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Glaucoma in high myopia and parapapillary delta zone
Jost B Jonas1, Pascal Weber1, Natsuko Nagaoka2
1Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University of Heidelberg, Mannheim, Germany.
Plos One
|April 6, 2017
Summary
Glaucomatous optic neuropathy (GON) prevalence increases with axial length in myopic patients. A larger parapapillary delta zone and optic disc size are associated with higher GON risk.
Area of Science:
- Ophthalmology
- Optometry
- Medical Imaging
Background:
- Glaucomatous optic neuropathy (GON) is a leading cause of irreversible blindness.
- High myopia is a significant risk factor for developing GON.
- Understanding the structural correlates of GON in myopic eyes is crucial for early detection and management.
Purpose of the Study:
- To determine the prevalence of GON in patients with medium to high myopia.
- To investigate the association between GON and parapapillary gamma and delta zones.
- To identify risk factors for GON in a myopic population.
Main Methods:
- Retrospective observational study of 519 eyes from patients attending Tokyo High Myopia Clinics (2012).
- Fundus photographs were used to define and assess glaucomatous optic neuropathy (GON).
- Multivariate analysis was performed to identify associations between GON and ocular parameters.
Main Results:
- GON was present in 27.2% of the studied eyes.
- GON prevalence increased significantly with longer axial length, reaching 42.1% in eyes with axial length ≥30mm.
- Higher GON prevalence was associated with larger parapapillary delta zone diameter (OR:1.86) and larger vertical optic disc diameter (OR:1.70), after adjusting for axial length and age.
Conclusions:
- A mean of 28.1% of medium to highly myopic eyes exhibited GON.
- The parapapillary delta zone, acting as a surrogate for an elongated peripapillary scleral flange, is associated with increased GON prevalence.
- Larger optic disc size is also a significant factor associated with GON in myopic individuals.