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Jost B Jonas, Kyoko Ohno-Matsui, Natsuko Nagaoka, Pascal Weber; Parapapillary Delta Zone as Risk Factor for Glaucoma in High Myopia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5491.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the prevalence and associated factors of glaucomatous optic neuropathy (GON) in a medium myopic to highly myopic patients.
The retrospective observational hospital-based study included patients who had attended the Tokyo High Myopia Clinics within January 2012 and December 2012 and for whom fundus photographs were available. GON was defined based on the appearance of the optic nerve head on the fundus photographs
The study included 519 eyes (262 individuals) with a mean age of 62.0±14.3 years (range:13-89 years) and mean axial length of 29.5±2.2 mm (range:23.2-35.3mm). GON was present in 164 (28.1%; 95% confidence intervals (CI):24.4,31.7%) eyes. GON prevalence increased from 12.2% (95%CI:1.7,22.7) in eyes with an axial length of <26.5mm to 28.5% (24.4,32.5), 32.6% (27.9,37.2), 35.6% (30.5,41.1), and 42.1% (35.5,48.8) in eyes with an axial length of ≥26.5mm, ≥28mm, ≥29mm and ≥ 29mm, respectively. In multivariate analysis, higher GON prevalence was associated (Nagelkerke r2: 0.28) with larger parapapillary delta zone diameter (P<0.001; odds ratio (OR):1.86;95%CI:1.33,2.61), longer axial length (P<0.001;OR:1.45;95%CI:1.26,1.67) and older age (P=0.01;OR:1.03;95%CI:1.01,1.05). If parapapillary delta zone width was replaced by vertical disc diameter, higher GON prevalence was associated (r2:0.24) with larger vertical optic disc diameter (P=0.04;OR:1.70;95%CI:1.03,2.81), after adjusting for longer axial length (P<0.001;OR:1.44;95%CI:1.26,1.64) and older age (P<0.001;OR:1.04;95%CI:1.02,1.06).
Axial elongation associated increase in GON prevalence (mean: 28.1% in a medium to highly myopic study population) was associated with parapapillary delta zone as surrogate for an elongated peripapillary scleral flange and with larger optic disc size.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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