{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:58:39Z","timestamp":1787497119074,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T00:00:00Z","timestamp":1742256000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study explores the relationship between retinal structure, vascular densities (VD), and the progression of myopia, aiming to identify novel biomarkers for assessing myopia severity. Materials and Methods: A total of 260 eyes were divided into four groups: Emmetropia (EM) (n = 74), Low Myopia (LM) (n = 68), Moderate Myopia (MM) (n = 64), and High Myopia (HM) (n = 54). VD and retinal thickness (RT) in the macular and peripheral quadrants were measured using optical coherence tomography-angiography (OCTA). SVD and DVD were analyzed across the paranasal, peritemporal, perisuperior, and peri-inferior quadrants. Results: Significant differences in superficial vessel density (SVD) were found in the paranasal (EM vs. MM, p = 0.017; EM vs. HM, p = 0.001), peritemporal (EM vs. MM, p = 0.006; EM vs. HM, p = 0.001; LM vs. HM, p = 0.004; MM vs. HM, p = 0.032), perisuperior (EM vs. MM, p = 0.005; EM vs. HM, p = 0.001; LM vs. HM, p = 0.027), and perifoveal quadrants (EM vs. MM, p = 0.003; EM vs. HM, p = 0.008; LM vs. HM, p = 0.004; MM vs. HM, p = 0.012). Deep vessel density (DVD) showed significant differences in the paranasal (p = 0.012\u20130.022), peritemporal (p = 0.002\u20130.026), perisuperior (p = 0.003\u20130.034), perifoveal (p = 0.002\u20130.017), and peri-inferior (p = 0.002\u20130.022) quadrants. Retinal thickness was significantly reduced in HM eyes, with the most pronounced reduction in the peritemporal quadrant (mean difference: 16.7 \u00b1 3.2 \u00b5m; p &lt; 0.001). Conclusions: Structural and vascular changes in the retina become more pronounced as myopia progresses from moderate to high. The strong correlation between DVD, RT, and myopia severity highlights their potential as reliable biomarkers for monitoring myopia progression through OCTA imaging. These findings provide new insights into the vascular and structural changes underlying myopia and their diagnostic significance.<\/jats:p>","DOI":"10.3390\/medicina61030532","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T10:43:51Z","timestamp":1742294631000},"page":"532","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Significance of OCTA in Studying Vessel Density and Retinal Thickness in Individuals with Myopia"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8576-213X","authenticated-orcid":false,"given":"Marija","family":"Veselinovi\u0107","sequence":"first","affiliation":[{"name":"Ophthalmology Clinic, University Clinical Center Ni\u0161, Boulevard Dr Zorana \u0110in\u0111i\u0107a 48, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7014-8110","authenticated-orcid":false,"given":"Marija","family":"Trenki\u0107","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, University Clinical Center Ni\u0161, Boulevard Dr Zorana \u0110in\u0111i\u0107a 48, 18000 Ni\u0161, Serbia"},{"name":"Faculty of Medicine, University of Ni\u0161, Boulevard Dr Zorana \u0110in\u0111i\u0107a 81, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"\u010canadanovi\u0107","sequence":"additional","affiliation":[{"name":"Eye Clinic, University Clinical Center of Vojvodina, Hajduk Veljkova 1\u20139, 21000 Novi Sad, Serbia"},{"name":"Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Predrag","family":"Jovanovi\u0107","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, University Clinical Center Ni\u0161, Boulevard Dr Zorana \u0110in\u0111i\u0107a 48, 18000 Ni\u0161, Serbia"},{"name":"Faculty of Medicine, University of Ni\u0161, Boulevard Dr Zorana \u0110in\u0111i\u0107a 81, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Veselinovi\u0107","sequence":"additional","affiliation":[{"name":"Special Hospital for Ophthalmology \u201cVeselinovi\u0107\u201d, Bulevar Nemanji\u0107a 67a, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Petrovi\u0107","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, University Clinical Center Ni\u0161, Boulevard Dr Zorana \u0110in\u0111i\u0107a 48, 18000 Ni\u0161, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Kasumovi\u0107 Be\u0107irovi\u0107","sequence":"additional","affiliation":[{"name":"Eye Polyclinic \u201cDr. Sefi\u0107\u201d, Ferhadija 5, 71000 Sarajevo, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s40942-024-00532-w","article-title":"Optical coherence tomography angiography of the macula of high myopia in children and adolescents","volume":"10","author":"Abdellah","year":"2024","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1111\/opo.13300","article-title":"Assessment of the effects of myopic and hyperopic anisometropia on choroidal vascular structure in children using SS-OCTA","volume":"44","author":"Cao","year":"2024","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1136\/bjophthalmol-2020-317632","article-title":"Quantitative OCT angiography of the retinal microvasculature and choriocapillaris in highly myopic eyes with myopic macular degeneration","volume":"106","author":"Zheng","year":"2022","journal-title":"Br. