Changes of retinal vessel density in low to moderate myopic eyes with orthokeratology evaluated by optical coherence tomography angiography

AIM:To explore the effect of orthokeratology(OK)fitting on retinal vessel density in low to moderate myopia adolescents by using optical coherence tomography angiography.METHODS:Children aged 10 to 14y with a cycloplegic spherical equivalent refraction of−0.50 diopter(D)to−5.00 D and astigmatism with more than−1.50 D were recruited.The enrolled adolescents were divided into OK group and spectacle group.During regular followup,adolescents were measured respectively at pre-wear,1,3,and 6mo after treatment.The follow-up included uncorrected distance visual acuity(UDVA),axial length(AL),superficial capillary plexus density(SCPD),deep capillary plexus density(DCPD),central retinal thickness(CRT),foveal avascular zone area(FAZ-A),foveal avascular zone perimeter(FAZ-P)and foveal vessel density in a 300-μmwide region around foveal avascular zone(FD-300).The collected data were analyzed using statistical methods.RESULTS:By one month,SCPD significantly increased in the fovea and superior retina,and DCPD significantly increased inferiorly in OK group compared to spectacle group(P<0.05).By three months,there were significant increases in SCPD in the fovea and inferior retina,and DCPD in the parafovea,superior,and inferior retina in OK group(P<0.05),while the increase in SCPD and DCPD in the fovea were observed by six months(P<0.05).The FD-300 significantly increased at every follow-up in OK group compared to spectacle group(P<0.05).No significant differences in the CRT,FAZ-A and FAZ-P and FD-300 were observed between two groups(P>0.05).OK group showed a significant improvement in UDVA after wearing OK,compared to spectacle group(P<0.01),while the AL did not show a significant difference between two groups(P>0.05).CONCLUSION:Short-term OK worn can increase local retinal vessel density in adolescents with low-to-moderate myopia.

Associated risk factors in the early stage of diabetic retinopathy

Background:To investigate the retinal capillary density(RCD)of the macula using optical coherence tomography angiography(OCT-A)in type 2 diabetic patients and to further determine the association with risk factors.Methods:A total of 212 eyes from 212 subjects were recruited;subjects included diabetics with no retinopathy(NDR,n=90 eyes),diabetics with mild retinopathy DR(MDR,n=36 eyes),and healthy participants(Control,n=86 eyes).All participants underwent OCT-A scanning.RCD was quantified by superficial and deep retinal capillary layers(SRCL and DRCL)from OCT-A images.Results:RCD in SRCL and DRCL was lower in NDR(P<0.001)as well as in MDR(P<0.001)when compared with control eyes.Diabetic patients were subdivided according to individual risk factors,complications related to diabetes,and hyperglycemia.Diabetic patients showed lower RCD in both the SRCL and DRCL when compared with healthy controls.Diabetics with age>55y,HbA1c>7%had significantly reduced DRCL(P<0.05)when compared with the other group of diabetics(age<55y,HbA1c<7%).Diabetics with a blood urea nitrogen(BUN)>8.2 mmol/L had significantly reduced SRCL and DRCL when compared to the other group of diabetics.Conclusions:Risk factors including older age,higher level of HbA1c,LDL-C and BUN,were associated with lower RCDs found in type 2 diabetic patients with and without mild DR by OCT-A.The impairment of retinal capillary by OCT-A may play a key role in the early monitoring of management in diabetes.