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Lee KM, Rhim JH, Ahn HJ, Kim M, Oh S, Park SW, Kim SH. Association between eyeball asymmetry and offset of openings in optic nerve head canal assessed by posterior polar eyeball topography. Sci Rep 2024; 14:9952. [PMID: 38688983 PMCID: PMC11061147 DOI: 10.1038/s41598-024-60716-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/26/2024] [Indexed: 05/02/2024] Open
Abstract
We investigated three-dimensional (3D) eyeball protrusion and its association with the offset between the lamina cribrosa (LC) and Bruch's membrane opening (BMO). 3D-MRI scans were taken from 93 subjects (186 eyes). An ellipsoid was fitted along the posterior 2/3 contour of each eyeball. Eyeball asymmetry with focal bulging was determined by the existence of an adjacent outward protrusion/reciprocal inward depression pair, and the angular deviation of the outermost protruded point (OPP) was measured from the nasal side of the fovea-BMO axis. The LC/BMO offset was evaluated by measuring the central retinal vascular trunk (CRVT) location from the BMO center: (1) the angular deviation and (2) the offset index as the ratio between the CRVT-BMO center distance and the BMO radius in the same direction. Seventy-nine eyes (42%) were classified as having eyeball asymmetry, which had a more superior LC/BMO offset (P < 0.001) and a larger offset index (P = 0.002). In those eyes, the angular deviation of the OPP showed a significant correlation with that of the LC/BMO offset (r = -0.724, P < 0.001), as did protrusion depth with the offset index (r = 0.291, P = 0.009). The presence of eyeball asymmetry was associated with superior LC/BMO offset (P = 0.004) and larger offset index (P = 0.009). Superior LC/BMO offset was associated with older age (P < 0.001), shorter axial length (P < 0.001) and inferior location of OPP (P < 0.001). The location and extent of focal bulging were closely associated with those of LC/BMO offset. This indicates that focal bulging during expansion might be associated with diverse directionality of LC/BMO offset.
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Affiliation(s)
- Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
- Department of Ophthalmology, Seoul National University Boramae Medical Center, 39 Boramae Road, Dongjak-gu, Seoul, 07061, Korea.
| | - Jung Hyo Rhim
- Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyoung Jun Ahn
- Department of Mathematical Modeling, Mind Flow Lab, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sun-Won Park
- Department of Radiology, Seoul National University Boramae Medical Center, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, The One Seoul Eye Clinic, Seoul, Korea
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Bak E, Kim M, Kim SH, Lee KM. Optic nerve head factors associated with initial central visual field defect in primary open-angle glaucoma. Sci Rep 2024; 14:8000. [PMID: 38580736 PMCID: PMC10997601 DOI: 10.1038/s41598-024-58749-6] [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: 10/24/2023] [Accepted: 04/02/2024] [Indexed: 04/07/2024] Open
Abstract
We investigated optic nerve head factors associated with initial parafoveal scotoma (IPFS) in primary open-angle glaucoma. Eighty (80) patients with an IPFS and 84 patients with an initial nasal step (INS) were compared. Central retinal vascular trunk (CRVT) deviation from the Bruch's membrane opening (BMO) center was measured as a surrogate of lamina cribrosa (LC)/BMO offset, and its obliqueness was defined as the absolute value of angular deviation from the fovea-BMO axis. Proximity of retinal nerve fiber layer defect (RNFLD) was defined as the angular deviation of the inner RNFLD margin from the fovea-BMO axis. Microvasculature dropout (MvD) was defined as a focal sectoral capillary dropout with no visible microvascular network identified in the choroidal layer. Factors associated with IPFS, as compared with INS, were assessed using logistic regression analyses and conditional inference tree analysis. The IPFS group had more oblique CRVT offset (P < 0.001), RNFLD closer to the fovea (P < 0.001), more MvD (P < 0.001), and more LC defects (P < 0.001) compared to the INS group. In logistic regression analyses, obliqueness of CRVT offset (P = 0.002), RNFLD proximity (P < 0.001), and MvD (P = 0.001) were significant factors influencing the presence of IPFS. Conditional inference tree analysis showed that RNFLD closer to the fovea (P < 0.001) in the upper level, more oblique CRVT offset (P = 0.013) and presence of MvD (P = 0.001) in the lower level were associated with the probability of having IPFS. IPFS was associated with closer RNFLD location to the fovea when assessed from the BMO. Oblique LC/BMO offset may not only mask RNFLD proximity to the fovea due to a deviated funduscopic disc appearance, but also potentiate IPFS via focal LC defect and MvD.