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhang, W., Li, C., Gong, Y., Liu, N., Cao, Y., Li, Z., and Zhang, Y. (2022). Advanced ultrawide-field optical coherence tomography angiography identifies previously undetectable changes in biomechanics-related parameters in nonpathological myopic fundus. Front. Bioeng. Biotechnol., 10.","DOI":"10.3389\/fbioe.2022.920197"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1038\/s41433-020-0824-1","article-title":"Alterations in optical coherence tomography angiography findings in patients with high myopia","volume":"34","author":"Ucak","year":"2020","journal-title":"Eye"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1097\/IAE.0000000000001489","article-title":"Overview of the complications of high myopia","volume":"37","author":"Ikuno","year":"2017","journal-title":"Retina"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"309","DOI":"10.3341\/kjo.2015.29.5.309","article-title":"Choroidal blood flow change in eyes with high myopia","volume":"29","author":"Yang","year":"2015","journal-title":"Korean J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Shi, Y., Ye, L., Chen, Q., Hu, G., Yin, Y., Fan, Y., Zhu, J., He, J., Zheng, Z., and Zou, H. (2021). Macular vessel density changes in young adults with high myopia: A longitudinal study. Front. Med., 8.","DOI":"10.3389\/fmed.2021.648644"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6020","DOI":"10.1167\/iovs.16-19542","article-title":"Retinal microvasculature alteration in high myopia","volume":"57","author":"Yang","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2017.11.003","article-title":"Optical coherence tomography angiography","volume":"64","author":"Spaide","year":"2018","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s40942-015-0005-8","article-title":"A review of optical coherence tomography angiography (OCTA)","volume":"1","author":"Romano","year":"2015","journal-title":"Int. J. Retin. Vitr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.preteyeres.2017.07.002","article-title":"Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications","volume":"60","author":"Kashani","year":"2017","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1038\/eye.2017.181","article-title":"An overview of the clinical applications of optical coherence tomography angiography","volume":"32","author":"Tan","year":"2018","journal-title":"Eye"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1364\/BOE.3.001182","article-title":"Motion correction in optical coherence tomography volumes on a per A-scan basis using orthogonal scan patterns","volume":"3","author":"Kraus","year":"2012","journal-title":"Biomed. Opt. Express"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1159\/000442770","article-title":"Optical coherence tomography angiography using the Optovue device","volume":"56","author":"Huang","year":"2016","journal-title":"Dev. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Khan, M.H., Lam, A.K.C., Armitage, J.A., Hanna, L., To, C.-h., and Gentle, A. (2020). Impact of axial eye size on retinal microvasculature density in the macular region. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082539"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9781987","DOI":"10.1155\/2018\/9781987","article-title":"Prevalence and related factors for myopia in school-aged children in Qingdao","volume":"2018","author":"Sun","year":"2018","journal-title":"J. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.preteyeres.2017.10.005","article-title":"Diagnosis and treatment guideline for myopic choroidal neovascularization due to pathologic myopia","volume":"63","author":"Ikuno","year":"2018","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1504834","DOI":"10.1155\/2023\/1504834","article-title":"Choroidal vascular density quantification in high myopia with or without choroidal neovascularization using optical coherence tomography angiography","volume":"2023","author":"Lu","year":"2023","journal-title":"J. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"7410","DOI":"10.1167\/iovs.14-13894","article-title":"Macular measurements using spectral-domain optical coherence tomography in Chinese myopic children","volume":"55","author":"Chen","year":"2014","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Si, Y., Pang, K., Song, Y., Zhang, X., Yang, H., and Cui, Y. (2024). Observation of structural and vascular features of retina and choroid in myopia using ultra-widefield SS-OCTA. BMC Ophthalmol., 24.","DOI":"10.1186\/s12886-024-03473-y"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1038\/s41433-020-01225-y","article-title":"Myopia-related stepwise and quadrant retinal microvascular alteration and its correlation with axial length","volume":"35","author":"Liu","year":"2021","journal-title":"Eye"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1136\/bjophthalmol-2021-319540","article-title":"Wide-field swept-source optical coherence tomography angiography in the assessment of retinal microvasculature and choroidal thickness in patients with myopia","volume":"107","author":"Moon","year":"2023","journal-title":"Br. J. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ajo.2016.10.018","article-title":"Retinal microvascular network and microcirculation assessments in high myopia","volume":"174","author":"Li","year":"2017","journal-title":"Am. J. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1159\/000317072","article-title":"Axial length of myopia: A review of current research","volume":"225","author":"Meng","year":"2011","journal-title":"Ophthalmologica"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Benavente-Perez, A. (2023). Evidence of vascular involvement in myopia: A review. