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Shin HJ, Park HYL, Ryu HK, Oh SE, Kim SA, Jung Y, Park CK. Clinical Characteristics and Associated Factors to the Development of Glaucoma in Eyes With Myopic Optic Neuropathy. Am J Ophthalmol 2024; 260:160-171. [PMID: 38191067 DOI: 10.1016/j.ajo.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/26/2023] [Accepted: 01/01/2024] [Indexed: 01/10/2024]
Abstract
PURPOSE To observe the development of glaucoma in myopic eyes with and without myopic optic neuropathy (MON) and analyze associated factors to the development of typical glaucomatous damage. DESIGN A prospective, observational, cohort study. METHODS A total of 233 myopic eyes with no definite evidence of glaucomatous damage were included. Myopic patients without any retinal nerve fiber layer (RNFL) or visual field (VF) abnormalities were classified as myopic eyes without MON. Myopic patients with decreased RNFL at the superonasal (SN) or nasal area, and with corresponding VF defects either in the temporal or inferotemporal (IT) region were classified as myopic eyes with MON. Myopic eyes that developed glaucoma were defined by the presence of glaucomatous VF in the SN region including defects in Bjerrum area, or a new localized RNFL defect in the IT region. Disc morphological features and optic nerve head (ONH) parameters of two groups were compared. RESULTS Myopic eyes with MON had a thinner average peripapillary RNFL thickness (P < 0.001), worse MD of the VF (P = 0.031), a higher percentage of IT VF defects (P < 0.001), smaller torsion degree (P = 0.047), and greater LCD (P = 0.022). Myopic eyes with MON who developed glaucoma had a thinner average peripapillary RNFL thickness (P = 0.009), greater PPA area (P = 0.049), greater LCD (P < 0.001), and thinner LCT (P < 0.001). Thinner baseline temporal RNFL thickness (HR, 0.956; 95% CI, 0.928-0.986; P = 0.004), greater baseline LCD (HR, 1.003; 95% CI, 1.000-1.005; P = 0.022), and greater PPA area (HR, 1.000; 95% CI, 1.000-1.003; P = 0.050) were significantly associated factors with glaucoma development. CONCLUSIONS Myopic eyes with MON have a greater risk to develop glaucoma compared to myopic eyes without MON. Structural weakness due to myopia, especially at the temporal side of the ONH and the peripapillary sclera, increases the risk of glaucoma in myopic eyes with MON.
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Affiliation(s)
- Hee Jong Shin
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, South Korea
| | - Hae-Young Lopilly Park
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, South Korea.
| | - Hee Kyung Ryu
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, South Korea
| | - Si Eun Oh
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, South Korea
| | - Seong Ah Kim
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, South Korea
| | - Younhea Jung
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Seoul St. Mary's Hospital (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., C.K.P.), Seoul, South Korea
| | - Chan Kee Park
- From the Department of Ophthalmology (H.J.S., H.Y.L.P., H.K.R., S.E.O., S.A.K., Y.J., C.K.P.), The Catholic University of Korea, Seoul, South Korea; Yeouido St. Mary's Hospital (Y.J.), Seoul, South Korea
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Joo CW, Choi YJ, Kim HU, Park SP, Na KI. Morphological differences of the neuroretinal rim between temporally tilted and non-tilted optic discs in healthy eyes. Sci Rep 2024; 14:6070. [PMID: 38480784 PMCID: PMC10937920 DOI: 10.1038/s41598-024-54116-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/08/2024] [Indexed: 03/17/2024] Open
Abstract
