Macula structural and vascular differences in glaucoma eyes with and without high axial myopia

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• High myopia presents unique challenges in diagnosing and monitoring glaucoma.
• Axial length (AL) and visual field mean deviation (VFMD) are key parameters in glaucoma assessment.
• Understanding retinal layer thickness and superficial vessel density (sVD) in myopia is crucial.

Purpose of the Study:

• To identify clinically relevant parameters for glaucoma detection in highly myopic eyes.
• To investigate the relationship between retinal layer thickness, sVD, AL, and VFMD.
• To evaluate the utility of specific retinal measures for glaucoma monitoring in myopia.

Main Methods:

• Cross-sectional study of 270 glaucoma patients (438 eyes) with varying degrees of myopia.
• Macular optical coherence tomography (OCT) and OCT-angiography imaging were performed.
• Associations between AL, VFMD, and GCIPL, mRNFL, GCC, mCT, and sVD were analyzed.

Main Results:

• Thinner GCIPL and GCC correlated with worse VFMD but not AL.
• Thicker macular retinal nerve fibre layer (mRNFL) showed weak association with AL and positive association with VFMD.
• Lower sVD associated with increasing AL and more severe VFMD; thinner macular choroidal thickness (mCT) associated with increasing AL.

Conclusions:

• GCIPL and GCC thickness are associated with glaucoma severity in highly myopic eyes.
• These parameters may serve as valuable tools for monitoring glaucoma progression in this population.
• Retinal layer thickness and sVD provide insights into glaucoma pathophysiology in myopia.