The Importance of Optical Coherence Tomography Angiography in the Detection and Analysis of Microvascular Changes in the Optic Disc and Macula in Patients with Myopia

[M. D. Veselinović]

163 list.

Biografija autora: list 163 Bibliografija: list. 142-158

Ophthalmology

In recent decades, there has been a marked increase in the prevalence of myopia, which today represents one of the leading causes of visual impairment globally. High myopia carries a particular risk of developing irreversible pathological changes affecting the retina and optic disc. The introduction of optical coherence tomography (OCT) and its angiographic variant (OCT-A) has enabled noninvasive, quantitative, and layer-specific analysis of microvascular and structural changes that accompany the progression of myopia, which is of critical importance for the early identification of high-risk patients. In this prospective observational study, a total of 260 eyes from 130 participants were analyzed. Based on spherical equivalent and axial length, subjects were classified into four diagnostic groups: emmetropia, low, moderate, and high myopia. Using OCT and OCT-A technology, multiple parameters were assessed, including axial length, central foveal thickness (CFD), retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), superficial and deep vascular densities (SVD, DVD), foveal avascular zone (FAZ) area, peripapillary vascular density (PVD), and the Flow Index (FI). The results showed a progressive increase in axial length and a simultaneous reduction in CFD, RNFL, and GCC in correlation with increasing refractive error. The most pronounced differences were observed in the superior and perifoveal regions. Vascular densities showed a consistent decline across most sectors, with significant reductions in the peritemporal, perisuperior, and paranasal zones. The FAZ area increased proportionally with the degree of myopia, while PVD and FI decreased markedly in high myopia patients. Correlation and regression analyses demonstrated strong associations between vascular and structural parameters, especially in the parafoveal regions. Multivariate models confirmed the predictive value of combined SVD, DVD, and retinal layer measurements in estimating central foveal thickness, depending on the patient group. The findings indicate that microvascular alterations precede overt structural damage and may serve as early biomarkers of myopia progression. The integration of quantitative OCT and OCT-A parameters provides a valuable tool for early detection of high-risk individuals and supports individualized monitoring strategies, ultimately contributing to the preservation of visual function.

Miopija; Optička koherentna tomografija sa angiografijom (OCT-A); Vaskularna gustina; Retinalna struktura; Mikrocirkulacija; Optička koherentna tomografija (OCT)

Myopia; Optical coherence tomography angiography (OCT-A); Vascular density; Retinal structure; Microcirculation; Optical coherence tomography (OCT)

617.735-001.15-073(034.3)

B620 Ophthalmology

Tekst