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

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. 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. 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). 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.