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Joseph T. Nezgoda, Sung Chul Park, Saman Kiumehr, Christopher C. Teng, Celso Tello, Jeffrey M. Liebmann, Robert Ritch; Enhanced Depth Imaging Optical Coherence Tomography of Deep Optic Nerve Complex Structures in High Myopia Compared to Low Myopia. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2195.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) findings of deep structures of the optic nerve complex (ONC: optic nerve head + peripapillary structures) in glaucoma between high and low myopia.
Serial horizontal and vertical B-scan images (interval between images: approximately 30 µm) of the optic nerve head were obtained using EDI SD-OCT for both eyes of glaucoma subjects. Lamina cribrosa (LC), peripapillary retina, choroid and vessels, and subarachoid space around the optic nerve were evaluated and compared between eyes with high myopia (spherical equivalent [SE] refractive error <-6 D) and those with low myopia (SE refractive error between -3 and 0 D).
A total of 46 glaucoma subjects (92 eyes) were included (30 eyes with high myopia and 62 with low myopia). SE refractive error was -9.4±2.1 D in the high myopia and -1.2±0.6 D in the low myopia group (P<0.01). Visual field mean deviation was similar between the high and low myopia groups (-10.4±3.2 vs. -9.7±4.1 dB, P=0.4). Both short posterior ciliary arteries (SPCAs) and their branches (Fig A) and the LC (Fig B) were better visualized in the high myopia group. The subarachnoid space around the optic nerve was more frequently visualized (14/30 eyes [47%] vs 8/62 eyes [13%], P=0.01) and with better detail in the high myopia group (Fig C). Intrachoroidal cavitation or choroidal schisis (Fig D) and a focal full-thickness defect of the ocular wall (retina-choroid-sclera) (Fig E), both of which had been clinically overlooked or unrecognized, were found in 3 and 1 high myopic eyes, respectively, but not in low myopic eyes.
Using EDI SD-OCT, deep ONC structures are better visualized in the eyes with high myopia than in those with low myopia. EDI SD-OCT is useful in detecting subclinical ONC abnormalities in high myopia.
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