Microcirculatory parameters as risk factors for predicting progression of posterior staphyloma in highly myopic eyes: a case-control study.

Abstract

Background: To assess the rate of macular blood flow decreasing in adults with and without posterior staphyloma (PS) using optical coherence tomography angiography (OCTA) and to identify risk factors associated with PS progression.

Methods: This longitudinal case-control study enrolled 122 eyes of 122 patients-64 patients with PS (PS group) and 58 patients without PS (NPS group). Participants underwent OCTA and clinical examinations at least twice, and those followed for at least one year were included in the analysis. Logistic regression analysis and machine learning were applied to explore the risk factors for PS and its progression.

Results: Patients in the PS group exhibited faster growth rates of spherical equivalent refraction (SER), axial length (AL), curvature index (CI), and posterior scleral height (PSH) as well as higher loss rates of choriocapillaris perfusion area (CCPA), choroid perfusion area (CPA) and choroidal vascularity index (CVI) compared to the NPS group (all P < 0.05). The baseline SER (B =  - 1.291, OR = 0.275, P = 0.008), baseline subfoveal scleral thickness (B =  - 1.621, OR = 0.198, P = 0.046), baseline PSH (B = 2.959, OR = 19.282, P = 0.001) and foveal CVI changes per year (B =  - 2.776, OR = 0.062, P < 0.001) were the risk factors for PS. Baseline AL (B = 0.561, OR = 1.752, P = 0.033), parafoveal choroidal thickness changes per year (B =  - 0.094, OR = 0.910, P = 0.032), foveal retinal vascular density changes per year (B = 0.104, OR = 1.110, P = 0.013) and foveal CCPA changes per year (B =  - 0.214, OR = 0.807, P = 0.038) were the risk factors for the PS progression.

Conclusions: During the progression of myopia in adults, changes in the morphology of the eye's posterior pole are not limited to axial lengthening alone; there also will be a phase of compensatory lateral expansion. Baseline AL and changes in the microcirculation can be utilized to predict the progression of PS.