Macula Deformability as a Potential Biomarker for High Myopia Eyes at Risk of Developing Glaucoma and Pathologic Myopia

Abstract

Purpose : To assess the macula deformation following IOP elevation in healthy, highly myopic (HM) eyes, highly myopic eyes with glaucoma (HMG) and pathologic myopia (PM).

Methods : We recruited 328 subjects, which comprised of 32 emmetropic controls, 50 HM (>26 mm in axial length), 108 HMG and 138 PM subjects (PM defined as HM + staphyloma and/or myopic macular degeneration). For each subject, we imaged the macula using Spectral-domain optical coherence tomography (OCT) under at baseline and under acute intraocular pressure (IOP) elevation through ophthalmodynamometry to ~40mmHg. Macula scans were manually-aligned using 4 choroidal landmarks to allow comparison of scans of a given eye at baseline vs. during IOP elevation. We then automatically segmented the sclera and the choroid tissues using a deep-learning algorithm and extracted the point clouds of the sclera-choroid interface. Macula curvatures were calculated by fitting a second-degree polynomial to the sclera-choroid points cloud along the nasal-temporal direction at 100-micron intervals).

Results : IOP elevation resulted in a high macula curvature change in the PM (10.5±10.2 micron^-1) and HMG (5.2±5.1 micron^-1) eyes as compared to HM (3.1±2.7 micron^-1) eyes (both p < 0.05). Interestingly, HM eyes had the same curvature change as emmetropic eyes (4.2±4.3 micron^-1).

Conclusions : We found that the macula of pathologic eye (i.e. eyes with HMG and/or PM) were more sensitive to IOP elevation as compared to HM eyes and emmetropic eyes. These preliminary results indicate that macula curvature changes may serve as a biomarker for HM eyes at risk of developing other pathologies (e.g. glaucoma and staphyloma).

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.