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Macular and submacular choroidal microvasculature in patients with primary open-angle glaucoma and high myopia
  1. Fengbin Lin1,
  2. Zhen Qiu2,
  3. Fei Li1,
  4. Yu Chen1,
  5. Yuying Peng1,
  6. Meiling Chen1,
  7. Yunhe Song1,
  8. Jian Xiong1,
  9. Weijing Cheng3,
  10. Yuhong Liu1,
  11. Mingkui Tan2,
  12. Xiulan Zhang1,
  13. Robert Weinreb4
  1. 1Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
  2. 2School of Software Engineering, South China University of Technology, Guangzhou, China
  3. 3Clinical Research Center for Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
  4. 4Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
  1. Correspondence to Professor Xiulan Zhang, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China; zhangxl2{at}; Professor Mingkui Tan, School of Software Engineering, South China University of Technology, Guangzhou, China; mingkuitan{at}


Aims To characterise the influence of primary open-angle glaucoma (POAG) and high myopia (HM) on the macular and choroidal capillary density (CD).

Methods Two hundred and seven eyes were enrolled, including 80 POAG without HM, 50 POAG with HM, 31 HM without POAG and 46 normal controls. A fovea-centred 6×6 mm optical coherence tomography angiography scan was performed to obtain the CD of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris. Macular and choroidal CDs were compared among the groups and the association of CDs with visual field mean deviation (MD) was determined using linear regression models.

Results Compared with normal eyes, SCP CD was decreased in the POAG without HM group (p<0.05), while DCP CD was significantly decreased in the HM without POAG group (p<0.05). Both SCP and DCP CDs were significantly decreased in the POAG with HM group (p<0.05). CD reduction occurred mainly in the outer rather than inner ring of the 6×6 mm scan size. In multivariate regression analysis, worse MD was associated with lower CD in the outer ring of the SCP in all the HM eyes (p<0.05).

Conclusions POAG and HM reduced macular CD in different layers of the retinal capillary plexus and both particularly in the outer ring of the 6×6 mm scans. Furthermore, assessment of the CD in the outer ring of the SCP may facilitate the diagnosis of glaucoma in eyes with HM.

  • choroid
  • glaucoma
  • macula
  • retina

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • FL and ZQ contributed equally.

  • Contributors Study design: XZ, MT and RW; data collection: FLin, ZQ, YC, YP, MC, YS, JX, WC and YL; data analysis and interpretation: XZ, MT, RW, FLin, ZQ and FLi; manuscript drafting and revision: FLin, ZQ, FLi, XZ, MT and RW; supervision: XZ.

  • Funding This research was supported by the High-level Hospital Construction Project, Zhongshan Ophthalmic Center, Sun Yat-sen University (303020104); the National Natural Science Foundation of China (82070955) and, in part, by NEI R01EY029058 and an unrestricted grant from Research to Prevent Blindness (New York, New York).

  • Competing interests RW is the recipient of research instruments from Carl Zeiss Meditec, Heidelberg Engineering, Topcon, Optovue and Centervue.

  • Patient and public involvement statement Written informed consent was obtained from all subjects before enrolment.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.