Advances of optical coherence tomography in myopia and pathologic myopia

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• High-axial myopia progression and associated pathologies remain incompletely understood.
• Optical coherence tomography (OCT) advancements offer novel insights into ocular structures in myopia.

Purpose of the Study:

• To explore new OCT findings in high myopia and their implications for understanding visual impairment.
• To highlight the clinical utility of OCT in diagnosing and managing myopic pathologies.

Main Methods:

• Utilized advanced optical coherence tomography (OCT), including swept source OCT, to image intraocular structures.
• Investigated specific OCT findings such as posterior precortical vitreous pocket, peripapillary intrachoroidal cavitation, and dome-shaped macula.
• Evaluated OCT's role in assessing optic nerve head pathologies and glaucomatous optic neuropathy.

Main Results:

• Identified novel OCT findings including posterior precortical vitreous pocket, precursor stages of posterior vitreous detachment, peripapillary intrachoroidal cavitation, and dome-shaped macula.
• Demonstrated swept source OCT's capability to image deeper posterior pole structures, aiding evaluation of optic nerve pits, lamina cribrosa, and retrobulbar spaces.
• Highlighted OCT's role in understanding visual field defects and glaucomatous optic neuropathy pathogenesis in high myopia.

Conclusions:

• OCT provides crucial diagnostic and monitoring capabilities for various conditions in pathologic myopia, including myopic traction maculopathy and myopic choroidal neovascularization.
• OCT is essential for evaluating surgical outcomes and understanding retinal nerve fiber redistribution in axial elongation for glaucoma management.
• Future validation of OCT-based biometry and topography will aid in classifying myopic maculopathy for research and clinical trials.