Prevalence and associations of central retinal vessel trunk (CRVT) dragging were assessed using OCT images of the optic disc and macula in 3,336 participants of the Beijing Eye Study (mean age 64.2 years; axial length range 20.16–30.88 mm).
CRVT dragging prevalence rose sharply with axial length: 0% in eyes ≤25.0 mm, 5.2% (25.01–26.0 mm), 12.2% (26.01–27.0 mm), 24.0% (27.01–28.0 mm), and 72.2% in eyes >28.0 mm. On multivariable analysis, longer optic disc–fovea distance (OR 5.82), parapapillary retinoschisis (OR 8.61), longer axial length (OR 1.95), and older age (OR 1.08) were independently associated with CRVT dragging.
Retrospective design limits causal inference. Single-eye analysis per participant may not capture bilateral variation. The study population is older Chinese adults (Beijing Eye Study), limiting generalizability to younger or other ethnic cohorts.
In highly myopic eyes (axial length >28 mm), CRVT dragging is present in nearly three-quarters of cases and distorts optic nerve head morphology — clinicians should account for this when diagnosing optic neuropathies such as glaucoma in high myopes. Increased fovea–disc distance is a key driver and may serve as a practical marker for suspecting this finding.
