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Atsuya Miki, Yasushi Ikuno, Tomoko Asai, Shinichi Usui, Kohji Nishida; Measurement of parapapillary atrophy area using swept-source optical coherence tomography in myopic eyes with and without glaucoma. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1027.
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© ARVO (1962-2015); The Authors (2016-present)
To clarify whether parapapillary atrophy (PPA) area is related to severity of myopia and glaucoma.
95 eyes of 64 consecutive myopic subjects with and without open-angle glaucoma were included. Mean age ± SD was 55.3 ± 12.8. Eyes were categorized into three subgroups; highly myopic eyes with glaucoma (MG, 50 eyes), highly myopic eyes without glaucoma (M, 22 eyes), and mild to moderate myopic eyes with glaucoma (G, 23 eyes). High myopia was defined as having a refractive error of - 6 diopter or greater, or an axial length of 26.5 mm or greater. Serial images of the optic nerve head and the parapapillary area were obtained using commercially available SS-OCT system (DRI-OCT1) with 3D raster scan mode. En-face images at the level of the parapapillary area were obtained from reconstructed 3D images using image processing software (EnView). Beta zone and gamma zone PPA area were measured in en-face images in each eye, while adjusting for ocular magnification with modified Littman’s formula. Measurements were compared between subgroups. Relationships between PPA area and patient characteristics including visual field mean deviation (MD), axial length, and age were statistically evaluated.
Average beta zone and gamma zone PPA area were 1.39 ± 1.28 mm2 and 1.29 ± 1.49 mm2, respectively. Average gamma zone PPA area was significantly greater in the M (1.72 ± 1.89 mm2) and the MG (1.56 ± 1.44 mm2) group than in the G group (0.30 ± 0.33 mm2, P=0.0008), while there was no significant difference in the beta zone PPA area between groups (P=0.1251). Multivariable analysis revealed that axial length was positively correlated to both beta zone (P=0.0123) and gamma zone (P<0.0001) PPA area, whereas MD and age were not significantly correlated with either beta or gamma zone PPA area.
Both beta zone and gamma zone PPA area measured with SS-OCT were most strongly correlated to myopia, and were not significantly correlated to visual field sensitivity or age in myopic subjects. Pathogenesis and clinical significance of PPA in myopic eyes may differ from that of non-myopic eyes.
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