Optic nerve head topography and retinal structural changes in eyes with macrodisks: a comparative study with spectral domain optical coherence tomography

Abstract

PurposeTo compare optic nerve head parameters, the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL), the macular retinal nerve fiber layer (mRNFL), the ganglion cell complex (GCC), and the ganglion cell–inner plexiform layer (GCIPL) in macrodisks and normal-sized healthy disks using spectral domain optical coherence tomography.Patients and methodsA total of 88 healthy eyes (42 macrodisks and 46 normal-sized disks) were prospectively enrolled in the study. Optic nerve head parameters as well as pRNFL, mRNFL, GCC, and GCIPL thicknesses were measured in all subjects. Optic disk areas (ODAs) >2.70 mm2 were defined as macrodisks. All spectral domain optical coherence tomography parameters were compared between normal-sized disks and macrodisks.ResultsThe mean age of the participants was 49.4±5.7 years in the normal size group and 51.55±6.3 years in the macrodisk group (P=0.65). The average ODAs were 2.23±0.29 mm2 and 3.30±0.59 mm2 in the normal size and the macrodisk groups, respectively. ODA (P<0.001), cup area (P<0.001), cup disk area ratio (P<0.001), horizontal cup disk ratio (P<0.001), vertical cup disk ratio (P<0.001), horizontal disk diameter (P<0.001), vertical disk diameter (P<0.001), and cup volume (P<0.001) were significantly higher in the macrodisk group. The inferior mRNFL thickness was significantly lower (P=0.042), and the GCC inferior and GCIPL inferior thicknesses were found to be lower with low significance (P=0.052, P=0.059, respectively) in the macrodisk group. Rim volume (P=0.622), total pRNFL (P=0.201), superior pRNFL (P=0.123), inferior pRNFL (P=0.168), average macular thickness (P=0.162), total mRNFL (P=0.171), superior mRNFL (P=0.356), total GCC (P=0.080), superior GCC (P=0.261), total GCIPL (P=0.214), and superior GCIPL (P=0.515) thicknesses were similar in both groups.ConclusionOptic disk topography and retinal structures show different characteristics in healthy eyes with macrodisks. These disk size-dependent variations suggest that large optic disks may be more susceptible to glaucomatous damage.

New Circumpapillary Retinal Nerve Fiber Layer Thickness and Bruch’s Membrane Opening-Minimum Rim Width Assessment in Nonglaucomatous Eyes with Large Discs

“…They reported significant differences for superior, inferior, and average RNFL thickness between the ONH size groups, and they observed that the RNFL thicknesses in all quadrants increased with ONH size. Öztürker et al [19] aimed to evaluate the optic disc and macular characteristics of eyes with macrodiscs using SD-OCT. They found no correlation between the average total, superior, or inferior pRNFL and ONH size.…”

On classification approaches, terminology and modern principles of treatment of pathologies associated with high myopia. Part 2. Terminology and approaches to classification

“…The association of myopia and ocular diseases (D. Flitcroft [3]) -прямая офтальмоскопия регистрируется с дополнительной линзой < -5,00 дптр и показывает такие изменения, как очаговая атрофия в сетчатке; -или прямая офтальмоскопия регистрируется с дополнительной линзой < -10,00 дптр A person who has vision impairment and vision acuity that is not improved by pinhole, which cannot be attributed to other causes, and: -the direct ophthalmoscopy records a supplementary lens < -5.00 D and shows changes such as ''patchy atrophy'' in the retina or; -the direct ophthalmoscopy records a supplementary lens < -10.00 D Специфические клинические состояния, характерные для патологической близорукости Specific clinical conditions characteristic of pathologic myopia Миопическая тракционная макулопатия (МТМ) Myopic traction maculopathy (MTM) Сочетание макулярного ретиношизиса, ламеллярного макулярного отверстия и/или фовеальной отслойки сетчатки (ФОС) в глазах с высокой степенью миопии, связанных с тракционными силами, возникающими из-за адгезии кортикальных слоев стекловидного тела, эпиретинальной мембраны, внутренней пограничной мембраны, сосудов сетчатки и задней стафиломы A combination of macular retinoschisis, lamellar macula hole and/or foveal retinal detachment (FRD) in eyes with high myopic attributable to traction forces arising from adherent vitreous cortex, epiretinal membrane, internal limiting membrane, retinal vessels, and posterior staphyloma Ассоциированная с миопией глаукомоподобная оптическая нейропатия Myopia-associated glaucomalike optic neuropathy Оптическая нейропатия, характеризующаяся потерей нейроретинального ободка и увеличением экскавации диска зрительного нерва, возникающая на глазах с высокой миопией с формированием вторичного макродиска* или перипапиллярной дельта-зоны** при нормальном внутриглазном давлении Optic neuropathy characterized by a loss of neuroretinal rim and enlargement of the optic cup, occurring in eyes with high myopia eyes with a secondary macrodisc* or peripapillary delta zone** at a normal intraocular pressure Примечание. * -(синоним -мегалодиск) -диск зрительного нерва большого размера с увеличенной экскавацией, нормальным объемом нейроретинального пояска, нормальным полем зрения и нормальным внутриглазным давлением [9,10]. ** -определяется в области между перипапиллярным кольцом (являющимся продолжением мягкой мозговой оболочки зрительного нерва) и линией слияния твердой мозговой оболочки зрительного нерва с задней частью склеры [11].…”

“…Note. * -(synonymous with megalodisc) -a large optic disc with increased excavation, normal volume of the neuroretinal rim, normal vision field, and normal intraocular pressure [9,10]. ** -determined in the area between the peripapillary ring (which is a continuation of the pia mater of the optic nerve) and the line of fusion of the dura mater of the optic nerve with the posterior part of the sclera [11].…”