We examined the association between Bruch’s membrane opening (BMO) area and various ocular parameters and investigated the implication of BMO enlargement on the myopic optic nerve head. One hundred eighty-five myopic eyes were included in this cross-sectional study. Among the included eyes, 53 having axial lengths between 26 and 27 mm were further analyzed to investigate the association between BMO area and various ocular parameters. BMO area, BMO-minimum rim width (BMO-MRW), peripapillary choroidal thickness (pCT), width of β-parapapillary atrophy with and without Bruch’s membrane (PPA+BM and PPA−BM), and presence of lamina cribrosa (LC) defect were evaluated. We found that BMO area tended to increase with increasing axial length, but varied among the highly myopic eyes even though they had similar degrees of myopia. In the subgroup analysis of eyes with axial lengths between 26 and 27 mm, BMO area was highly variable and it significantly correlated with PPA−BM width and temporal-inferior, nasal-inferior, and nasal BMO-MRW and pCT. LC defects were more common in myopic eyes with enlarged BMO. A multivariate regression model revealed that higher intraocular pressure, enlarged BMO, and thinner BMO-MRW were associated with LC defects in highly myopic eyes. These findings should be considered when evaluating myopic eyes.
A 73-year-old Asian male presented with a 2-week history of acute visual disturbance in his right eye. Visual acuity in his right eye was hand movement and fundus examination showed right optic disc oedema and splinter haemorrhages on the disc margin. Each time the patient visited our clinic, spectral domain optical coherence tomography (OCT) was performed. He was diagnosed to have non-arteritic anterior ischaemic optic neuropathy. Optical coherence tomography showed disagreement between the areas of early peripapillary retinal nerve fibre layer thickening and macular ganglion cell layer thickness reduction.
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