Macular thickness and vessel density in glaucoma eyes with and without high axial myopia

Abstract

Purpose : To investigate the association between various macular layer thicknesses and superficial vessel density measurements and both axial length (AL) and glaucoma severity to improve glaucoma detection in highly myopic eyes.

Methods : 248 glaucoma patients (401 eyes) with AL measurements and macular optical coherence tomography (OCT) imaging were stratified into three axial myopia groups of no- (146 eyes), mild- (208 eyes) and high-axial myopia (AL > 26mm) (47 eyes). Ganglion cell inner plexiform layer (GCIPL) thickness, macular retinal nerve fiber layer (mRNFL) thickness, ganglion cell complex (GCC) thickness and the macular superficial vessel density (sVD) were measured with the built-in software and macular choroidal thickness (mCT) was assessed using deep learning strategies for each axial myopia group. Univariate and age- and VFMD-adjusted models were assessed to evaluate the association between structural measures and AL and VFMD.

Results : Thinner global GCIPL and GCC were not associated with AL (p<0.350) but were significantly associated with visual field mean deviation (VFMD) (R²=35.1; and R²=33.4; respectively p<0.001). Thicker mRNFL showed a weak association with larger AL (R²=3.4; p=0.001) and a positive association with VFMD (global R²=20.5; p<0.001). Lower sVD was moderately associated with worse VFMD (R²=31.8; p<0.001) and weakly associated with larger AL (R²=2.3; p=0.016). Thinner MCT was not associated with VFMD (P=0.262) but was associated with larger AL (R²=17.3; p<0.001).

Conclusions : Thinner GCIPL and GCC were associated with more severe glaucoma and were not associated with AL suggesting that these measurements might be useful for glaucoma detection in myopic eyes.

This is a 2021 ARVO Annual Meeting abstract.