Abstract
Myopic people face an elevated risk of primary open angle glaucoma. Changes in the fundus in people with high myopia often lead to misdiagnosis of glaucoma, as this condition has many clinical signs in common with myopia, making the diagnosis of glaucoma more challenging. Compared to reduction of the visual field, a decrease in retinal nerve fibre layer (RNFL) thickness occurs earlier in glaucoma, which is widely considered useful for distinguishing between these conditions. With the development of optical coherence tomography (OCT), RNFL thickness can be measured with good reproducibility. According to previous studies, this variable is not only affected by axial length but also related to the patient's age, gender, ethnicity, optic disc area, and retinal blood flow in myopia. Herein, we intend to summarize the factors relevant to the RNFL in myopia to reduce the false-positive rate of glaucoma diagnosis and facilitate early prevention of myopia.
Highlights
Myopia is one of the most common ocular diseases worldwide. e prevalence of myopia is estimated at approximately 20% to 30% among children in Singapore [1], and this figure is expected to increase in the future
Considering the way age affects the retinal nerve fibre layer (RNFL) in myopia, it is crucial to enter the correct date of birth, which can prevent irregularities in RNFL thickness measurement that could lead to misdiagnosis
It has been reported that at least one segmentation error occurred in 19.9% to 46.3% of scans [89]. Such segmentation artefacts are especially likely to occur in high myopia [90]. is relatively high estimation of the possibility of segmentation errors might be attributed to thinner RNFL thickness caused by elongation of the eye [91]. erefore, this segmentation error caused by thinner RNFL thickness might result in more errors in both high myopia and glaucomatous eyes since glaucoma is associated with decreased regional RNFL thickness
Summary
Myopia is one of the most common ocular diseases worldwide. e prevalence of myopia is estimated at approximately 20% to 30% among children in Singapore [1], and this figure is expected to increase in the future. SS-OCT uses a longer wavelength (1050–1060 nm) than conventional OCT, allowing the beams to penetrate the retinal pigment epithelium (RPE) and image deeper tissues such as the choroid and posterior sclera [4, 5]; conventional OCT, with a shorter wavelength of approximately 840 nm, has difficulty measuring these tissues [6]. It is suitable for the measurement of eyes with cataracts due to its reduced attenuation from scattering in opaque media [7]. Considering the way age affects the RNFL in myopia, it is crucial to enter the correct date of birth, which can prevent irregularities in RNFL thickness measurement that could lead to misdiagnosis
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