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1112996"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1007\/s00417-018-4012-y","article-title":"Vessel density, retinal thickness, and choriocapillaris vascular flow in myopic eyes on OCT angiography","volume":"256","author":"Milani","year":"2018","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Dan, Y.S., Cheong, K.X., Lim, S.Y., Wong, Q.Y., Chong, R.S., Wong, C.W., and Hoang, Q.V. (2023). Quantitative assessment of the choroidal vasculature in myopic macular degeneration with optical coherence tomographic angiography. Front. Ophthalmol., 3.","DOI":"10.3389\/fopht.2023.1202445"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Baksh, J., Lee, D., Mori, K., Zhang, Y., Torii, H., Jeong, H., Hou, J., Negishi, K., Tsubota, K., and Kurihara, T. (2024). Myopia is an ischemic eye condition: A review from the perspective of choroidal blood flow. J. Clin. Med., 13.","DOI":"10.3390\/jcm13102777"},{"key":"ref_31","first-page":"439","article-title":"Autonomic control of the eye","volume":"5","author":"McDougal","year":"2015","journal-title":"Compr. Physiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1007\/s10792-018-1014-z","article-title":"Assessment of superficial retinal microvascular density in healthy myopia","volume":"39","author":"Guo","year":"2019","journal-title":"Int. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Go\u0142\u0119biewska, J., Bia\u0142a-Gosek, K., Czeszyk, A., and Hautz, W. (2019). Optical coherence tomography angiography of superficial retinal vessel density and foveal avascular zone in myopic children. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0219785"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ajo.2016.05.002","article-title":"Deep retinal capillary nonperfusion is associated with photoreceptor disruption in diabetic macular ischemia","volume":"168","author":"Scarinci","year":"2016","journal-title":"Am. J. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1097\/IAE.0000000000001784","article-title":"Considerations in the understanding of venous outflow in the retinal capillary plexus","volume":"37","author":"Garrity","year":"2017","journal-title":"Retina"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1159\/000523938","article-title":"The deep vascular plexus density is closely related to myopic severity","volume":"65","author":"Yao","year":"2022","journal-title":"Ophthalmic Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s00417-003-0836-0","article-title":"Reduction of retinal blood flow in high myopia","volume":"242","author":"Shimada","year":"2004","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1167\/iovs.16-21289","article-title":"Quantitative OCT angiography of the retinal microvasculature and the choriocapillaris in myopic eyes","volume":"58","author":"Phasukkijwatana","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"445","DOI":"10.4103\/0366-6999.199844","article-title":"Reduced macular vascular density in myopic eyes","volume":"130","author":"Fan","year":"2017","journal-title":"Chin. Med. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1167\/iovs.62.15.1","article-title":"Longitudinal macular retinal and choroidal microvasculature changes in high myopia","volume":"62","author":"Lin","year":"2021","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Yoshikawa, Y., Shoji, T., Kanno, J., Ibuki, H., Weinreb, R.N., Araie, M., and Shinoda, K. (2020). Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-63931-7"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1038\/s41433-019-0438-7","article-title":"Association between retinal microvasculature and optic disc alterations in high myopia","volume":"33","author":"He","year":"2019","journal-title":"Eye"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1136\/bjophthalmol-2020-316222","article-title":"Peripapillary vessel parameters and mean ocular perfusion pressure in young healthy eyes: OCT angiography study","volume":"105","author":"Yun","year":"2021","journal-title":"Br. J. Ophthalmol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1167\/iovs.17-21551","article-title":"Axial length variation impacts on superficial retinal vessel density and foveal avascular zone area measurements using optical coherence tomography angiography","volume":"58","author":"Sampson","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"6069833","DOI":"10.1155\/2021\/6069833","article-title":"Vessel density and retinal thickness from optical coherence tomography angiography as new indexes in adolescent myopia","volume":"2021","author":"Zhu","year":"2021","journal-title":"J. Ophthalmol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Jiang, Y., Lou, S., Li, Y., Chen, Y., and Lu, T.C. (2021). High myopia and macular vascular density: An optical coherence tomography angiography study. BMC Ophthalmol., 21.","DOI":"10.1186\/s12886-021-02156-2"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/532\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:56:00Z","timestamp":1760028960000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/3\/532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,18]]},"references-count":46,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["medicina61030532"],"URL":"https:\/\/doi.org\/10.3390\/medicina61030532","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,18]]}}}