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Tin A. Tun, Xiaofei Wang, Mani Baskaran, Monisha E. Nongpiur, Yih-Chung Tham, Shamira A. Perera, Nicholas G. Strouthidis, Tin Aung, Ching-Yu Cheng, Michaël J. A. Girard; Variation of Peripapillary Scleral Shape With Age. Invest. Ophthalmol. Vis. Sci. 2019;60(10):3275-3282. doi: https://doi.org/10.1167/iovs.19-26777.
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To define the shape of the anterior surface of the peripapillary sclera (PPS) and evaluate its relationship with age and ocular determinants in a population-based Chinese cohort.
The optic nerve heads of 619 healthy Chinese subjects were imaged with spectral-domain optical coherence tomography. To assess the shape of the PPS/Bruch's membrane (BM), we measured the angle between a line parallel to the nasal anterior PPS/BM boundary and one parallel to the temporal side. A negative value indicated that the PPS/BM followed an inverted v-shaped configuration (peak pointing toward the vitreous), whereas a positive value indicated that it followed a v-shaped configuration (peak pointing toward the orbital tissues). A linear regression model was used to evaluate the relationship between the PPS angle and other ocular parameters.
The mean PPS angle was 3.68° ± 6.73° and the BM angle was 9.69° ± 5.05°. The PPS angle increased on average by 0.233 deg/y. A v-shaped PPS was significantly associated with age (β = 0.087, P = 0.004), peripapillary choroidal thickness (β = −0.479, P < 0.001), lamina cribrosa depth (β = 0.307, P < 0.001), and BM angle (β = 0.487, P < 0.001) after adjusting for best corrected visual acuity, central corneal thickness, and axial length.
The anterior surface of PPS of an elderly adult population had a v-shaped configuration and was more pronounced with increasing age, thin peripapillary choroid, and a deep cup. Such a change in shape with age could have an impact on the biomechanical environment of the optic nerve head.
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