Quantification of Macular and Peripapillary Vascular Density in Myopia Using Optical Coherence Tomography Angiography

Background: Myopia is a leading cause of correctable visual impairment worldwide, with its prevalence rapidly increasing, particularly in Asia. High myopia (spherical equivalent > -6.00 D) is associated with structural ocular complications that can result in permanent visual loss. Optical coherence tomography angiography (OCTA) allows non-invasive, high-resolution evaluation of retinal and peripapillary vascular changes in myopic eyes. This study aimed to evaluate macular and peripapillary vessel density changes among myopic adults using OCTA and identify associated factors. Methods: A prospective cross-sectional study was conducted from December 2023 to April 2024 involving 60 eyes of myopic adults (18-42 years) at an eye clinic center. Participants were grouped by myopia severity: mild, moderate, and high. OCTA was used to measure vessel density in five macular and peripapillary regions. Statistical analysis included ANOVA and Pearson's correlation. Results: Significant reductions in macular and peripapillary vessel densities were observed in high myopia, particularly in nasal and temporal areas (p<0.0001). Vessel density correlated positively with spherical equivalent and negatively with axial length. Conclusion: Vascular alterations increase with myopia severity. OCTA is a valuable tool in detecting early microvascular changes, emphasizing its role in the monitoring and management of myopic progression.