Quantitative OCT Angiography of the Retinal Microvasculature and the Choriocapillaris in Myopic Eyes.

Purpose To study the retinal capillary microvasculature and the choriocapillaris (CC) in myopic eyes using quantitative optical coherence tomography angiography (OCTA) analysis. Methods Macular OCTA images of 3 × 3 mm were obtained using the RTVue-XR Avanti with AngioVue. Quantitative measurements of the retinal capillary microvascular layers and the CC were analyzed using en face projection images. Vessel density and fractal dimension of the superficial and deep retinal capillary plexus, and area and density of flow reduction in the CC were analyzed, quantified, and compared with an age-matched control group. Results Fifty eyes with myopia and 34 age-matched healthy eyes were included in this study. The vessel density and the vessel branching complexity using fractal dimension of the retinal capillary microvasculature were significantly lower in myopic eyes (P < 0.001 and P = 0.001). The total number of flow voids in the CC was lower (108.93 vs. 138.63, P = 0.001) but the total and average flow void area was significantly higher (total area 3.715 ± 0.257 vs. 3.596 ± 0.194 mm2, P = 0.026; average area 0.044 ± 0.029 vs. 0.028 ± 0.010 mm2, P = 0.002) compared with the healthy control group. Average choroidal thickness was lower in the myopic group versus the normal control cohort (123.538 ± 73.477 vs. 246.97 ± 41.745 μm, P < 0.05) and significantly reduced in eyes with lacquer cracks (LC) compared with myopic eyes without LC formation (P = 0.003). There was no correlation between choroidal thickness and quantitative parameters of the CC in the myopic eyes. Conclusions The density of the retinal capillary microvasculature is reduced and the area of flow deficit in the CC is increased in eyes with greater myopia. The relevance of microvascular alterations in the setting of myopia warrants further study.

[1]  T. Ozdemir,et al.  Choroidal and retinal blood flow changes in degenerative myopia. , 1996, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[2]  D. Broadway,et al.  Ocular blood flow measurements in healthy human myopic eyes , 2010, Graefe's Archive for Clinical and Experimental Ophthalmology.

[3]  C. Cheung,et al.  Regional variations in the relationship between macular thickness measurements and myopia. , 2007, Investigative ophthalmology & visual science.

[4]  N. Phansalkar,et al.  Adaptive local thresholding for detection of nuclei in diversity stained cytology images , 2011, 2011 International Conference on Communications and Signal Processing.

[5]  J. Fujimoto,et al.  IMAGE ARTIFACTS IN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY , 2015, Retina.

[6]  I. Morita,et al.  Topographic analyses of shape of eyes with pathologic myopia by high-resolution three-dimensional magnetic resonance imaging. , 2011, Ophthalmology.

[7]  Stephen E. Smith,et al.  Factors influencing the ocular pulse — axial length , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[8]  E. Rahimy,et al.  Grading of posterior staphyloma with spectral-domain optical coherence tomography and correlation with macular disease. , 2013, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[9]  T. Tokoro,et al.  On the definition of pathologic myopia in group studies , 1988, Acta ophthalmologica. Supplement.

[10]  K. Ohno-Matsui,et al.  THE PROGRESSION OF LACQUER CRACKS IN PATHOLOGIC MYOPIA , 1996, Retina.

[11]  R. Linsenmeier,et al.  The electroretinogram and choroidal PO2 in the cat during elevated intraocular pressure. , 1988, Investigative ophthalmology & visual science.

[12]  Jianhua Wang,et al.  Retinal Microvasculature Alteration in High Myopia. , 2016, Investigative ophthalmology & visual science.

[13]  C. Chen,et al.  Assessment of macular retinal thickness and volume in normal eyes and highly myopic eyes with third-generation optical coherence tomography , 2008, Eye.

[14]  Yasushi Ikuno,et al.  3-D Choroidal Thickness Maps from EDI-OCT in Highly Myopic Eyes , 2013, Optometry and vision science : official publication of the American Academy of Optometry.

[15]  M. Mochizuki,et al.  Reduction of retinal blood flow in high myopia , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[16]  Kyoko Ohno-Matsui,et al.  WHAT IS THE FUNDAMENTAL NATURE OF PATHOLOGIC MYOPIA? , 2017, Retina.

[17]  Rosa Dolz-Marco,et al.  Fractal Dimensional Analysis of Optical Coherence Tomography Angiography in Eyes With Diabetic Retinopathy. , 2016, Investigative ophthalmology & visual science.

