Comparative analysis of retinal and choroidal microvascular characteristics by gender in myopic children: A SS-OCTA study.

PURPOSE: To investigate gender differences in retinal and choroidal thickness and vascular density (VD) among myopic children using swept-source OCT angiography (SS-OCTA).

METHODS

This cross-sectional study included 673 Chinese myopic children (8-16 years; 305 males, 368 females). Macular and optic disc regions were imaged. Parameters were compared using ANCOVA adjusted for age and refractive error, with supplementary partial correlation analyses.

RESULTS

Females showed significantly lower foveal and parafoveal superficial vascular complex (SVC) and macular choriocapillaris (CC) VD (all P < 0.05). Axial length (AL) correlated positively with foveal and parafoveal thickness and VD, and negatively in the perifovea (all P < 0.05).It also positively correlated with RNFL and GCC thickness, SVC, and RPC VD in temporal optic-disc sectors (r = 0.11 to 0.19, P < 0.01), and negatively in nasal sectors (r = -0.11 to -0.23, P < 0.01). In males, correlations between AL and foveal SVC VD (Z = -2.53, P < 0.05), AL and parafoveal deep vascular complex VD (Z = -2.34, P < 0.05), and SE and perifoveal CC VD (Z = -2.82, P < 0.01) were significantly stronger.

CONCLUSIONS

Females exhibited reduced SVC and CC VD. Both genders showed significant associations between refractive parameters and vascular parameters, with partially stronger correlations observed in males. These gender differences in ocular blood flow suggest that gender may influence vascular alterations associated with myopia, warranting further research. Recognition of gender-based differences in ocular vasculature and structure may inform individualized myopia-control strategies and improve treatment efficacy across genders.