Eight Years and Beyond Longitudinal Changes of Peripapillary Structures on OCT in Adult Myopia

To investigate the long-term changes of peripapillary structures detected by enhanced depth imaging of optical coherence tomography (OCT) in adult myopia.

Observational case series.

Myopic participants who had undergone a full baseline ophthalmologic examination and had been followed up for a minimum of 8 years were included. Using enhanced depth imaging of OCT, scans around the optic disc in the Spectralis software Follow-up mode, which enabled capturing of the same positions, were performed in 65 eyes. The peripapillary parameters including the size of border tissue, Bruch membrane opening (BMO), peripapillary choroidal thickness, and the angle between peripapillary Bruch membrane (BM) and anterior sclera were manually delineated and measured.

The axial length showed a significant elongation after a mean follow-up of 9.46 ± 0.92 years. The rates of changes were 0.015 ± 0.011 mm/y in the medium myopia group and 0.057 ± 0.039 mm/y in the high myopia group. At the last visit, the average border tissue length and BMO diameter were increased. The angle between peripapillary BM did not show significant change, while the angle between the peripapillary sclera showed a significant rise. On multivariate analysis, the border tissue elongation, BMO enlargement, and increased sclera angle were all associated with a change in axial length. The development of a BM defect and inward protrusion of sclera in the temporal peripapillary region was observed on 8 eyes (34.8%) in the high myopia group, along with an extreme thinning or disappearing of the peripapillary choroid.

Marked longitudinal changes in peripapillary structures including border tissue, BM, choroid, and sclera could be observed in adult myopic eyes, which may impact the biomechanical environment around the optic nerve head.