This study aimed to compare morphological differences of the neuroretinal rim between the temporally tilted and non-tilted optic discs in healthy eyes. We prospectively enrolled participants aged 20-40 years with temporally tilted or non-tilted optic discs. The optic nerve head parameters were analyzed using spectral domain-optical coherence tomography. The angle between the Bruch's membrane opening (BMO) plane and BMO-minimum rim width (BMO-MRW) was termed "BMO-MRW angle". Peripapillary retinal nerve fiber layer thickness (pRNFLT) and BMO-based parameters were compared between the temporally tilted and non-tilted disc groups. As a result, 55 temporally tilted disc eyes and 38 non-tilted disc eyes were analyzed. Global pRNFLT, global BMO-MRW, and total BMO-minimum rim area (BMO-MRA) were similar between the two groups (p = 0.138, 0.161, and p = 0.410, respectively). In the sectoral analysis, temporally tilted disc group exhibited thicker BMO-MRW in the temporal sector (p = 0.032) and thinner in the nasal superior and nasal sectors (p = 0.025 and p = 0.002, respectively). Temporally tilted disc group showed larger BMO-MRA in the temporal, temporal superior, and temporal inferior sectors (p < 0.001, p < 0.001, and p < 0.016, respectively), alongside a higher BMO-MRW angle in the temporal sector and lower in the nasal superior and nasal sectors. In conclusion, the neuroretinal rim, represented by BMO-MRW and BMO-MRA, showed morphological differences between temporally tilted and non-tilted optic discs in healthy eyes. BMO-MRW and BMO-MRA showed temporalization in the same manner as pRNFLT in the temporally tilted disc eyes. The BMO-MRW angle showed that in temporally tilted disc eyes, optic nerve fibers met the BMO plane steeply in the nasal sector and gently in the temporal sector than in non-tilted disc eyes, suggesting potential stress region of optic nerve fibers in temporally tilted disc eyes.
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Affiliation(s)
- Chan Woong Joo
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea
| | - Youn Joo Choi
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea
| | - Han Ul Kim
- Department of Ophthalmology, Armed Forces Seoul District Hospital, Seoul, South Korea
| | - Sung Pyo Park
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea
| | - Kyeong Ik Na
- Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, #150 Seongan-ro, Gangdong-gu, Seoul, 05355, South Korea.
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Zhang X, Jiang J, Kong K, Li F, Chen S, Wang P, Song Y, Lin F, Lin TPH, Zangwill LM, Ohno-Matsui K, Jonas JB, Weinreb RN, Lam DSC. Optic neuropathy in high myopia: Glaucoma or high myopia or both? Prog Retin Eye Res 2024; 99:101246. [PMID: 38262557 DOI: 10.1016/j.preteyeres.2024.101246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/25/2024]
Abstract
Due to the increasing prevalence of high myopia around the world, structural and functional damages to the optic nerve in high myopia has recently attracted much attention. Evidence has shown that high myopia is related to the development of glaucomatous or glaucoma-like optic neuropathy, and that both have many common features. These similarities often pose a diagnostic challenge that will affect the future management of glaucoma suspects in high myopia. In this review, we summarize similarities and differences in optic neuropathy arising from non-pathologic high myopia and glaucoma by considering their respective structural and functional characteristics on fundus photography, optical coherence tomography scanning, and visual field tests. These features may also help to distinguish the underlying mechanisms of the optic neuropathies and to determine management strategies for patients with high myopia and glaucoma.
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Affiliation(s)
- Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Jingwen Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Kangjie Kong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Peiyuan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China.
| | - Timothy P H Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA.
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA.
| | - Dennis S C Lam
- The International Eye Research Institute of the Chinese University of Hong Kong (Shenzhen), Shenzhen, China; The C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China.
