Bruch’s membrane opening enlargement and its implication on the myopic optic nerve head

Sung, Mi Sun; Heo, Min Young; Heo, Hwan; Park, Sang Woo

doi:10.1038/s41598-019-55926-w

Cited by 15 publications

(33 citation statements)

References 43 publications

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“…is also described in our recent report 8 . All subjects underwent comprehensive ophthalmologic examination consisting of the measurement of best-corrected visual acuity (BCVA), intraocular pressure (IOP) by Goldmann applanation tonometry, and refractive error by automated refraction.…”

supporting

confidence: 67%

“…The inclusion criteria were: (1) healthy subjects 20 to 35 years old, (2) highly myopic eyes with axial length greater than 26 mm, (3) astigmatism within ± 2 diopters (D), (4) BCVA of 20/25 or better, (5) IOP ≤ 21 mmHg, (6) normal anterior chamber angles, (7) nonglaucomatous ONHs on stereoscopic photographs (8) absence of any RNFL abnormalities on red-free fundus photographs, and (9) normal visual field (VF) results in both eyes. Because myopic refractive error can be affected by lenticular changes, and aging may increase the incidence of glaucoma, we excluded subjects older than 35 years.…”

mentioning

confidence: 99%

“…All the B-scans were manually checked, and BMO points were corrected when necessary. When BMO points were indiscernible, the points were fitted with a spline to derive a closed curve and a smooth contour line based on BMO points of adjacent B-scans 8 . If BMO points were indiscernible on four or more consecutive B-scan images, the eyes were excluded from the study.…”

mentioning

confidence: 99%

“…1A). The details on the ONH measurements are also described in our previous reports 6,8 . The ONH was scanned by centering a 15° × 10° rectangular scan on the ONH.…”

mentioning

confidence: 99%

“…In case of the termination of BM is not clearly visible on the horizontal EDI B-scan, we reviewed the radial B-scans from GMPE mode to identify the result of BMO delineation, and referred to them for determination of BM termination points on the EDI B-scans. The measurement was performed using a previously described method [6][7][8][9][10][11] .…”

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confidence: 99%

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Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Sung

Heo

Piao

et al. 2020

Sci Rep

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We investigated the relationship between microstructure of β-parapapillary atrophy (β-ppA) and morphologic features of optic nerve head (onH) and posterior pole in highly myopic eyes. eighty-nine highly myopic eyes were included in this study. Bruch's membrane opening (BMo) area, lamina cribrosa (Lc) thickness, anterior laminar depth, peripapillary and subfoveal choroidal thickness (ct), macular Bruch's membrane (BM) length, and width of β-ppA with and without Bruch's membrane (ppA +BM and ppA −BM ) were evaluated. The mean age and axial length of the included subjects were 26.88 ± 2.44 years and 27.03 ± 0.88 mm, respectively. The width of PPA −BM was larger with increasing BMo area (P = 0.001), whereas the BMO area was not associated with the width of PPA +BM . the large ppA +BM was significantly related to a thinner LC (P = 0.003), deeper anterior lamina surface (P < 0.001), longer macular BM length (P = 0.008), and thinner temporal peripapillary CT (P = 0.034). We found that the morphologic features of the ONH and posterior pole in highly myopic eyes were different based on the microstructure of β-ppA. Whether these features are linked to the development of glaucoma in myopic eyes should be investigated in future studies.Classic funduscopic β-parapapillary atrophy (β-PPA) is a region of visible large choroidal vessels and sclera due to the lack of retinal pigment epithelium (RPE). β-PPA can be histologically subclassified based on the presence or absence of Bruch's membrane (BM): β-PPA with BM (PPA +BM ; β zone) and β-PPA without BM (PPA −BM ; γ zone). It has been known that PPA +BM might be due to age-related atrophy of the RPE and associated with the development of glaucoma 1-4 . Whereas, PPA −BM has been considered as a result of mechanical stretching in the peripapillary sclera and border tissue during axial elongation; hence a significant association between axial length and PPA −BM width has been consistently reported 1-3,5 . However, we previously reported that PPA +BM was also found in 20-30-year-old myopia subjects and suggested that PPA +BM in young myopia patients might be related to axial elongation, not age-related atrophy 6 . In accordance with our report, Lee et al. 7 recently found an enlargement of PPA +BM as myopia progressed and proposed that PPA +BM found in children might be an entirely different entity from PPA +BM in elderly individuals, sharing an etiology with PPA −BM .Several factors might contribute to β-PPA development during axial elongation, but the etiology of PPA +BM and PPA −BM enlargement remains elusive so far. It is unclear why some myopia patients exhibit only PPA −BM , whereas others with a similar degree of myopia exhibit both PPA +BM and PPA −BM . In this study, we hypothesized that morphologic features of the optic nerve head (ONH) and the posterior pole might give clues to the mechanisms of differential developments of β-PPA in myopic eyes. Therefore, the purpose of this work was to investigate the relationship between microstructure of β-PPA and the morphologic featur...

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supporting

confidence: 67%

mentioning

confidence: 99%

mentioning

confidence: 99%

“…1A). The details on the ONH measurements are also described in our previous reports 6,8 . The ONH was scanned by centering a 15° × 10° rectangular scan on the ONH.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Sung

Heo

Piao

et al. 2020

Sci Rep

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Deep Transfer Learning for Ethnically Distinct Populations: Prediction of Refractive Error Using Optical Coherence Tomography

Jain,

Yoo,

Ryu

et al. 2023

Ophthalmol Ther

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Introduction The mismatch between training and testing data distribution causes significant degradation in the deep learning model performance in multi-ethnic scenarios. To reduce the performance differences between ethnic groups and image domains, we built a deep transfer learning model with adaptation training to predict uncorrected refractive errors using posterior segment optical coherence tomography (OCT) images of the macula and optic nerve. Methods Observational, cross-sectional, multicenter study design. We pre-trained a deep learning model on OCT images from the B&VIIT Eye Center (Seoul, South Korea) ( N = 2602 eyes of 1301 patients). OCT images from Poona Eye Care (Pune, India) were chronologically sorted into adaptation training data ( N = 60 eyes of 30 patients) for transfer learning and test data ( N = 142 eyes of 71 patients) for validation. Deep learning models were trained to predict spherical equivalent (SE) and mean keratometry ( K ) values via transfer learning for domain adaptation. Results Both adaptation models for SE and K were significantly better than those without adaptation ( P < 0.001). In myopia/hyperopia classification, the model trained on circular optic disc OCT images yielded the best performance (accuracy = 74.7%). It also performed best in estimating SE with the lowest mean absolute error (MAE) of 1.58 D. For classifying the degree of corneal curvature, the optic nerve vertical algorithm performed best (accuracy = 65.7%). The optic nerve horizontal model achieved the lowest MAE (1.85 D) when predicting the K value. Saliency maps frequently highlighted the retinal nerve fiber layers. Conclusions Adaptation training via transfer learning is an effective technique for estimating refractive errors and K values using macular and optic nerve OCT images from ethnically heterogeneous populations. Further studies with larger sample sizes and various data sources are needed to confirm the feasibility of the proposed algorithm. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-023-00842-6.

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Optical coherence tomography technology in clinical applications

Tang,

Magalhães,

Wisniowiecki

et al. 2024

Biophotonics and Biosensing

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Bruch’s membrane opening enlargement and its implication on the myopic optic nerve head

Cited by 15 publications

References 43 publications

Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Deep Transfer Learning for Ethnically Distinct Populations: Prediction of Refractive Error Using Optical Coherence Tomography

Optical coherence tomography technology in clinical applications

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