL was an independent and significant predictor for the FAZ-area, as well as parafoveal and perifoveal SCP and DCP-VD.

Conclusion

High myopia results in a reduction of VD in both the SCP and DCP, which can be non-invasively detected and monitored using OCTA. While lower VD may, in part, be attributed to lower OCTA image quality, our findings demonstrate that AL independently and significantly predicts macular vascular parameters on OCTA in children.

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Data availability

Data is available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Asmaa Shuaib, Somaya A. Salem, Ayman G. Elnahry, Dalia A. Ghalwash & Ahmed A. Mohalhal

  2. Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA

    Ayman G. Elnahry

Authors
  1. Asmaa Shuaib
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  2. Somaya A. Salem
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  3. Ayman G. Elnahry
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  4. Dalia A. Ghalwash
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  5. Ahmed A. Mohalhal
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Contributions

AS, AGE, and AAM were responsible for the design of the study. AS, SAS, AGE, and DAG conducted the study. AS, AGE, and AAM analysed the data and interpreted the results. AS and AGE drafted the manuscript. DAG and AAM revised the manuscript. All authors read an approved the final version of the manuscript.

Corresponding author

Correspondence to Ayman G. Elnahry.

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The authors declare no competing interests.

Ethical approval

This report was approved by Cairo University research ethics committee (Approval ID: MS-130-2021) and followed the tenets of the Declaration of Helsinki.

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Shuaib, A., Salem, S.A., Elnahry, A.G. et al. Correlation of the macular microvasculature to the axial length in pediatric patients with high axial refractive errors. Eye 38, 507–513 (2024). https://doi.org/10.1038/s41433-023-02712-8

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