The purpose of this study was to evaluate the correlation between axial length (AL) and retinal oxygen dynamic parameters in adult patients. This was an observational cross-sectional study with 79 Chinese adults with myopia aged 18 to 37 years. All participants underwent AL measurements, cycloplegic refraction, and other ophthalmic examinations. Additionally, the retinal oxygen kinetics imaging and analysis (ROKIA) system was utilized to obtain the retinal oxygen dynamic parameters of all patients. Simple and multiple linear regression tests were used to assess the correlation between various oxygen dynamic parameters and AL. The mean age, AL, and spherical equivalent (SE) of subjects were 26.32 ± 5.4 years, 25.78 ± 1.06 mm, and -5.13 ± 2.1 diopters (D), respectively. The Pearson correlation coefficients among AL and retinal oxygen delivery (DO2) and retinal oxygen metabolism (MO2) were -0.44 (95% confidence interval = -0.24 to -0.60, P < 0.001), -0.26 (95% confidence interval = -0.04 to -0.46, P = 0.02), respectively. The group with high myopia exhibited lower DO2 and higher oxygen extraction fraction (OEF) compared with the group with moderate myopia, and no significant difference was observed in MO2 between the two groups. In multivariate analyses adjusting for age, sex, intraocular pressure (IOP), and anterior chamber depth (ACD), a longer AL was significantly associated with decreased DO2 (standardized regression coefficient B = -0.47, P < 0.001). Retinal oxygen dynamic parameters, including DO2 and MO2, were decreased with longer AL in myopic eyes. Patients with high myopia demonstrated an elevated OEF than those with moderate myopia. This study demonstrated that the retinal oxygen metabolism changes in myopia, as confirmed using a novel device that quantifies retinal oxygen dynamic parameters and provides a new monitoring approach for other hypoxic retinal diseases.
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