Abstract
Purpose The aim of this cross-sectional study was to characterize and compare the retinal vasculature and microstructure in patients with early dry-type myopic maculopathy. Methods Patients with a refractive error of less than −6 diopters were enrolled and classified into two groups. Group 1 comprised 82 eyes with a tessellated fundus, and group 2 comprised 56 eyes with diffuse chorioretinal atrophy (DCA). The clinical characteristics, refractive error, axial length, retinal vessel density of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), macular choroidal thickness, and best-corrected visual acuity (BCVA), were compared between the groups. Logistic regression was used to determine the protective and risk factors for DCA. Results Group 1 patients were significantly younger and had better BCVA, less myopia, and shorter axial length than group 2 patients. The vessel densities of the SCP and DCP, choroidal thickness, retinal nerve fiber layer thickness, ganglion cell complex thickness, and retinal thickness were reduced in group 2. Multiple logistic regression analysis revealed that the vessel densities of the SCP and DCP were protective factors for DCA. Conclusions The vessel density of the SCP had the highest diagnostic value (sensitivity = 78.0% and specificity = 96.6%). When the SCP vessel density was reduced to ≤49.98%, DCA was indicated. The retinal vessel densities of the SCP and DCP and parameters of the microstructure were reduced significantly in patients with DCA. Vessel density may be a better diagnostic indicator of the development of DCA.
Highlights
Myopic maculopathy is a major cause of irreversible visual impairment and blindness worldwide, in East Asia. e Beijing Eye Study [1] and Shihpai Eye Study [2] revealed that myopic maculopathy is the second most frequent cause of low vision and blindness in China, which is more prevalent than age-related macular degeneration (AMD)
In a new grading system for pathological myopia (META-PM classification), early dry-type myopia equates to tessellated fundus (category 1 (C1)) and diffuse chorioretinal atrophy (DCA) (category 2 (C2)) [4]. e appearance of tessellated fundus in the eye may act as a marker for determining visual performance, the degree of myopia, or the risk of myopia progression [5]
Maculopathy. e mean vessel densities in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were significantly greater in group 1 than in group 2 (P < 0.001 for both) (Table 2 and Figure 2)
Summary
Myopic maculopathy is a major cause of irreversible visual impairment and blindness worldwide, in East Asia. e Beijing Eye Study [1] and Shihpai Eye Study [2] revealed that myopic maculopathy is the second most frequent cause of low vision and blindness in China, which is more prevalent than age-related macular degeneration (AMD).Myopic maculopathy can be classified as either wet- or dry-type AMD depending on the presence or absence of choroidal neovascularization (CNV), respectively [3]. E Beijing Eye Study [1] and Shihpai Eye Study [2] revealed that myopic maculopathy is the second most frequent cause of low vision and blindness in China, which is more prevalent than age-related macular degeneration (AMD). In a new grading system for pathological myopia (META-PM classification), early dry-type myopia equates to tessellated fundus (category 1 (C1)) and diffuse chorioretinal atrophy (DCA) (category 2 (C2)) [4]. Myopic eyes with DCA have poorer BCVA and thinner macular choroidal thickness than eyes with a tessellated fundus [3]. A series of critical sight-threatening pathological consequences may appear due to DCA, such as lacquer cracks, CNV, patchy atrophy, and macular atrophy. Lacquer cracks, diffuse atrophy, and patchy atrophy at the initial examination may exhibit CNV development [6]. Lacquer cracks, diffuse atrophy, and patchy atrophy at the initial examination may exhibit CNV development [6]. erefore, the early detection of highly susceptible eyes among those with drytype myopic maculopathy is crucial
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