Features of Optical Coherence Tomography of the Optic Nerve Head in Patients with High Myopia

Purpose: to evaluate the differences in the structural parameters of the optic nerve head (ONH) and peripapillary region in patients with high myopia in comparison with patients without refractive errors.

Patients and methods. The first group included patients with an equivalent refractive error ≥ -6.00 diopters and an eye length ≥ 26.00 mm (74 eyes). The second group consisted of patients with a refraction of -0.5 diopters — +1,25 diopters and an eye length of 22,50–24,20 mm (32 eyes). Axial length measurements were carried out using an IOLMaster 700 (Zeiss, Germany). Optical coherence tomography (OCT) of the ONH was performed with SOLIX (Optovue, USA) using the AngioAnalytics software. For statistical analysis of the results, the nonparametric Mann-Whitney’s test and Spearman’s rank correlation coefficient were used. Results. In the first group, the cup-to-disc vertical ratio (VCDR) values were lower (0.38 (0.14–0.51), p < 0.05), and there was a decrease in the average thickness of the retinal nerve fiber layer (RNFL) (86.00 (80.00–94.00), p < 0.01), as well as RNFL thickness measured in individual sectors (p < 0.01), compared with the second group. The thickness of the RNFL in the temporal quadrant, in the inferior sector of the temporal quadrant (TI), on the contrary, was greater (71.00 (58.05–87.25), p < 0.01). All radial peripapillary capillary vessel density (RPC VD) values were not significantly different between groups (p > 0.05). The highest RPC VD is in the upper sector of the temporal quadrant (TS) (56.65 (51.72–59.47)). The density of all vessels (VD) was significantly lower in patients with high myopia, except for the zones corresponding to the temporal quadrant and the inside disc zone (ID) (p > 0.05).

Conclusion. Significant differences were revealed between the groups in VCDR, RNFL thickness and VD in all areas, except the temporal quadrant. A decrease in the thickness of the RNFL in the temporal quadrant, TI, as well as a decrease in the thickness of the RPC VD in the ID zone and the temporal quadrant, TS, can be the most indicative parameters for diagnosing optic nerve pathology in patients with high myopia, not associated with axial elongation of the eyeball.

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