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Central Retinal Vessel Trunk Dragging in Highly Myopic Eyes
Jost B Jonas1, Rahul A Jonas2, Ya Xing Wang3
1From the Rothschild Foundation Hospital, Paris, France (J.B.J., S.P.-J.); Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore (J.B.J.); Beijing Visual Science and Translational Eye Research Institute, Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China (J.B.J., Y.X.W.); L V Prasad Eye Institute, Hyderabad, Telangana, India (J.B.J., S.P.-J.); Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong (J.B.J.); New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA (J.B.J.); Privatpraxis Prof Jonas und Dr. Panda-Jonas, Heidelberg, Germany (J.B.J., S.P.-J.).
Purpose:
To assess occurrence and associations of central retinal vessel trunk (CRVT) dragging.
Design:
Retrospective, population-based cohort study.
Methods:
Using optical coherence tomographic images of the optic disc and macula, taken from the participants of the Beijing Eye Study, we assessed the prevalence of CRVT dragging, defined as an optic disc tissue prominence at the inferior, superior, and nasal, but not the temporal, optic disc border.
Results:
The study included 3336 individuals (3336 eyes) (mean age: 64.2 ± 9.6 years; axial length: 23.4 ± 1.2 mm [range: 20.16-30.88 mm]). CRVT dragging prevalence increased from 0/3046 (0%) to 9/173 (5.2%; 95% CI: 2, 9), 9/74 (12.2%; 95% CI: 5, 20), 6/25 (24.0%; 95% CI: 6, 42), and 13/18 (72.2%; 95% CI: 49, 95) in eyes with an axial length of ≤25.0 mm, 25.01 mm to 26.0 mm, 26.01 mm to 27.0 mm, 27.01 mm to 28.0 mm, and >28.0 mm, respectively. A higher CRVT dragging prevalence was associated (multivariable analysis) with a longer optic disc-fovea distance (odds ratio [OR]: 5.82; 95% CI: 2.23, 15.2; P < .001) and a higher prevalence of parapapillary retinoschisis (OR: 8.61; 95% CI: 2.43, 30.5; P < .001), after adjusting for longer axial length (OR: 1.95; 95% CI: 1.25, 3.05; P = .003) and older age (OR: 1.08; 95% CI: 1.02, 1.14; P = 0.008). In eyes with an axial length of ≥25.0 mm, CRVT dragging prevalence increased 5.69-fold (95% CI: 2.30, 14.1) for each millimeter increase in fovea-disc distance. These relationships were complemented by univariate associations between CRVT dragging prevalence and temporal retinal vessel straightening, smaller angle κ, higher myopic macular degeneration stage and prevalence, and larger parapapillary β zone and γ zone.
Conclusions:
CRVT dragging, as a common feature in highly myopic eyes, may be etiologically explained by the myopic axial elongation-related increase in the fovea-disc distance. Influencing the 3-dimensional appearance of the optic nerve head, CRVT dragging may be of importance for the morphologic diagnosis of optic neuropathies in highly myopic eyes.