[18]  S. Uzun,et al.  Vascular Density in Retina and Choriocapillaris as Measured by Optical Coherence Tomography Angiography. , 2016, American journal of ophthalmology.

[19]  G. Querques,et al.  Static characteristics and dynamic functionality of retinal vessels in longer eyes with or without pathologic myopia , 2016, Graefe's Archive for Clinical and Experimental Ophthalmology.

[20]  Brian T. Soetikno,et al.  Choriocapillaris Nonperfusion is Associated With Poor Visual Acuity in Eyes With Reticular Pseudodrusen. , 2017, American journal of ophthalmology.

[21]  R. Spaide Choriocapillaris Flow Features Follow a Power Law Distribution: Implications for Characterization and Mechanisms of Disease Progression. , 2016, American journal of ophthalmology.

[22]  Mayank Bansal,et al.  Optical Coherence Tomography Angiography of Type 1 Neovascularization in Age-Related Macular Degeneration. , 2015, American journal of ophthalmology.

[23]  D. Sarraf,et al.  OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF A29 BIRDSHOT CHORIORETINOPATHY COMPLICATED BY RETINAL NEOVASCULARIZATION , 2017, Retinal cases & brief reports.

[24]  Y. Tano,et al.  LACQUER CRACK FORMATION AND CHOROIDAL NEOVASCULARIZATION IN PATHOLOGIC MYOPIA , 2008, Retina.

[25]  S. Sadda,et al.  A Promising Future for Optical Coherence Tomography Angiography. , 2015, JAMA ophthalmology.

[26]  Tien Yin Wong,et al.  Choroidal thickness and high myopia: a case–control study of young Chinese men in Singapore , 2015, Acta ophthalmologica.

[27]  Jay S Duker,et al.  The relationship between axial length and choroidal thickness in eyes with high myopia. , 2013, American journal of ophthalmology.

[28]  Peter Heiduschka,et al.  Exploring choriocapillaris under reticular pseudodrusen using OCT-Angiography , 2016, Graefe's Archive for Clinical and Experimental Ophthalmology.

[29]  Kevin W Eliceiri,et al.  NIH Image to ImageJ: 25 years of image analysis , 2012, Nature Methods.

[30]  James G. Fujimoto,et al.  Motion correction in optical coherence tomography volumes on a per A-scan basis using orthogonal scan patterns , 2012, Biomedical optics express.

[31]  D. Karlin,et al.  Axial length measurements and fundus changes of the myopic eye. , 1971, American journal of ophthalmology.

[32]  Mayss Al-Sheikh,et al.  Swept-Source OCT Angiography Imaging of the Foveal Avascular Zone and Macular Capillary Network Density in Diabetic Retinopathy. , 2016, Investigative ophthalmology & visual science.

[33]  D. Sarraf,et al.  Retinal Capillary Density and Foveal Avascular Zone Area Are Age-Dependent: Quantitative Analysis Using Optical Coherence Tomography Angiography. , 2016, Investigative ophthalmology & visual science.

[34]  A. Negi,et al.  Morphological changes of choriocapillaris in experimentally induced chick myopia , 1998, Graefe's Archive for Clinical and Experimental Ophthalmology.

[35]  E. Rahimy,et al.  Assessing Deep Retinal Capillary Ischemia in Paracentral Acute Middle Maculopathy by Optical Coherence Tomography Angiography. , 2016, American journal of ophthalmology.

[36]  Martin F. Kraus,et al.  Split-spectrum amplitude-decorrelation angiography with optical coherence tomography , 2012, Optics express.

[37]  James G. Fujimoto,et al.  Quantitative 3D-OCT motion correction with tilt and illumination correction, robust similarity measure and regularization , 2014, Biomedical optics express.

[38]  B. Masters,et al.  Fractal analysis of the vascular tree in the human retina. , 2004, Annual review of biomedical engineering.

[39]  R D Sperduto,et al.  Prevalence of myopia in the United States. , 1983, Archives of ophthalmology.

[40]  R. Spaide,et al.  Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. , 2015, JAMA ophthalmology.

[41]  Yong Wang,et al.  Choroidal thickness and high myopia: a cross-sectional study and meta-analysis , 2015, BMC Ophthalmology.

[42]  K Bailey Freund,et al.  Optical Coherence Tomography Angiography Reveals Choriocapillaris Flow Reduction in Placoid Chorioretinitis. , 2017, Ophthalmology. Retina.

[43]  Paul D. Gamlin,et al.  Reduction in choroidal blood flow occurs in chicks wearing goggles that induce eye growth toward myopia. , 1993, Current eye research.