Optical Coherence Tomographic Optic Nerve Head Morphology in Myopia III: The Exposed Neural Canal Region in Healthy Eyes—Implications for High Myopia - 23/01/24

Doi : 10.1016/j.ajo.2023.08.012

Seungwoo Hong ^a,^b, Hongli Yang ^a, Stuart K. Gardiner ^c, Haomin Luo ^a,^d, Glen P. Sharpe ^e, Joseph Caprioli ^f, Shaban Demirel ^c, Christopher A. Girkin ^g, Christian Y. Mardin ^h, Harry A. Quigley ⁱ, Alexander F. Scheuerle ^j, Brad Fortune ^c, Anuwat Jiravarnsirikul ^a,^k, Camila Zangalli ^l, Balwantray C. Chauhan ^e, Claude F. Burgoyne ^a,^⁎
^a From the Devers Eye Institute, Optic Nerve Head Research Laboratory, Legacy Research Institute (S.H., H.Y., H.L., A.J., C.F.B.), Portland, Oregon, USA
^b Yebon Eye Clinic (S.H.), Seoul, Korea
^c Devers Eye Institute, Discoveries in Sight Research Laboratories, Legacy Research Institute (S.K.G., S.D., B.F.), Portland, Oregon, USA
^d Department of Ophthalmology, Hunan Provincial People's Hospital, Hunan Normal University (H.L.), Changsha, Hunan Province, China
^e Ophthalmology and Visual Sciences, Dalhousie University (G.P.S., B.C.C.), Halifax, Nova Scotia, Canada
^f Jules Stein Eye Institute, David Geffen School of Medicine at UCLA (J.C.), Los Angeles, California, USA
^g Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham (C.A.G.), Birmingham, Alabama, USA
^h Department of Ophthalmology, University of Erlangen (C.Y.M.), Erlangen, Germany
ⁱ Wilmer Eye Institute, Johns Hopkins University (H.A.Q.), Baltimore, Maryland, USA
^j Department of Ophthalmology, University of Heidelberg (A.F.S.), Heidelberg, Germany
^k Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University (A.J.), Bangkok, Thailand
^l Department of Glaucoma, Hospital de Olhos Niteroi (C.Z.), Rio de Janeiro, Brazil

^⁎Inquiries to Claude F. Burgoyne, Optic Nerve Head Research Laboratory, Devers Eye Institute, Legacy Research Institute, Portland, Oregon, USAOptic Nerve Head Research LaboratoryDevers Eye InstituteLegacy Research InstitutePortlandOregonUSA

Résumé

Purpose

To determine the prevalence and magnitude of optical coherence tomography (OCT) exposed neural canal (ENC), externally oblique choroidal border tissue (EOCBT), and exposed scleral flange (ESF) regions in 362 non–highly myopic (spherical equivalent –6.00 to 5.75 diopters) eyes of 362 healthy subjects.

Design

Cross-sectional study.

Methods

After OCT optic nerve head (ONH) imaging, Bruch membrane opening (BMO), the anterior scleral canal opening (ASCO), and the scleral flange opening (SFO) were manually segmented. BMO, ASCO, and SFO points were projected to the BMO reference plane. The direction and magnitude of BMO/ASCO offset as well as the magnitude of ENC, EOCBT, and ESF was calculated within 30° sectors relative to the foveal-BMO axis. Hi-ESF eyes demonstrated an ESF ≥100 µm in at least 1 sector. Sectoral peri–neural canal choroidal thickness (pNC-CT) was measured and correlations between the magnitude of sectoral ESF and proportional pNC-CT were assessed.

Results

Seventy-three Hi-ESF (20.2%) and 289 non–Hi-ESF eyes (79.8%) were identified. BMO/ASCO offset as well as ENC, EOCBT, and ESF prevalence and magnitude were greatest inferior temporally where the pNC-CT was thinnest. Among Hi-ESF eyes, the magnitude of each ENC region correlated with the BMO/ASCO offset magnitude, and the sectors with the longest ESF correlated with the sectors with proportionally thinnest pNC-CT.

Conclusions

ONH BMO/ASCO offset, either as a cause or result of ONH neural canal remodeling, corresponds with the sectoral location of maximum ESF and minimum pNC-CT in non–highly myopic eyes. Longitudinal studies to characterize the development and clinical implications of ENC Hi-ESF regions in non–highly myopic and highly myopic eyes are indicated.

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Plan

METHODS

DEFINITIONS AND TERMINOLOGY

SUBJECTS

OCT IMAGE ACQUISITION AND SEGMENTATION

SECTORAL ENC, EOCBT, AND ESF MEASUREMENTS

BMO/ASCO OFFSET MAGNITUDE AND DIRECTION

BMO, ASCO, SFO/ASCO CONJUGATE OPENING, AND NEURAL CANAL MINIMUM CROSS-SECTIONAL AREA SIZE AND SHAPE MEASUREMENTS

pNC CHOROIDAL THICKNESS

INTEROBSERVER REPRODUCIBILITY

	Supplemental Material available at AJO.com.
	Seungwoo Hong and Hongli Yang are co–first authors.

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Vol 258

P. 55-75 - février 2024 Retour au numéro

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Optical Coherence Tomographic Optic Nerve Head Morphology in Myopia III: The Exposed Neural Canal Region in Healthy Eyes—Implications for High Myopia - 23/01/24

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Purpose

Design

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Results

Conclusions

Plan

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