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Optic nerve head (ONH) abnormalities are common in nonpathologic high myopia, with over 90% of eyes showing changes. These ONH findings correlate with visual field defects, aiding in differentiating from glaucoma.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diseases

Background:

  • High myopia is a significant risk factor for various ocular pathologies.
  • Optic nerve head (ONH) structure can be altered in myopia, potentially mimicking glaucomatous changes.
  • Understanding ONH abnormalities in nonpathologic high myopia is crucial for accurate diagnosis.

Purpose of the Study:

  • To characterize ONH abnormalities in nonpathologic highly myopic eyes using swept-source optical coherence tomography (OCT).
  • To investigate the relationship between identified ONH abnormalities and visual field (VF) defects.
  • To provide a basis for differentiating myopic ONH changes from pathologic conditions like glaucoma.

Main Methods:

  • Secondary analysis of a longitudinal cohort study.
  • Inclusion of highly myopic patients without significant myopic maculopathy.
  • Swept-source OCT imaging of the ONH, with classification of 3 major types and 12 subtypes of abnormalities.
  • Analysis of the prevalence, characteristics, and correlation with VF defects.

Main Results:

  • 91.86% of 1389 eyes exhibited at least one ONH abnormality.
  • Specific abnormalities like peripapillary hyperreflective ovoid mass-like structures and visible retrobulbar subarachnoid space were common.
  • VF defects correlated with abnormalities such as peripapillary retinal detachment and retinoschisis.
  • Glaucoma-like VF defects were associated with deep optic cups and optic disc pit/pit-like changes.

Conclusions:

  • Nonpathologic high myopia frequently presents with distinct ONH structural abnormalities.
  • These OCT-defined ONH changes are associated with specific visual field patterns.
  • The findings aid in distinguishing myopic ONH changes from those seen in pathologic myopia or glaucoma.