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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Structural and Functional Progression in Open-Angle Glaucoma with Unilateral Peripapillary Intrachoroidal Cavitation.

Kaho Akiyama1, Shuichiro Aoki1, Shiroaki Shirato2

  • 1Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Tokyo 113-8655, Japan.

Journal of Clinical Medicine
|March 28, 2026
PubMed
Summary

Open-angle glaucoma (OAG) eyes with peripapillary intrachoroidal cavitation (PICC) show similar visual field and retinal nerve fiber layer thickness progression to non-PICC eyes over five years. However, PICC is linked to slower superior visual field progression, while greater myopia-related changes correlate with faster progression.

Keywords:
circumpapillary retinal nerve fiber layer thicknessglaucomahigh myopialongitudinal studyoptic neuropathyperipapillary atrophyvisual field

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Retinal Imaging

Background:

  • Open-angle glaucoma (OAG) is a progressive optic neuropathy.
  • Peripapillary intrachoroidal cavitation (PICC) is a rare finding in highly myopic eyes, often associated with glaucoma.
  • Understanding the impact of PICC on glaucoma progression is crucial for patient management.

Purpose of the Study:

  • To investigate longitudinal changes in visual field (VF) and circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in OAG patients with unilateral PICC.
  • To identify factors associated with VF progression in these patients.

Main Methods:

  • Retrospective longitudinal observational study of 30 OAG patients with unilateral PICC (60 eyes).
  • Humphrey 24-2 VF testing and optical coherence tomography (OCT) over 5 years.
  • Analysis of VF progression (MD, TD slopes) and structural progression (cpRNFLT thinning rates).

Main Results:

  • No significant difference in overall VF or cpRNFLT progression rates between PICC and non-PICC eyes.
  • PICC presence was associated with slower superior VF progression (p=0.037).
  • Greater scleral flange opening (SFO)/Bruch's membrane opening (BMO) offset magnitude correlated with faster progression (p=0.047).

Conclusions:

  • OAG eyes with PICC demonstrate comparable functional and structural progression to fellow non-PICC eyes over five years.
  • PICC may have a protective effect on superior VF progression.
  • Myopia-associated optic nerve head deformation influences glaucoma progression rates.