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. 2021 Jul 1;62(9):40.
doi: 10.1167/iovs.62.9.40.

Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes

Hao Wu  1   2   3 , Zhu Xie  1   2   3 , Pengqi Wang  1   2   3 , Mengqi Liu  1   2   3 , Yuanyuan Wang  1   2   3 , Jiadi Zhu  1   2   3 , Xiangqin Chen  1   2   3 , Zhiqiang Xu  1   2   3 , Xinjie Mao  1   2   3 , Xiangtian Zhou  1   2   3   4
Affiliations

Differences in Retinal and Choroidal Vasculature and Perfusion Related to Axial Length in Pediatric Anisomyopes

Hao Wu et al. Invest Ophthalmol Vis Sci. .

Abstract

Purpose: The purpose of this study was to evaluate the interocular differences in choroidal vasculature, choriocapillaris perfusion, and retinal microvascular network, and to explore their associations with interocular asymmetry in axial lengths (ALs) in children with anisomyopia.

Methods: Refractive error, AL, and other biometric parameters were measured in 70 children with anisomyopia. Using optical coherence tomography (OCT) and OCT-angiography, we measured the submacular choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), choriocapillaris flow deficit (CcFD), retinal vessel density (VD), and foveal avascular zone (FAZ) area.

Results: The mean interocular differences in spherical equivalent refraction and AL were -2.26 ± 0.94 diopters and 0.95 ± 0.46 mm, respectively. Submacular ChT, TCA, LA, SA, and CVI were all significantly lower in the more myopic (longer AL) eyes than in the less myopic (shorter AL) fellow eyes. In eyes with longer ALs, both the CcFD and FAZ areas were significantly greater, whereas the superficial and deep retinal VDs were significantly less. After adjusting for corneal power and intraocular pressure, interocular differences in LA (β = -0.774), SA (β = -0.991), and CcFD (β = 0.040) were significantly associated with interocular asymmetry in AL (all P < 0.05).

Conclusions: In pediatric anisomyopes, eyes with longer ALs tended to have lower choroidal vascularity and choriocapillaris perfusion than the contralateral eyes with shorter ALs. Longitudinal investigations would be useful follow-ups to test for a causal role of choroidal circulation in human myopia.

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Conflict of interest statement

Disclosure: H. Wu, None; Z. Xie, None; P. Wang, None; M. Liu, None; Y. Wang, None; J. Zhu, None; X. Chen, None; Z. Xu, None; X. Mao, None; X. Zhou, None

Figures

Figure 1.
Figure 1.
Choroidal image binarization. (A) Original OCT B-scan in horizontal meridian. (B) Binarized image with outline of choroidal area. (C) Overlay of binarized choroidal area on original image.
Figure 2.
Figure 2.
En face angiography for retinal vascular network and choriocapillaris layer. (A) Segmentation of retinal vascular layers and choriocapillaris. En face images of (B) inner retina with outline of FAZ, (C) retinal SVC, (D) DVC, and (E) choriocapillaris. Vessel density analysis in the parafoveal region for en face images of SVC and DVC, respectively. Flow deficit analysis for the choriocapillaris in the 2.5-mm submacular region. FAZ, foveal avascular zone; SVC, superficial vascular complex; DVC, deep vascular complex.
Figure 3.
Figure 3.
Correlation of interocular difference in AL with those in choroidal and retinal parameters. (A) TCA_V, (B) LA_V, (C) SA_V, (D) TCA_H, (E) LA_H, (F) SA_H, (G) CVI_V, (H) CVI_H, (I) CcFD, (J) superficial retinal VD, (K) deep retinal VD, and (L) FAZ area. Those parameters with a significant correlation with AL were fitted with a regression line. _V, vertical meridian; _H, horizontal meridian. TCA, total choroidal area; LA, luminal area; SA, stromal area; CVI, choroidal vascularity index; CcFD, choriocapillaris flow deficits; VD, vessel density; FAZ, foveal avascular zone.
Figure 4.
Figure 4.
Scatter plots of the interocular differences in choroidal parameters at the corresponding vertical and horizontal meridians. (A) TCA, (B) LA, (C) SA, and (D) CVI. The dashed line (y = x) represents perfect symmetry between vertical (_V) and horizontal (_H) scan meridians. TCA, total choroidal area; LA, luminal area; SA, stromal area; CVI, choroidal vascularity index.
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