Cilioretinal Arteries and Macular Vasculature in Highly Myopic Eyes An OCT Angiography-Based Study

Purpose: To determine the association between the presence of cilioretinal arteries and the macular vasculature in highly myopic eyes using OCT angiography (OCTA). Design: Retrospective, observational case series. Participants: Four hundred eighty-one highly myopic eyes of 481 patients. Methods: Fundus photographs were reviewed to determine the presence of a cilioretinal artery and its distribution, based on whether its path or visible branches reached the region within 500 mm of the foveal center. The macular vasculature was analyzed in OCTA images, including the vessel density (VD), fractal dimension (FD), and foveal avascular zone (FAZ). The associations between the presence of a cilioretinal artery and its distribution and between the macular vasculature and visual acuity were evaluated. Main Outcome Measures: Cilioretinal arteries, macular vasculature, and their associations. Results: Of the eyes included, 17.05% (82/481) had a cilioretinal artery. Based on the OCTA analysis, the eyes with cilioretinal arteries showed significantly higher VD and FD in both superficial and deep capillary plexuses and smaller FAZ than those without (all P < 0.001). However, these differences were not found in the subgroup of eyes with an axial length of more than 30 mm. Eyes with cilioretinal arteries that reached the central foveal area showed significantly higher VD and FD in both capillary plexuses and smaller FAZ than those that did not (all P < 0.05). Better best-corrected visual acuity was identified in the eyes with cilioretinal arteries than in those without (0.09 +/- 0.14 logarithm of the minimum angle of resolution [logMAR] vs. 0.21 +/- 0.27 logMAR, respectively; P < 0.001). In particular, eyes with cilioretinal arteries that reached the central foveal area had better visual acuity than those without (0.05 +/- 0.06 logMAR vs. 0.16 +/- 0.20logMAR, respectively; P = 0.005). Conclusions: This OCTA-based study suggested that cilioretinal arteries in highly myopic eyes potentially may improve the macular vasculature and influence visual function. (C) 2020 by the American Academy of Ophthalmology