Vascular flow density in pathological myopia: an optical coherence tomography angiography study

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Abstract

Objectives

To investigate vascular flow density in pathological myopia with optical coherence tomography (OCT) angiography.

Design

A prospective comparative study was conducted from December 2015 to March 2016.

Setting

Participants were recruited in Beijing Tongren Hospital.

Participants

A total of 131 eyes were enrolled, which were divided into three groups: 45 eyes with emmetropia (EM; mean spherical equivalent (MSE) 0.50D to −0.50D), 41 eyes with high myopia (HM; MSE ≤−6.00D, without pathological changes), and 45 eyes with pathological myopia (PM; MSE ≤−6.00D and axial length (AL) ≥26.5 mm, and with pathological changes).

Main outcome measures

Macular, choriocapillaris and radial peripapillary capillary (RPC) flow densities were measured and compared between groups, and their relationships with AL and best corrected visual acuity (BCVA) were analysed.

Results

Significant differences were found in macular, choriocapillaris and RPC flow densities among the three groups (p<0.05). Multiple comparisons revealed that, compared with the EM and HM groups, macular and RPC flow densities of the PM group were significantly decreased (p<0.05), but no significant difference in choriocapillaris flow density was found between the PM and HM groups (p=0.731). Compared with the EM group, retinal flow density in the macular and arcuate fibre region was not decreased in the HM group. In addition, there was a negative correlation between AL and superficial macular flow density (β=−0.542, p<0.001), deep macular flow density (β=−0.282, p=0.002) and RPC flow density (β=−0.522, p<0.001); and a positive correlation between BCVA and superficial macular flow density (β=0.194, p=0.021), deep macular flow density (β=0.373, p<0.001), and choriocapillaris flow density (β=0.291, p=0.001).

Conclusions

Macular and RPC flow densities decreased in pathological myopia compared with high myopia and emmetropia. No significant decrease of retinal flow density in the macular and arcuate fibre region was found in high myopic eyes compared with emmetropic eyes. Moreover, macular and RPC flow densities were negatively related to AL, and macular flow density was positively related to BCVA.

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Most cited references 20

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Optical coherence tomography angiography of optic disc perfusion in glaucoma.

Yali Jia, Eric Wei, Xiaogang Wang … (2014)

To compare optic disc perfusion between normal subjects and subjects with glaucoma using optical coherence tomography (OCT) angiography and to detect optic disc perfusion changes in glaucoma.

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Updates of pathologic myopia.

Kyoko Ohno-Matsui, Timothy Lai, Chi-Chun Lai … (2016)

Complications from pathologic myopia are a major cause of visual impairment and blindness, especially in east Asia. The eyes with pathologic myopia may develop loss of the best-corrected vision due to various pathologies in the macula, peripheral retina and the optic nerve. Despite its importance, the definition of pathologic myopia has been inconsistent. The refractive error or axial length alone often does not adequately reflect the 'pathologic myopia'. Posterior staphyloma, which is a hallmark lesion of pathologic myopia, can occur also in non-highly myopic eyes. Recently a revised classification system for myopic maculopathy has been proposed to standardize the definition among epidemiological studies. In this META-PM (meta analyses of pathologic myopia) study classification, pathologic myopia was defined as the eyes having chorioretinal atrophy equal to or more severe than diffuse atrophy. In addition, the advent of new imaging technologies such as optical coherence tomography (OCT) and three dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to pathologic myopia. New therapeutic approaches including intravitreal injections of anti-vascular endothelial growth factor agents and the advance of vitreoretinal surgeries have greatly improved the prognosis of patients with pathologic myopia. The purpose of this review article is to provide an update on topics related to the field of pathologic myopia, and to outline the remaining issues which need to be solved in the future.

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Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study.

Liang Xu, Yaxing Wang, Yibin Li … (2006)

To evaluate the causes of visual impairment and blindness in adult Chinese in an urban and rural region of Beijing, China. Population-based prevalence survey. From a rural region and an urban region of Greater Beijing, 4439 of 5324 > or=40-year-old invited subjects participated in the study (response rate, 83.4%). Using the World Health Organization (WHO) standard and the United States standard, blindness was defined as best-corrected visual acuity (BCVA) in the better-seeing eye of or =20/400, and of or =2/20, respectively. Determination of BCVA, pneumotonometry, frequency doubling perimetry, evaluation of photographs of the fundus and lens, and clinical examination. Causes of visual impairment and blindness. Visual acuity measurements were available for 8816 eyes of 4409 subjects (99.3%). Using the WHO standard and the U.S. standard, 49 (1.1%) subjects and 95 (2.2%) subjects, respectively, had low vision, and 13 (0.3%) subjects and 15 (0.3%) subjects, respectively, were blind by definition. Taking the whole study population, the most frequent cause of low vision/blindness was cataract (36.7%/38.5%), followed by degenerative myopia (32.7%/7.7%), glaucoma (14.3%/7.7%), corneal opacity (6.1%/15.4%), and other optic nerve damage (2.0%/7.7%). Age-related macular degeneration (AMD) (2.0%/7.7%) and diabetic retinopathy (0%/7.7%) were responsible for a minority of cases. In subjects 40 to 49 years old, the most frequent cause of low vision and blindness was degenerative myopia. In the 50- to 59-year age group, the most frequent cause was cataract, followed by degenerative myopia. In the 60- to 69-year-old subjects and the > or =70-year group, the most frequent cause of low vision and blindness was cataract, followed by degenerative myopia and glaucoma. The most frequent cause of low vision and blindness in adult Chinese is cataract, followed by degenerative myopia and glaucomatous optic neuropathy, with degenerative myopia dominating in younger groups and cataract dominating in elder groups. In contrast to studies in Western countries, AMD and diabetic retinopathy appear to play a minor role as a cause of visual impairment in elderly Chinese.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2017

Publication date (Electronic): 3 February 2017

Volume: 7

Issue: 2

Electronic Location Identifier: e013571

Affiliations

[1 ]Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University , Beijing, China

[2 ]Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing, China

Author notes

[Correspondence to ] Professor Wenbin Wei; weiwenbintr@ 123456163.com

Article

Publisher ID: bmjopen-2016-013571

DOI: 10.1136/bmjopen-2016-013571

PMC ID: 5294002

PubMed ID: 28159853

SO-VID: 6cc7e2e2-ab8c-48cb-9104-3561d4aec97e

Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

License:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

History

Date received : 24 July 2016

Date revision received : 4 November 2016

Date accepted : 12 December 2016

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Vascular flow density in pathological myopia: an optical coherence tomography angiography study

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Abstract

Objectives

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Related collections

Vascular Biology

Most cited references 20

Optical coherence tomography angiography of optic disc perfusion in glaucoma.

Updates of pathologic myopia.

Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study.

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Cited by 57

Most referenced authors 246