Tufts University School of Medicine.
New England Eye Center, Tufts Medical Center, Boston, MA.
J Glaucoma. 2021 May 1;30(5):e213-e221. doi: 10.1097/IJG.0000000000001834.
Myopic glaucoma suspects, particularly with high myopia, experience thinning of nontemporal parameters of retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), without change in optic nerve head (ONH) parameters.
The aim was to assess the effect of myopia on RNFL, GCIPL, and ONH parameters in glaucoma suspects.
Seventy-six eyes of glaucoma suspects studied with Cirrus high definition optical coherence tomography were divided into low (n=27), moderate (n=25), and high myopia (n=24) groups. Optical coherence tomography parameters were correlated with spherical equivalent (SE) and evaluated with areas under the receiver operating characteristic curve for quantifying diagnostic ability to differentiate high myopia from nonhigh myopia.
In high myopia, SE was positively correlated with thinning of average, minimum, and nontemporal GCIPL and thinning of average and nontemporal RNFL (P<0.05 for all), but not for inferior RNFL (P=0.28). In moderate myopia, SE was correlated with thinning of inferonasal and minimum GCIPL as well as superior and inferior RNFL (P<0.05 for all). SE was not correlated with ONH parameters in moderate or high myopia (P>0.05). The largest areas under the receiver operating characteristic curve for RNFL and GCIPL parameters were for superior (0.82) and superonasal (0.80) regions, respectively, with comparable diagnostic ability (P=0.74).
High myopia, in particular, is associated with thinning of average RNFL, average and minimum GCIPL, and nontemporal parameters of both RNFL and GCIPL, warranting consideration of refractive status in glaucoma suspects.
近视性青光眼疑似患者,尤其是高度近视患者,会出现视网膜神经纤维层(RNFL)和神经节细胞内丛状层(GCIPL)的非颞侧参数变薄,而视神经头(ONH)参数不变。
评估近视对青光眼疑似患者的 RNFL、GCIPL 和 ONH 参数的影响。
使用 Cirrus 高清光学相干断层扫描仪对 76 只青光眼疑似患者的眼睛进行研究,将其分为低度近视(n=27)、中度近视(n=25)和高度近视(n=24)组。将光学相干断层扫描参数与等效球镜(SE)相关联,并通过受试者工作特征曲线下面积评估其区分高度近视与非高度近视的诊断能力。
在高度近视中,SE 与平均、最小和非颞侧 GCIPL 的变薄以及平均和非颞侧 RNFL 的变薄呈正相关(所有 P<0.05),但与下方 RNFL 无关(P=0.28)。在中度近视中,SE 与鼻下和最小 GCIPL 以及上、下 RNFL 的变薄相关(所有 P<0.05)。在中度或高度近视中,SE 与 ONH 参数无关(P>0.05)。RNFL 和 GCIPL 参数的受试者工作特征曲线下面积最大的区域分别为上方(0.82)和超鼻侧(0.80),诊断能力相当(P=0.74)。
高度近视,尤其是平均 RNFL、平均和最小 GCIPL 以及 RNFL 和 GCIPL 的非颞侧参数变薄,这与近视有关,因此在青光眼疑似患者中需要考虑屈光状态。