Objective  Using the optical coherence tomography angiography (OCTA) technology to detect the macular retinal blood vessel density and thickness levels and to analyze their correlation in myopic adolescents with different myopia degree.

Methods  A total of 196 adolescent myopia patients (392 eyes) diagnosed and treated in Eye Hospital, Wenzhou Medical University from June 2019 to June 2022 were selected. According to the equivalent spherical degree (SE), they were divided into mild myopia group (43 cases), moderate myopia group (55 cases), high myopia group (51 cases), and super high myopia group (47 cases). OCTA technology was used to quantitatively measure the retinal blood vessel density and thickness in the macular area of the four groups of patients; Pearson analysis was used to analyze the correlation between retinal vascular density and thickness in the macular area; linear regression analysis was used to investigate the relevant influencing factors of retinal vascular density in the macular area.

Results  There was a statistically significant difference in SE and axial length among the four groups (P<0.05). As the degree of myopia increased, SE gradually decreased and the length of the eye axis gradually increased (P<0.05). Comparison of the retinal blood vessel density in different parts of the macular area (fovea, parafovea, upper side, nasal side, inferior side, and temporal side) among the four groups, the difference was statistically significant (P<0.05). As the degree of myopia increased, and the retinal blood vessel density in different parts of the macular area decreased (P<0.05). Comparison of retinal thickness in different parts of the macular area (fovea, parafovea, upper side, nasal side, inferior side, and temporal side) among the four groups, the difference was statistically significant (P<0.05). As the degree of myopia increased, and the thickness of the retina in different parts of the macular area decreased (P<0.05). Pearson correlation analysis showed that the macular fovea, the retinal blood vessel density and the fovea adjacent to the fovea (r=0.464, 0.515), adjacent to the fovea (r=0.312, 0.330), upper side (r=0.398, 0.422), nasal side (r=0.391, 0.326), inferior side (r=0.324, 0.273), and temporal side (r=0.353, 0.428) were positively correlated (P<0.05). Linear regression analysis showed the axial length and SE had negative impact on retinal vascular density in the fovea and parafovea of the macular area (P<0.05).

Conclusion  As the degree of myopia in adolescents in-creased, the density and thickness of retinal blood vessels in the macular area decreased, and there was a positive correlation between the density and thickness of retinal blood vessels in the macular area, and negative correlation with axial length.

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