Pourbagherkhah Parva, Shojaee Saeed, Farjami Mohammad, Baghban Jaldian Hemn
Department of Optometry, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.
Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ophthalmic Physiol Opt. 2025 Sep;45(6):1534-1548. doi: 10.1111/opo.13554. Epub 2025 Jul 26.
To evaluate the impact of myopia severity (mild, moderate or high) on retinal vascular density (VD) and the foveal avascular zone (FAZ) using optical coherence tomography angiography (OCTA).
Studies were included based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria required studies reporting mean VD or FAZ for three severities of myopia. The quality assessment followed the Newcastle-Ottawa Scale (NOS). Data were pooled using fixed- or random-effects models depending on heterogeneity. The research protocol was published in the Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42025638165.
Twelve studies (2302 eyes) met the inclusion criteria. VD was assessed in both macular (foveal, parafoveal and perifoveal) and peripapillary regions, depending on the included study, and showed a decrease in the superficial capillary plexus (SCP) with increasing myopia severity, while the FAZ size remained relatively stable across groups. High myopia was associated with lower VD, particularly in the foveal and parafoveal regions in both the SCP and deep capillary plexus (DCP). VD in the foveal SCP was higher in mild (24.13%) compared to high myopia (20.59%). Similarly, parafoveal VD in the SCP was 52.53% and 49.66% in mild and high myopia, respectively. FAZ size remained relatively stable across groups, ranging from 0.30 to 0.32 mm.
This meta-analysis demonstrates that high myopia is associated with a lower VD, particularly in SCP, with no consistent enlargement of the FAZ. The findings highlight the progressive impact of myopia severity on retinal microvasculature.
使用光学相干断层扫描血管造影（OCTA）评估近视严重程度（轻度、中度或高度）对视网膜血管密度（VD）和黄斑无血管区（FAZ）的影响。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南纳入研究。纳入标准要求研究报告三种近视严重程度的平均VD或FAZ。质量评估遵循纽卡斯尔-渥太华量表（NOS）。根据异质性，使用固定效应或随机效应模型汇总数据。研究方案已发表在系统评价前瞻性注册库（PROSPERO）中，注册号为CRD42025638165。
12项研究（2302只眼）符合纳入标准。根据纳入的研究，在黄斑（中心凹、旁中心凹和周边中心凹）和视乳头周围区域评估VD，结果显示随着近视严重程度增加，浅表毛细血管丛（SCP）的VD降低，而FAZ大小在各组中保持相对稳定。高度近视与较低的VD相关，尤其是在SCP和深部毛细血管丛（DCP）的中心凹和旁中心凹区域。与高度近视（20.59%）相比，轻度近视（24.13%）中心凹SCP的VD更高。同样，SCP中旁中心凹VD在轻度和高度近视中分别为52.53%和49.66%。FAZ大小在各组中保持相对稳定，范围为0.30至0.32毫米。
这项Meta分析表明，高度近视与较低的VD相关，尤其是在SCP中，且FAZ无一致扩大。研究结果突出了近视严重程度对视网膜微血管的渐进性影响。
