ORIGINAL RESEARCH article
Front. Med.
Sec. Ophthalmology
This article is part of the Research TopicThe Role of Light in MyopiaView all 6 articles
Early retinal and Choroidal Changes in the Macula Region Associated with Axial length in Myopic Children and Adolescents Based on Swept-Source OCTA
Provisionally accepted
- 1Northern Jiangsu People's Hospital, Yangzhou University, Yangzhou, China
- 2First Affiliated Hospital of Harbin Medical University, Harbin, China
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Purpose: To investigate the association between axial length (AL) and early retinal/choroidal structural and hemodynamic changes in the macula of myopic children and adolescents using swept-source optical coherence tomography angiography (ssOCTA). Methods: This cross-sectional study included 136 eyes from 136 myopic participants (aged 4-17 years). Participants underwent a comprehensive ophthalmic examination, including AL measurement and 6x6 mm macular ssOCTA scans. Hemodynamic parameters (vessel density, choroidal vessel/stromal volumes) and thickness metrics across retinal/choroidal layers and ETDRS subfields were analyzed. Participants were grouped by AL (<26 mm vs ≥26 mm). Multivariate linear regression (adjusted for age and gender) assessed correlations between AL and OCTA parameters. Results: Increased AL was significantly correlated with reduced deep retinal vessel density (DVD) in most macular regions (except perifoveal inferior) and decreased choroidal vessel volume (CVV) and choroidal stromal volume (CSV). Superficial retinal vessel density (SVD) and choriocapillaris flow showed no significant correlation with AL. Retinal and choroidal thickness significantly decreased with longer AL in most regions (except the foveal region of the retina). Regional analysis revealed that the perifoveal nasal area exhibited the greatest reduction in CVV and CSV, while the perifoveal inferior area showed the least reduction in DVD. Foveal retinal thickness also decreased less than other regions with AL elongation. Conclusions: Axial elongation in young myopes is associated with specific early microvascular and structural alterations detectable by ssOCTA. Deep retinal vascular attenuation and choroidal volumetric loss (CVV, CSV) are prominent hemodynamic changes linked to AL, showing regional variations within the macula. These findings highlight the early structural and hemodynamic changes for myopic progression in pediatric or juvenile populations.
Keywords: Axial length, Children and adolescents, Choroid, Myopia, Swept-source OCTA
Received: 16 Aug 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 Cao, Gao, Zhu and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jun Zhu
Fang Chen
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