![]() However, further evidence of vascular change in the choroidal level is limited. also described a lower retinal vessel density and a larger foveal avascular zone in high myopia. found that the density of both superficial and deep microvascular plexuses dropped remarkably in highly myopic patients with normal visual ability before irreversible retinal damage. Previous studies have suggested that high myopia is associated with decreased blood supply. While improved strategies-such as the use of atropine or anti-hypoxia drugs, wearable optical devices, surgical management, and orthokeratology, for example-have been employed to intervene early in and limit myopia progression, the exact pathological mechanism of the myopia of the human eye remains elusive, hindering the development of successful treatment and the reduction in the burden of disease. Accordingly, there has been a push to better control the onset and worsening of myopia and to place this public health problem high on the agenda. With the increase in refractive error and axial length (AL), the risk of adverse ocular tissue alterations-including posterior staphyloma, retinoschisis, retinal detachment, choroidal/scleral thinning, lacquer crack formation, myopic choroidal neovascularization, and glaucoma –increases dramatically, especially in populations with high levels of myopia. Myopia, the major cause of vision impairment and the second most common cause of blindness, affects nearly two billion people (28.3% of the global population), which includes 277 million people (4.0% of the global population) with high myopia. In this disorder, OCTA is important for characterizing the underlying pathophysiological adaptations. (4) Conclusions: This study found that MvDs represent choroidal microvascular alterations in young-adult high myopes, which were correlated with age, SE, AL, and the PPA-β zone. Linear regression analysis showed that the MvD area correlated with age, SE, AL, and the PPA-β area (all p < 0.05). 0.089 ± 0.082 mm 2, p < 0.001) compared with mildly to moderately myopic eyes, and a lower average density in the choriocapillaris. Highly myopic eyes exhibited a significantly greater area for the PPA-β zone (1.221 ± 0.073 vs. (3) Results: The MvD was identified in 195 eyes (95.1%). The area of MvD and the PPA-β zone, spherical equivalent (SE), and axial length (AL) were collected and compared across groups. The choroidal vascular network was imaged using OCTA, and the images underwent manual adjustments to determine the peripapillary atrophy (PPA)-β zone and microvascular dropout (MvD). (2) Methods: This cross-sectional control study included 205 young adults’ eyes (95 with high myopia and 110 with mild to moderate myopia). Here, we used optical coherence tomography angiography (OCTA) to explore factors involved in these alterations. (1) Background: The microstructural alterations of the peripapillary choriocapillaris in high myopes remain elusive.
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