Macular microvasculature asymmetry in high myopia patients with early open-angle glaucoma.

To evaluate the effectiveness of vertical asymmetry analysis of the macular microvasculature in high myopia patients with open-angle glaucoma (OAG). Participants were divided into two groups: those with high myopia (group 1) and those with both high myopia and OAG (group 2). Peripapillary retinal nerve fiber layer (RNFL) thickness, vessel density (VD), and the absolute vertical difference of RNFL thickness (vdRNFL) and VD (vdVD) were compared. A logistic regression analysis determined the factors associated with OAG, and diagnostic accuracy was assessed using the area under the curve (AUC). Mean RNFL thickness was 91.2 ± 11.5 and 78.2 ± 13.0 μm (P < 0.001) and the VD of the full area was 17.5 ± 1.9 and 16.6 ± 2.4 mm (P = 0.040) in group 1 and group 2, respectively. The vdRNFL was not significantly different (P = 0.385), whereas the vdVD showed a significant difference (P < 0.001) between the groups. Multivariate analysis revealed that mean RNFL thickness (OR 0.88, P < 0.001) and vdVD (OR 3.07, P = 0.004) were significantly associated with OAG in high myopia patients. The AUC for vdVD was 0.82 (95% CI 0.73-0.90) and the combining mean RNFL thickness with vdVD yielded the highest AUC (0.91, 95% CI 0.85-0.96). For diagnosing OAG in high myopia patients, vertical asymmetry analysis of the macular microvasculature, combined with mean RNFL thickness, is advantageous.