Perforating scleral vessels in children and myopia‐related pattern

PURPOSE: To compare prevalence, location and orientation of perforating scleral vessels (PSVs) at the ocular posterior pole between emmetropic and myopic children. METHODS: The prospective observational study included children undergoing standardized 20° × 20° enhanced-depth imaging optical coherence tomography (EDI-OCT). PSVs were defined as tubular hypo-reflective structures detectable on macular OCT images and traversing the sclera. Curvature-conforming PSVs were oriented following, and against-curvature PSVs were oriented against the physiological curvature of the sclera. RESULTS: The study included 102 eyes (51 children; age: 10.3 ± 3.3 years; range: 4-16 years). Total PSV number (mean: 1.8 ± 2.4; median: 1.5; range: 0-8) was significantly higher in the myopic group (n = 52 eyes) than the non-myopic group (n = 50) (3.1 ± 2.6 vs. 1.5 ± 2.3; p = 0.036). Against-curvature PSV number was higher in the myopic group than the non-myopic group (2.4 ± 1.7 vs. 0.3 ± 0.9; p < 0.001), as was the prevalence of eyes containing at least one against-curvature PSV (57.7% vs. 18.0%; p < 0.001). Non-myopic eyes showed a greater number of curvature-conforming PSVs (1.2 ± 1.7 vs. 0.7 ± 0.9; p = 0.04). The PSVs were located significantly more often in the outer inferior sector and outer superior macular sector in the myopic group than in the non-myopic group. In the central sector, PSV prevalence was marginally (p = 0.08) higher in the myopic eyes than in the non-myopic eyes, and correspondingly, PSV prevalence in the outer nasal sector was marginally (p = 0.12) higher in the non-myopic eyes. PSV entry angle was smaller in the myopic eyes than in the non-myopic eyes (38° ± 16° vs. 51° ± 15°; p < 0.001). CONCLUSIONS: Count, location, entry angle and direction of PSVs differed between myopic versus non-myopic eyes. Further longitudinal studies will help clarify the role of this finding in myopic axial elongation.