Retinal and choroidal changes in young adults during near work and eye closure measured by wide-field OCTA

BACKGROUND: Myopia is a major global public health concern, and near work has been identified as a key risk factor for its onset and progression. This study aimed to evaluate short-term retinal and choroidal vascular and structural responses to near work and subsequent eye-closure rest in young adults. METHODS: Thirty medical students (aged 18-24 years) underwent wide-field swept-source OCTA at baseline, after 20, 40, and 60 min of near work, and after 10, 20, and 30 min of eye-closure rest. Vascular parameters of the nerve fiber layer vascular plexus (NFLVP), superficial vascular complex (SVC), deep vascular complex (DVC), choriocapillaris, and choroid were analyzed. RESULTS: During near work, NFLVP vessel density (VD) and vessel diameter index increased in the temporal 1-3 mm and 6-9 mm sectors; the 6-9 mm temporal sector remained elevated above baseline throughout rest (all p < 0.05). SVC VD, small vessel density, and vessel length density in the superior 3-6 mm sector fell below baseline during rest (all p < 0.05). Choroidal perfusion area, thickness, and stromal volume declined significantly relative to pre-rest values at 20 min of rest (all p < 0.05). CONCLUSIONS: NFLVP perfusion in the temporal 6-9 mm sector increased during near work and remained elevated above baseline throughout the rest period; SVC perfusion in the same sector likewise remained above baseline during rest, while SVC perfusion in the superior 3-6 mm sector fell below baseline. These alterations may provide important insights into the vascular regulatory mechanisms underlying myopia development.