Superficial Retinal Vessel Density and Ganglion Cell Complex Parameters in Myopic Children

Abstract

Background: Myopia is a major cause of visual impairment worldwide, with severe cases leading to blindness. Its progression, driven by genetic and environmental factors, involves axial elongation that induces retinal structural changes and reduced perfusion, potentially causing myopic chorioretinopathy. Optical coherence tomography angiography (OCTA) enables simultaneous assessment of retinal vascular and neural parameters, making it valuable for investigating the relationship between superficial retinal vessel density, ganglion cell complex thickness, and axial length in myopic children aged 7–16 years. Objectives: This study aims to determine the correlation between ganglion cell complex (GCC) parameters and superficial retinal vessel density (SRVD), as well as their association with axial length, in myopic children using optical coherence tomography angiography (OCTA). Methods: A total of 136 eyes were evaluated: 40 eyes from 20 emmetropic children (control group) and 96 eyes from 48 myopic children. Myopia was defined as spherical equivalent < −1.0 D; emmetropia as +0.5 to −0.5 D. Mean axial length (AL) was 24.58 mm in the myopic group vs. 22.88 mm in controls. Participants aged 7–18 years underwent ophthalmologic exams. GCC thickness and retinal vessel density were measured with SS-OCTA DRI Triton (Topcon, Tokyo), and axial length by ultrasound biometry. Results: Control eyes had significantly higher total and parafoveal SRVD than myopic eyes. A significant correlation was observed between spherical equivalent, age, and SRVD in the myopic group, but not in the emmetropic group. The GCC layer was significantly thinner in high myopia compared to low/moderate myopia and emmetropia. Conclusions: SS-OCTA revealed a strong relationship between AL, GCC thickness, and SRVD in myopic children, suggesting reduced perfusion and neural thinning in this population.