Retinal Vascular Changes in Optical Coherence Tomography Angiography of Highly Myopic Patients Undergoing Uncomplicated Cataract Surgery

Purpose To investigate long-term structural changes in the retina of highly myopic patients following uncomplicated cataract surgery using optical coherence tomography angiography (OCTA). Methods This cross-sectional, observational study included 61 eyes of 37 highly myopic patients who underwent uncomplicated cataract surgery as the study group and 71 eyes of 42 highly myopic patients under clinical follow-up as the control group. Retinal vascular structures in the macular regions were examined in detail and quantitatively assessed using OCT and OCTA. Data from these two groups were compared. Results There were no statistically significant differences between the groups in terms of age, sex, best corrected visual acuity, or axial length. The mean duration between cataract surgery and OCTA imaging in the study group was 18.2 months. A statistically significant decrease in microvascular vessel density was observed in all quadrants of the foveal and parafoveal areas in the study group (p < 0.05). However, no significant difference was found in the foveal avascular zone area between the groups (p = 0.267). Conclusions In highly myopic patients undergoing uncomplicated cataract surgery, long-term macular vessel density was reduced compared to the control group. Our study is significant as it is the first to assess retinal vascular structural changes in cataract-operated highly myopic patients with a control group consisting of highly myopic individuals. Furthermore, this study provides a valuable perspective for cases where postoperative visual decline cannot be explained despite the absence of complications.