Association of Retinal Microvasculature With Myopia Progression in Children: The Hong Kong Children Eye Study.

PURPOSE: To investigate the associations between optical coherence tomography angiography (OCT-A) metrics and myopia progression in children.

METHODS

This prospective, longitudinal cohort study recruited children ages 6 to 8 years for 2- to 6-year follow-ups. OCT-A captured macular images from the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Annual progression of spherical equivalent (SE) and axial length (AL) was calculated as (SE/AL at last visit - SE/AL at baseline)/follow-up duration. Multivariable linear regression analysis evaluated the associations of OCT-A metrics with SE/AL progression. Restricted cubic spline (RCS) analysis evaluated both linear and nonlinear associations. Holm-Bonferroni correction was applied to account for multiple comparisons.

RESULTS

A total of 920 children were analyzed. Multivariable linear regression, adjusted for age, sex, baseline SE/AL, and other covariates, showed that baseline foveal avascular zone (FAZ) circularity was negatively associated with annual AL elongation (β = -0.06; 95% confidence interval [CI], -0.10 to -0.02; adjusted P = 0.045). Similarly, the baseline FAZ circularity was positively associated with annual SE progression (β = 0.15; 95% CI, 0.05-0.26; adjusted P = 0.045). No significant associations were found between OCT-A metrics in the DCP with annual AL/SE progression. Furthermore, RCS analysis demonstrated no significant nonlinear associations between OCT-A metrics and annual AL/SE progression (P for nonlinearity > 0.05).

CONCLUSIONS

Baseline FAZ circularity in the SCP was significantly associated with annual AL elongation and annual SE progression in children, suggesting its potential as an imaging biomarker for monitoring myopia progression.