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Abstract Objectives: The aim of the study is to compare the vascular density (VD) of the macular superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC), and foveal avascular zone (FAZ) area in age-matched high hyperopic, high myopic, and emmetropic children using optical coherence tomography angiography (OCTA). Methodology: The study was conducted on 80 eyes of 53 otherwise healthy children with 30, 30 and 20 eyes in the high myopic, high hyperopic and emmetropic groups, respectively. Patients were recruited from Abu El Reesh and Al Kasr Al Ainy outpatient clinics. OCTA imaging was performed using the RTVue XR Avanti spectral-domain OCT device with AngioVue software. Both the 3x3 and 6x6 mm macular scans were utilized centered on the fovea and axial length (AL) measurements were done using (Lenstar LS900 Haag Streit). Results: The mean age of patients included was 11.30, 10.90, and 12.30 years in high myopes, high hyperopes, and emmetropes respectively. In between-groups comparison showed that there was significant thinning in the parafovea in high myopes relative to high hyperopes and emmetropes (p < 0.001). At level of the SCP, the VD was lower in high myopes compared to high hyperopes and emmetropes in all areas except the fovea. (all p<0.001). At the level of the DCP, the VD was lower in high myopes compared to high hyperopes and emmetropes in the parafovea (p=0.009 and 0.017 respectively) and perifovea (p=<0.001 and 0.001 respectively) |