Subclinical Microvascular Deficits as a Promising Biomarker for Functional Impairment in Non-Pathological High Myopia: A Cross-Sectional Study

Qin Chen,1,* Jing Liu,1,* Wen Yan,2 Qingwei Meng,2,3 Xi Chen,1 Zhu Zeng,1 Ye Sheng,2 Hua Zhong2 1Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, People’s Republic of China; 2Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, People’s Republic of China; 3Department of Ophthalmology, HeiLongJiang Sengong Red Cross General Hospital, Harbin, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hua Zhong, Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, People’s Republic of China, Email [email protected] Qin Chen, Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, People’s Republic of China, Email [email protected]: Myopia causes retinal structural and microvascular alterations, impairing visual function. This study examined macular vessel density using optical coherence tomography angiography (OCTA) and its relationship with macular light sensitivity (MLS) in myopic eyes, particularly in extreme myopia, to determine if vessel density can serve as an early marker for detection and monitoring of functional changes.Patients and Methods: A cross-sectional study included 283 myopic eyes (age 18-60 years) grouped into low/moderate (LM&MM: − 0.50D ≥ SE > − 6.00D), high (HM: SE − 6.00D to − 10.00D), and extremely high myopia (EHM: SE ≤− 10.00D). All eyes underwent OCT and OCTA (6 × 6mm macular scans) to measure retinal and ganglion cell complex thicknesses and superficial (SVD) and deep vessel densities (DVD), as well as MP-1 microperimetry to assess MLS in central and parafoveal regions. Key outcome parameters were SVD, DVD, GCCT, and MLS.Results: Macular SVD, DVD, and MLS decreased with increasing myopia severity (p