Abstract
BackgroundTo investigate the relationship between an oval optic disc and the occurrence of myopic foveoschisis (MF) using swept-source optic coherence tomography (SS-OCT).MethodsFifty eyes of 25 patients with unilateral MF were included in this retrospective observational study. The biometric features of the optic disc and peripapillary structures were evaluated using SS-OCT.ResultsThe ovality index (OI) of the optic disc was significantly smaller (P = 0.003) and the optic disc tilt angle was greater (P = 0.023) in the eyes with MF than in the contralateral eyes. The optic disc tilt angle was significantly correlated with the OI (P = 0.000). Generalized estimating equation (GEE) model (linear regression) demonstrated that spherical equivalent refraction (P = 0.001), narrow macular staphyloma (P = 0.001) and the occurrence of MF (P = 0.026) were the independent factors associated with the OI. Narrow macular staphyloma was more frequent (P = 0.020) and the staphyloma was deeper (P = 0.006) in eyes with MF. GEE model (logistic regression) revealed that narrow macular staphyloma was the only independent factor related to the occurrence of MF (P = 0.013).ConclusionsAn oval optic disc in eyes with MF resulted from the increased tilt around the vertical disc axis. The optic disc tilt was related to narrow macular staphyloma, which was the only independent factor associated with the occurrence of MF. The clinical relevance needs further exploration through longitudinal analysis.
Highlights
To investigate the relationship between an oval optic disc and the occurrence of myopic foveoschisis (MF) using swept-source optic coherence tomography (SS-optical coherence tomography (OCT))
Peripapillary Average staphyloma depth, μm MF Myopic foveoschisis, SD Standard deviation model, spherical equivalent refraction (β = − 0.016, 95% CI = − 0.025 to − 0.006, P = 0.001), narrow macular staphyloma (β = − 0.152, 95% CI = − 0.240 to − 0.065, P = 0.001) and the occurrence of MF (β = − 0.073, 95% CI = − 0.137 to − 0.009, P = 0.026) were the independent factors associated with the ovality index (OI) (Table 4)
Demographic and ocular characteristics Age, years Axial length, mm Optic disc OI Disc tilt angle, degrees Disc torsion angle, degrees peripapillary atrophy (PPA)-β/γ zone PPA-β/γ width, μm Peripapillary scleral bending Scleral bending angle, degrees Posterior staphyloma Type II. narrow, macular Average staphyloma depth, μm Central foveal ChT, μm MF Myopic foveoschisis, OR Odds ratio, CI Confidence interval, GEE Generalized estimating equationm, OI Ovality index, PPA-β/γ Peripapillary atrophy-β/γ, ChT Choroidal thickness disc tilt degree was significantly correlated with the OI. These results suggest that the ovality of the optic disc in eyes with MF results from the optic disc tilt around the vertical disc axis [10], in which the temporal disc edge is angled towards the rear of the eye and the nasal edge is angled towards the front of the eye [12]
Summary
To investigate the relationship between an oval optic disc and the occurrence of myopic foveoschisis (MF) using swept-source optic coherence tomography (SS-OCT). High myopia is one of the most common causes of irreversible vision loss and blindness [1,2,3]. It has been estimated that high myopia will affect more than 1 billion people worldwide by 2050 [4, 5]. The typical degeneration that occurs in highly myopic eyes increases the risk of macular diseases, including choroidal neovascularization, foveoschisis, and macular hole (MH) [2, 3, 6, 7]. MF occurs in 8–34% of highly myopic eyes [9], and may gradually develop to foveal detachment, MH, or MH-associated retinal detachment [2, 8].
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