Optic Nerve Head Abnormalities in Nonpathologic High Myopia and the Relationship With Visual Field.

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.