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Choe S, Joo YH, Kim YW, Kim YK, Jeoung JW, Lee JC, Park KH. Nasal and temporal curvatures of lamina CRIBROSA in myopic eyes. Sci Rep 2022; 12:16561. [PMID: 36195652 PMCID: PMC9532408 DOI: 10.1038/s41598-022-20372-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022] Open
Abstract
Little is known about the myopic characteristics of lamina cribrosa (LC) curvature. As such, we investigated nasal and temporal LC curvatures in myopia. In this retrospective, cross-sectional study, 144 myopic eyes (refraction < − 2D) and 88 non-myopic eyes (refraction > − 0.5D) underwent swept-source optical coherence tomography scanning of the LC. The anterior border of LC curvature was delineated with 17 points and interpolated with the “cardinal spline” curve-fitting method. The average curvature indices of the temporal and nasal sides were presented as the temporal and nasal curvatures. Myopic eyes had a mean refraction of − 6.7 ± 2.8D, while for non-myopic eyes, the value was 0.3 ± 1.0D. Nasal LC curvature was visible in 54 myopia (37.5%) and 42 non-myopia (47.7%) cases (P = 0.126), and temporal LC curvature was visible in 142 myopia (98.6%) and 68 non-myopia (77.3%) cases (P = 0.001). The nasal LC curvature was significantly larger in myopia than in non-myopia (P < 0.001). Contrastingly, the temporal LC curvature was significantly smaller in myopia than in non-myopia (P < 0.001). Axial length was associated with larger nasal LC curvature, smaller temporal LC curvature, and larger nasal–temporal LC curvature difference (all P’s < 0.05). In myopic relative to non-myopic eyes, LC curvature was decreased temporally and increased nasally.
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Affiliation(s)
- Sooyeon Choe
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoon Ha Joo
- Interdisciplinary Program in Bioengineering, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Yong Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Chan Lee
- Department of Biomedical Engineering, College of Medicine and Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Republic of Korea.,Institute of BioEngineering, Bio-Max Institute, Seoul National University, Seoul, Republic of Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea.
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Iwase A, Tsutsumi T, Fujii M, Sawaguchi S, Araie M. Risk factors for glaucoma are reflected in abnormal responses to frequency-doubling technology screening in both normal and glaucoma eyes. Sci Rep 2022; 12:11705. [PMID: 35810182 PMCID: PMC9271086 DOI: 10.1038/s41598-022-15891-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 06/30/2022] [Indexed: 12/05/2022] Open
Abstract
The frequency-doubling technology (FDT) screening test (FDT-C-20-1) has adopted in many recent population-based glaucoma surveys, but factors associated with false-positive (FP) responses to FDT-C-20-1 in normal eyes and false-negative (FN) responses in glaucoma eyes were not known. These factors were investigated in a population-based setting using the data from 3805 normal eyes (2381 subjects) and 272 eyes with definite glaucoma (215 subjects) in the Kumejima Study participants with reliable FDT-C-20-1 results. Considering the presence of at least one abnormal test point (P < 0.01) as abnormal, the specificity and sensitivity of FDT-C-20-1 for glaucoma were 91.8% (95% confidence interval, 91.1 ~ 92.5) and 56.3% (47.0 ~ 62.5), respectively. Multivariate linear mixed-model logistic regression analysis showed correlations with older age, worse visual acuity, greater β-peripapillary area (P < 0.001 for all comparisons) and more myopic refraction (P = 0.030) with the FP responses in normal eyes, and normal-tension glaucoma (P = 0.043), a better mean deviation value of Humphrey perimetry (P = 0.001), larger rim area (P = 0.041), and absence of disc hemorrhage (P = 0.015) with the FN responses in glaucoma eyes. In a population-based setting, abnormal responses to FDT-C-20-1 indicate the presence of a risk factor for glaucoma in normal eyes and risk factors for more rapid progression in glaucoma eyes.
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Affiliation(s)
- Aiko Iwase
- Tajimi Iwase Eye Clinic, 3-101-1 Honmachi, Tajimi, Gifu Prefecture, 507-0033, Japan.
| | - Tae Tsutsumi
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Makoto Fujii
- Division of Health and Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shoichi Sawaguchi
- Department of Ophthalmology, Faculty of Medicine, University of the Ryukyu, Okinawa, Japan
| | - Makoto Araie
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.,Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan
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