Utility of OCT for Detection or Monitoring of Glaucoma in Myopic Eyes

Abstract

Evaluation of glaucomatous structural changes in myopic eyes is difficult due to the considerable morphological variations in the optic nerve head (ONH) and other posterior segment structures of the eye. The ONH can frequently mimic glaucoma in healthy myopic eyes. Optical coherence tomography (OCT) allows in vivo quantitative analysis of the ONH, retinal nerve fiber layer (RNFL), and macular area but interpreting the findings in myopic and especially highly myopic eyes, may be challenging due to the anatomical changes associated with enlargement of the eye; this is complicated by the absence of normative databases tailored to myopic individuals. Still, OCT can be used as a complementary test to clinical exam and visual field testing for detection of glaucoma as well as for progression analysis. Clinicians should be familiar with the practical aspects and cognizant of the pitfalls of OCT imaging in patients with myopia with or without glaucoma.