Measurement of disc parameters.

<p>Before the measurement, refraction, corneal curvature, and axial length were entered to the software to adjust for the ocular magnification effect. A) Ovality Index: Longest (1) and shortest (2) diameters of the optic disc were identified and manually traced. The length of the line was automatically calculated with the data management software (Imagenet R4). The ovality index was calculated by dividing the shortest disc diameter by the longest diameter. B) Disc Area: The edge of the optic disc was manually traced. The area surrounded by the line (= disc area) was automatically calculated. C) β-zone parapapillary atrophy area: First the line was manually drawn to enclose both optic disc and parapapillary atrophy. The area of the optic disc plus β-zone parapapillary atrophy was automatically calculated. Then the area of β-zone parapapillary atrophy was calculated by subtracting the disc area.</p

Baseline Demographics of the four groups.

<p>F, female; M, male; IOP: intraocular pressure; D, diopters. P values represent the result of comparison between groups with mixed-effects modeling (numeric variables) or clustered chi-square test (categorical variables).</p><p>Baseline Demographics of the four groups.</p

Identification of the defect location.

<p>A) The superior disc edge identified on a fundus image obtained with the SS-OCT in reference to the color fundus photograph. In this case, the superior disc edge was located at the 90th scan of the sequential horizontal scans. B) The inferior disc edge was identified in a way similar to the superior edge. In this case, the inferior disc edge was located at the 180th scan. This means the center of the disc is located at the 135th scan. C) The location of the defect. A defect of the lamina cribrosa was identified in the OCT image (arrow). In this case the defect was located from 115th through 118th scan, which means the defect location is in the superior half of the disc. D) In the reference fundus image, a horizontal white line shows the location of the scan.</p

Representative cases with LC defects in A) the M group (high myopia without glaucoma), B) the G group (glaucoma without high myopia), and C) the MG group (glaucoma with high myopia), respectively.

<p>Each panel shows (from left to right) infrared fundus images, OCT images, and SAP visual field printouts. The locations of the scan lines are shown as horizontal lines in infrared images (left panels). The arrows in OCT images show the locations of the defects (center panels).</p

Demographic and Ocular Factors in Eyes with and without LC Defects.

<p>LC, lamina cribrosa, D, diopters; IOP, intraocular pressure, PPA, parapapillary atrophy</p><p>P values represent the result of a comparison between eyes with and without defects with mixed-effects modeling (numeric variables) or clustered chi-square test (categorical variables).</p><p>Demographic and Ocular Factors in Eyes with and without LC Defects.</p

Defects of the Lamina Cribrosa in High Myopia and Glaucoma

<div><p>Purpose</p><p>We evaluated the prevalence and characteristics of the defects of the lamina cribrosa (LC) in high myopia and glaucoma, and compared them with control eyes using swept-source optical coherence tomography (SS-OCT).</p><p>Methods</p><p>One hundred fifty-nine eyes of 108 participants were divided into four subgroups; high myopia with glaucoma (MG, 67 eyes of 46 subjects), glaucoma without high myopia (G, 22 eyes of 13 subjects), high myopia without glaucoma (M, 35 eyes of 29 subjects), and a control group with neither glaucoma nor high myopia (C, 35 eyes of 20 subjects). The LC defects were identified and located using a standardized protocol in serial horizontal OCT scans. The prevalence rates of the defects were compared among the groups. Demographic and ocular factors were compared between eyes with and without defects.</p><p>Results</p><p>LC defects were observed in one eye (0.03%) in the C group, 8 eyes (22.9%) in the M group, 11 eyes (50%) in the G group, and 28 eyes (41.8%) in the MG group. The prevalence rates of the defects differed significantly among the groups (P = 0.0009). Most eyes with defects in the G and MG groups (79.5%) had damage in the corresponding visual hemifields. Other factors such as visual acuity, intraocular pressure, axial length, refractive error, disc ovality, or parapapillary atrophy area did not differ significantly between eyes with and without LC defects.</p><p>Conclusions</p><p>High myopia and glaucoma significantly increased the risk of LC damage. The LC damage in non-glaucomatous highly myopic eyes may at least partly explain the increased risk of developing glaucoma in myopic eyes.</p></div

Multiple regression analysis of the changes in axial length per year by sex and choroidal neovascularization.

<p>Multiple regression analysis of the changes in axial length per year by sex and choroidal neovascularization.</p

Axial length changes in highly myopic eyes and influence of myopic macular complications in Japanese adults

<div><p>Purpose</p><p>To investigate changes of the axial length in normal eyes and highly myopic eyes and influence of myopic macular complications in Japanese adults.</p><p>Study design</p><p>Retrospective longitudinal case series.</p><p>Methods</p><p>The changes in the axial length of 316 eyes from 316 patients (mean age, 63.8 ± 9.0 years; range, 34–82; 240 females) examined using IOLMaster with a follow-up period of at least 1 year were studied. This study included 85 non-highly myopic eyes (|refractive error| ≤ 5 diopters; 63 females; non-highly myopic group), 165 highly myopic eyes (refractive error ≤ −6 diopters or axial length ≥ 26 mm; 124 females) without macular complications (no complications group), 32 eyes (25 females) with myopic traction maculopathy (MTM group), and 34 eyes (28 females) with myopic choroidal neovascularization (CNV group).</p><p>Results</p><p>All groups showed a significant increase in the axial length during the follow-up period (mean follow-up, 28.7 ± 16.8 months; range, 12–78) (P < 0.01). Changes in the axial length/year in the no complications group (0.041 ± 0.05 mm) were significantly greater than those in the non-highly myopic group (0.007 ± 0.02 mm) (P < 0.0001). Furthermore, changes in the CNV group (0.081 ± 0.04 mm) were significantly greater than those in the no complications (P < 0.0001) and MTM (0.040 ± 0.05 mm) (P = 0.0059) groups, whereas no significant difference was found between the changes in the MTM and no complications groups (P = 0.91). Multiple regression analyses indicated that CNV eyes (P < 0.0001) and female patients’ eyes (P = 0.04) showed greater changes in the axial length/year.</p><p>Conclusions</p><p>All groups showed an increase in the axial length, which was greater for highly myopic eyes. In particular, CNV eyes showed greater increases, indicating that larger changes in the axial length may require careful follow-up.</p></div

Clinical characteristics at the initial examination.

<p>Clinical characteristics at the initial examination.</p

Comparison of the changes in the axial length per year between non-highly myopic eyes and highly myopic eyes with no complications and between highly myopic eyes with myopic traction maculopathy, choroidal neovascularization, and no complications.

<p>Comparison of the changes in the axial length per year between non-highly myopic eyes and highly myopic eyes with no complications and between highly myopic eyes with myopic traction maculopathy, choroidal neovascularization, and no complications.</p