Sector-Specific Patterns of RNFL and Ganglion Cell Complex Thinning Across the Myopia Spectrum: A Cross-Sectional...

Area of Science:

• Ophthalmology
• Retinal Imaging
• Myopia Research

Background:

• Myopia is a growing global health issue, primarily caused by axial elongation.
• Axial elongation stresses the inner retina, leading to progressive thinning of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC).
• The sector-specific patterns of RNFL and GCC changes in myopia require further characterization.

Purpose of the Study:

• To analyze RNFL and GCC changes at a sector level across four myopia severity grades using OCTA.
• To quantify correlations between RNFL/GCC thickness, axial length (AL), and central foveal thickness (CFD).

Main Methods:

• Prospective cross-sectional study of 260 eyes from 130 participants (emmetropia, low, moderate, high myopia).
• Optical coherence tomography angiography (OCTA) was used for imaging.
• RNFL thickness assessed in 5 peripapillary sectors; GCC thickness in 12 macular zones.
• Statistical analysis included ANOVA, Kruskal-Wallis, and Pearson correlations.

Main Results:

• Progressive RNFL and GCC thinning observed with increasing myopia severity.
• Superior RNFL and paratemporal GCC showed earliest structural changes, detectable in low myopia.
• Axial length correlated negatively with RNFL and GCC thickness.
• Central foveal thickness showed stronger coupling with GCC thickness in higher myopia grades.

Conclusions:

• Myopic RNFL and GCC thinning is progressive and sector-specific, driven by axial elongation.
• Superior RNFL and paratemporal GCC are early indicators of inner retinal changes in myopia.
• Findings support a neural-first model of myopia-related retinal remodeling, advocating for targeted monitoring.