Abstract
PurposeTo evaluate the clinical features of peripapillary microvasculature in myopic eyes and investigate the association between the superficial and deep peripapillary microvascular density and the myopic optic disc characteristics.Materials and methodsThis cross-sectional study included one hundred and fifty healthy myopic eyes with β-peripapillary atrophy (β-PPA). Ovality index, degree of optic disc rotation, and the area of β-PPA were measured. Superficial and deep peripapillary microvascular density was measured using optical coherence tomography angiography. Logistic regression analysis was performed to look for the factors associated with peripapillary microvascular reduction.ResultsThe mean superficial peripapillary microvascular density was 62.14 ± 5.47%; 33 (22.0%) participants were found to have decreased microvascular density. Increased axial length (p < 0.001) and decreased average peripapillary retinal nerve fiber layer thickness (p = 0.027) were associated with the superficial peripapillary microvascular reduction. The mean deep peripapillary microvascular density was 73.76 ± 4.02%; 26 (17.33%) participants were found to have decreased microvascular density. Larger ovality index (p = 0.028) and more inferiorly rotated optic disc (p = 0.021) were associated with the deep peripapillary microvascular reduction.ConclusionsAxial elongation was significantly associated with microvascular reduction in the superficial peripapillary retina, whereas it was not associated with deep peripapillary microvascular reduction. The deep peripapillary microvascular density was independently associated with myopic optic disc characteristics such as ovality index and optic disc rotation.
Highlights
Myopic eyes, especially highly myopic eyes, demonstrate various morphologic changes in the optic disc, such as β-peripapillary atrophy (β-PPA), optic disc tilt, and rotation
The deep peripapillary microvascular density was independently associated with myopic optic disc characteristics such as ovality index and optic disc rotation
We found that eyes with inferiorly rotated optic disc show more glaucomatous constitutional anatomical changes, such as large β-PPA and reduced peripapillary retinal nerve fiber layer and macular ganglion cell-inner plexiform layer thickness compared to eyes with superiorly rotated optic disc
Summary
Especially highly myopic eyes, demonstrate various morphologic changes in the optic disc, such as β-peripapillary atrophy (β-PPA), optic disc tilt, and rotation. To investigate the anatomic mechanisms of the increased glaucoma susceptibility in myopic eyes, the above mentioned structural changes have been the focus of several studies [1, 2]. It was reported that the direction of optic disc tilt and rotation were important predictors of visual field (VF) defect location in normal-tension glaucoma. We found that eyes with inferiorly rotated optic disc show more glaucomatous constitutional anatomical changes, such as large β-PPA and reduced peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness compared to eyes with superiorly rotated optic disc. The association between peripapillary microvascular circulatory state and the morphologic changes of myopic optic disc have not been clearly elucidated yet
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