​​OCT-A Reveals Enlarged FAZ, Reduced Vessel Density in High Myopic Eyes

The authors suggest that these findings enhance the understanding of myopia-related fundus microvascular changes and highlight the clinical value of routine OCT-A examinations for screening and early detection of complications in highly myopic patients. Photo: Steven Ferrucci, OD. Click image to enlarge. In a recent study, researchers sought to evaluate changes in retinal and choroidal microvasculature with increasing myopia severity using OCT-A. They found an enlargement of the foveal avascular zone (FAZ) area in high myopia eyes, as well as significant reductions in parafoveal and perifoveal vessel density. The findings were reported in Ophthalmology Science.The study analyzed 47 studies (7,293 eyes) using OCT-A measurements on retinal and/or choroidal changes across different myopia severities. Included were the cross-sectional or prospective case-control and cohort designs that reported outcomes of FAZ area and vessel densities in the retina and choroid.Highly myopic eyes showed a significantly enlarged FAZ area in both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) compared to emmetropic eyes.Macular vessel density was significantly reduced in the SCP for moderate and high myopia. Significant reductions were also observed in parafoveal and perifoveal regions in the high myopia subgroup, which could be attributed to axial elongation associated with worsening myopia.Peripapillary vessel density showed reductions across mild, moderate and high myopia subgroups. This is consistent with prior studies, which have suggested that axial elongation in myopic eyes leads to mechanical stretching and thinning of the peripapillary region, causing impaired perfusion and reduced vessel density, the authors wrote in their paper, and added that these changes may contribute to the increased risk of glaucoma in highly myopic individuals.These findings underscore the importance of OCT-A screening in managing high myopic patients to facilitate early interventions to slow down or prevent the development of myopia-related pathological fundus complications, the authors concluded.Click here for the journal source. Lin ZX, Tang F, Zhang XJ, et al. Retinal and choroidal microvasculature at different myopia severities: a systemic review and meta-analysis. Ophthalmol Sci. August 12, 2025. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.