Effects of Beta-zone Peripapillary Atrophy and Focal Lamina Cribrosa Defects on Peripapillary Vessel Parameters in Young Myopic Eyes

Precis: The development of beta-zone peripapillary atrophy (β-PPA) and focal lamina cribrosa defect (FLD) was significantly associated with decreased peripapillary optical coherence tomography angiography (OCTA) vessel parameters in young myopic eyes.

Purpose: The purpose of this study was to investigate whether β-PPA and FLD affect peripapillary vessel density (VD) or perfusion density (PD) from OCTA in young myopic eyes.

Materials and methods: In a cross-sectional study, 330 eyes of 165 healthy volunteers with myopia were involved. Eyes underwent OCTA to measure peripapillary PD and VD. Eyes were grouped according to the presence of β-PPA or FLD: eyes without β-PPA or FLD (group A), eyes with β-PPA but without FLD (group B), and eyes with both β-PPA and FLD (group C). PD and VD were compared among 3 groups, and linear mixed-effect regression model was used to investigate the determinants of PD.

Results: β-PPA was found in 219 eyes (66.4%), and FLD was detected in 27 eyes (8.2%). The average VD and PD were greatest in group A (19.13±2.04 mm-1 and 0.375±0.038), followed by group B (18.34±2.26 mm-1 and 0.363±0.042) and group C (16.71±2.81 mm-1 and 0.330±0.052) (P<0.001). The linear mixed-effect model demonstrated that presence of FLD (P=0.001) or β-PPA (P<0.001), FLD count (P=0.004), and maximal β-PPA width (P<0.001) were significantly associated with average PD after controlling for multiple confounding factors.

Conclusions: Development of β-PPA and FLD, which is closely related with axial elongation in myopic eyes, was significantly associated with reduced OCTA vessel parameters in young myopic eyes. OCTA may help to detect vascular changes and assess glaucoma risk in these eyes.