Effect of peripapillary tilt direction and magnitude on central visual field defects in primary open-angle glaucoma with high myopia

Usui, Shinichi; Ikuno, Yasushi; Asai, Tomoko; Kikawa, Tsutomu; Miki, Atsuya; Matsushita, Kazunobu; Kawasaki, Ryo; Nishida, Kohji

doi:10.1007/s10384-020-00747-y

Cited by 4 publications

(1 citation statement)

References 37 publications

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“… 62 , 63 The direction and degree of peripapillary tilt in high myopia was significantly correlated with central VF damage. 64 Damage to the lamina cribrosa was also associated with optic disc tilt, which may explain why the location of VF damage is within the central VF region in myopic eyes. 65 In addition to structural deformation associated with myopia, other factors, such as impaired blood flow, could be in accordance with central scotoma in myopic eyes.…”

Section: Discussionmentioning

confidence: 99%

Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia

Hong

Kim

Shin

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to investigate the ocular and hemodynamic factors contributing to the central visual function in glaucoma patients with myopia. Methods This study was a prospective observational study, which included 236 eyes of 140 patients with normal-tension glaucoma (NTG), which includes 114 eyes with mild myopia (axial length ≥24 and <26 mm) and 122 eyes with moderate-to-severe myopia (axial length ≥26 mm). Ocular characteristics were axial length and posterior pole profiles, including peripapillary atrophy (PPA) to disc area ratio, disc tilt ratio, disc torsion, and disc-foveal angle. Hemodynamic factors included standard deviation of the mean of qualified normal-to-normal intervals (SDNN) of a heart rate variability (HRV) test and vessel density (VD) parameters from optical coherence tomography angiography (OCTA). The root mean square error was estimated as a measure of the VD fluctuation. Association between ocular characteristics and VD parameters of the OCTA with the central sensitivity of the 10-degree visual field or the presence of central scotoma were analyzed. Results Deep layer VD of the peripapillary and macular areas showed significant differences between mild and moderate-to-severe myopia ( P = 0.034 and P = 0.045, respectively). Structural parameters, especially PPA to disc area ratio, had significant correlation with peripapillary VD parameters in myopic eyes. Lower SDNN value (ß = 0.924, P = 0.011), lower deep VD of the macular area (ß = 0.845, P = 0.001), and greater fluctuation of deep VD in the peripapillary area (ß = 1.517, P = 0.005) were associated with the presence of central scotoma in patients with glaucoma with myopia in multivariate logistic regression analysis. Conclusions The structural changes by myopia, especially in the peripapillary region, affected VD parameters in myopic eyes. Lower deep VD and greater VD fluctuation in the peripapillary region showed association with central scotoma in patients with glaucoma with myopia, suggesting both structural and vascular changes by myopia may be related to central visual function in glaucoma patients with myopia.

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Section: Discussionmentioning

confidence: 99%

Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia

Hong

Kim

Shin

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Progress in clinical characteristics of high myopia with primary open-angle glaucoma

Lu,

Ji,

Jia

et al. 2023

Biotechnology and Genetic Engineering Reviews

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Central visual field damage in glaucoma eyes with choroidal microvasculature dropout with and without high axial myopia

Micheletti¹,

El-Nimri²,

Nishida³

et al. 2023

Br J Ophthalmol

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PurposeTo characterise the relationship between a deep-layer microvasculature dropout (MvD) and central visual field (VF) damage in primary open-angle glaucoma (POAG) patients with and without high axial myopia.DesignCross-sectional study.MethodsSeventy-one eyes (49 patients) with high axial myopia and POAG and 125 non-highly myopic POAG eyes (97 patients) were enrolled. Presence, area and angular circumference of juxtapapillary MvD were evaluated on optical coherence tomography angiography B-scans and en-face choroidal images.ResultsJuxtapapillary MvD was detected more often in the highly myopic POAG eyes (43 eyes, 86%) than in the non-highly myopic eyes (73 eyes, 61.9%; p=0.002). In eyes with MvD, MvD area and angular circumference (95% CI) were significantly larger in the highly myopic eyes compared with the non-highly myopic eyes (area: (0.69 (0.40, 0.98) mm2vs 0.31 (0.19, 0.42) mm2, p=0.011) and (angular circumference: 84.3 (62.9, 105.8) vs 74.5 (58.3, 90.9) degrees, p<0.001), respectively. 24-2 VF mean deviation (MD) was significantly worse in eyes with MvD compared with eyes without MvD in both groups (p<0.001). After adjusting for 24-2 MD VF, central VF defects were more frequently found in eyes with MvD compared with eyes without MvD (82.7% vs 60.9%, p<0.001). In multivariable analysis, higher intraocular pressure, worse 24-2 VF MD, longer axial length and greater MvD area and angular circumference were associated with worse 10-2 VF MD.ConclusionsMvD was more prevalent and larger in POAG eyes with high myopia than in non-highly myopic POAG eyes. In both groups, eyes with MvD showed worse glaucoma severity and more central VF defects.

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Effect of peripapillary tilt direction and magnitude on central visual field defects in primary open-angle glaucoma with high myopia

Cited by 4 publications

References 37 publications

Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia

Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients With Myopia

Progress in clinical characteristics of high myopia with primary open-angle glaucoma

Central visual field damage in glaucoma eyes with choroidal microvasculature dropout with and without high axial myopia

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