The Deep Vascular Plexus Density Is Closely Related to Myopic Severity

<b><i>Objectives:</i></b> The aim of the study was to investigate the relationship between myopic severity and the retinal microvasculature based on quantitative variables using optical coherence tomography angiography (OCTA) and to identify OCTA indicators of microvascular network loss in myopia. <b><i>Methods:</i></b> This cross-sectional study included 123 eyes of 123 myopic subjects. The included eyes were divided into three groups according to the spherical equivalent (SE) and axial length (AL): low myopia (LM) (−3.00 D ≤ SE ≤ −0.50 D), moderate myopia (MM) (−6.00 D ≤ SE &#x3c; −3.00 D), and high myopia (HM) (−9.00 D ≤ SE &#x3c; −6.00 D or AL &#x3e;26 mm). All the eyes underwent OCTA scans. The densities and thicknesses of the macular and peripapillary zones, including the foveal avascular zone (FAZ) area, superficial vascular plexus (SVP) density, deep vascular plexus (DVP) density, ganglion cell complex (GCC) thickness, full retinal thickness, radial peripapillary capillary plexus (RPCP) density, and retinal nerve fiber layer (RNFL) thickness, were automatically exported. <b><i>Results:</i></b> Compared to the LM or MM group, the HM group had a significantly reduced FAZ area (<i>p</i> &#x3c; 0.05). In most sectors of the parafoveal and perifoveal areas, the HM group had significantly lower DVP density and higher retinal thickness than the LM and MM groups (all <i>p</i> &#x3c; 0.05). However, significant differences among the three groups in only one or several sectors were observed with regard to SVP density, GCC thickness, and RNFL thickness, and no significant differences among the three groups in any sector were noticed in RPCP density. Perifoveal DVP density and perifoveal full retinal thickness were positively associated with SE and negatively associated with AL in stepwise multiple linear regression analyses adjusted for sex and age. <b><i>Conclusion:</i></b> DVP density was closely related to myopic severity. Reduced perifoveal DVP density may serve as an indicator of microvascular network loss in myopia. OCTA may provide useful and crucial information for monitoring the progression of myopia.