Purchase this article with an account.
Daiyan Xin, Nicole De Cuir, Maria Anna Mavrommatis, Juan Reynaud, Ravivarn Jarukasetphon, C Gustavo De Moraes, Brad Fortune, Robert Ritch, Donald Charles Hood; High myopia and glaucoma: The nature of paravascular defects (PD) and macular epiretinal membranes (ERMs) as seen on en-face slab OCT images.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):861.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Both high myopia and glaucoma are associated with paravascular defects (PDs) and epiretinal membranes (ERMs).[1-3] To categorize the frequency and spatial distribution of PDs and ERMs, myopic glaucoma or glaucoma suspect eyes were studied with en-face OCT slab images.[4,5]
Wide-field, swept-source OCT cube scans (9x12 mm, DRI-OCT, Topcon, Inc) were obtained on 103 eyes of 60 patients (51.7±13.7 yrs) with axial lengths ≥26.5 mm and/or refractive error ≤-6D. All eyes had abnormal or suspicious discs on stereo-photos. 45 eyes were classified as glaucoma suspects (GLS) and 58 as glaucomatous (GL) based upon 24-2 VFs. 68 eyes from 49 healthy individuals (55.6±9.6 yrs) had a refractive error between ±6D. Using special purpose software (ATL 3D-Suite), and the inner limiting membrane (ILM) as a reference, 52 um thick en-face slabs of average reflective intensity were generated (figs). Two graders, masked as to eye classification, identified PDs (yellow arrow) and ERMs (red arrow) on the en-face slab images using horizontal and derived vertical b-scans (fig. 1), as previously described. An ERM had to show both a thickening of the ILM and a separation between the ILM and the retinal nerve fiber layer.
The PDs/ERMs were found in 22(37.9%)/15 (25.8%) of the 58 GL eyes, 12(26.7%)/4(8.9%) of the 45 GLS eyes, and 2(2.9%)/0(0%) of the controls. PDs were significantly more common in GL eyes than in GLS eyes (P= 0.003), which in turn were more common than in control eyes (P=0.001). ERMs were significantly more common in GL eyes than in GLS eyes (P<0.001), which in turn were more common than in control eyes (P< 0.001). The 41 PDs in 34 patient eyes were most often adjacent to the superior (79.4% of eyes) and inferior (41.2%) temporal vessels (fig 2, yellow borders). The ERM locations were typically in the macular area (63.2% of eyes with ERMs)(fig 2, red border). 11 of the 19 eyes with ERMs also had PDs.
PDs and ERMs are common in patients with high myopia and glaucoma. It remains to be determined how they affect both visual fields and glaucoma diagnosis. 1. Xin et al. IOVS 2011; 2. Muraoka et al. JAMA Ophth 2015; 3. Vela J et al. Int Ophalmol 2015; 4. Fortune et al. IOVS 2014. 5. Hood, et al. IOVS 2015.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Fig 1. En-face slab images with b-scan insets.
Fig 2: Location of PDs (yellow) and ERMs (red)
This PDF is available to Subscribers Only