Regional differences in optical coherence tomography (OCT) optic nerve head and macula parameters for detecting glaucoma in eyes with and without high axial myopia

Abstract

Purpose : To identify regional differences in structural optic nerve head (ONH) and macula OCT parameters to improve discrimination between myopia and glaucoma in eyes with high axial myopia.

Methods : 885 eyes of 514 glaucoma patients and 767 eyes of 401 healthy subjects were stratified into 3 axial myopia groups: no myopia (n=368 glaucoma eyes and 411 healthy eyes), mild myopia (24mm < axial length [AL] < 26mm, n=393 glaucoma eyes and 271 healthy eyes), and high myopia (AL > 26 mm, n=124 glaucoma eyes and 85 healthy eyes). Linear mixed models were used to compare eye characteristics between groups, and age-, visual field mean deviation- and image quality score-adjusted area under the receiver operating characteristic curves (AUC) were used to evaluate the diagnostic accuracies of thickness parameters in 6 ONH sectors and 8 macula sectors.

Results : The distribution of the ONH thickness parameters (peripapillary RNFL [pRNFL], Bruch’s membrane opening minimum rim width [BMO-MRW]) and macula thickness parameters (ganglion cell inner plexiform layer [GCIPL] and macular RNFL [mRNFL]) varied by myopia status as shown in Figure 1 (healthy eyes) and Figure 2 (glaucoma eyes).
For ONH parameters the diagnostic accuracy was highest for global (AUC=0.95) and inferotemporal (AUC=0.91) pRNFL for high myopes and global BMO-MRW for non-myopes (AUC=1.0) and mild myopes (AUC=0.97).
The diagnostic accuracy of sectoral macula GCIPL was higher (AUC 0.79-0.92) than sectoral mRNFLT (AUC 0.52-0.89) in high myopes.

Conclusions : The diagnostic accuracy of ONH-derived pRNFL and macula-derived GCIPL for detecting glaucoma was high for high axial myopic eyes and can be used for glaucoma management in high myopes.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Distribution of global and sectoral optic nerve head and macula parameters in healthy eyes.

Abbreviaions Figure 1 and 2: BMO-MRW: Bruchs membrane opening minimum rim width, G: global, GCIPL: ganglion cell inner plexiform layer, I: inferior, IR: inner ring, mRNFL: macular retinal nerve fiber layer, N: nasal, NI: inferonasal, NS: superonasal, OR: outer ring, pRNFL: peripapillary retinal nerve fiber layer, S: superior, T: temporal, TI: inferotemporal, TS: superotemporal
* statistical significance between healthy and glaucoma group
# statistical significance between myopia groups

 

Distribution of global and sectoral optic nerve head and macula parameters in glaucoma eyes