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Affiliation(s)
- Eunoo Bak
- Department of Ophthalmology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | | | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Ophthalmology, Seoul National University Boramae Medical Center, 39 Boramae Road, Dongjak-gu, Seoul, 07061, Korea.
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KhalafAllah MT, Fuchs PA, Nugen F, El Hamdaoui M, Levy AM, Samuels BC, Grytz R. Heterogenous thinning of peripapillary tissues occurs early during high myopia development in juvenile tree shrews. Exp Eye Res 2024; 240:109824. [PMID: 38336167 DOI: 10.1016/j.exer.2024.109824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
Myopia is an independent risk factor for glaucoma, but the link between both conditions remains unknown. Both conditions induce connective tissue remodeling at the optic nerve head (ONH), including the peripapillary tissues. The purpose of this study was to investigate the thickness changes of the peripapillary tissues during experimental high myopia development in juvenile tree shrews. Six juvenile tree shrews experienced binocular normal vision, while nine received monocular -10D lens treatment starting at 24 days of visual experience (DVE) to induce high myopia in one eye and the other eye served as control. Daily refractive and biometric measurements and weekly optical coherence tomography scans of the ONH were obtained for five weeks. Peripapillary sclera (Scl), choroid-retinal pigment epithelium complex (Ch-RPE), retinal nerve fiber layer (RNFL), and remaining retinal layers (RRL) were auto-segmented using a deep learning algorithm after nonlinear distortion correction. Peripapillary thickness values were quantified from 3D reconstructed segmentations. All lens-treated eyes developed high myopia (-9.8 ± 1.5 D), significantly different (P < 0.001) from normal (0.69 ± 0.45 D) and control eyes (0.76 ± 1.44 D). Myopic eyes showed significant thinning of all peripapillary tissues compared to both, normal and control eyes (P < 0.001). At the experimental end point, the relative thinning from baseline was heterogeneous across tissues and significantly more pronounced in the Scl (-8.95 ± 3.1%) and Ch-RPE (-16.8 ± 5.8%) when compared to the RNFL (-5.5 ± 1.6%) and RRL (-6.7 ± 1.8%). Furthermore, while axial length increased significantly throughout the five weeks of lens wear, significant peripapillary tissue thinning occurred only during the first week of the experiment (until a refraction of -2.5 ± 1.9 D was reached) and ceased thereafter. A sectorial analysis revealed no clear pattern. In conclusion, our data show that in juvenile tree shrews, experimental high myopia induces significant and heterogeneous thinning of the peripapillary tissues, where the retina seems to be protected from profound thickness changes as seen in Ch-RPE and Scl. Peripapillary tissue thinning occurs early during high myopia development despite continued progression of axial elongation. The observed heterogeneous thinning may contribute to the increased risk for pathological optic nerve head remodeling and glaucoma later in life.
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Affiliation(s)
- Mahmoud T KhalafAllah
- Vision Science Graduate Program, The University of Alabama at Birmingham, Birmingham, AL, United States; Department of Ophthalmology, Menoufia University, Shebin Elkom, Menoufia, Egypt
| | - Preston A Fuchs
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Fred Nugen
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mustapha El Hamdaoui
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Alexander M Levy
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Brian C Samuels
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Rafael Grytz
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, AL, United States.
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Fan Y, Huang Y, Huang X. Association between Axial Length to Corneal Curvature Radius Ratio and Myopia in Adult Patients. J Ophthalmol 2024; 2024:4981095. [PMID: 38449717 PMCID: PMC10917480 DOI: 10.1155/2024/4981095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/08/2024] Open
Abstract
Purpose To analyze the distribution characteristics of axial length to corneal curvature radius ratio (AL/CR) and other ocular biometric parameters in adult myopia patients and their association with myopia. Methods A cross-sectional study was conducted among patients with no eye diseases except ametropia who attended the optometry clinic of the First Affiliated Hospital of Hainan Medical College from January 2022 to June 2022. In total, 187 eyes (right eye) of 187 myopic patients aged 18-35 years were selected by random sampling. Based on the results of spherical equivalent (SE, (D)) obtained by postdilation optometry, all subjects were divided into three groups: mild myopia (≤-0.50D and >-3.00D, 42 eyes), moderate myopia (≤-3.00D and >-6.00D, 80 eyes), and high myopia (≤-6.00D, 65 eyes). The axial length (AL), corneal curvature radius (CR), and AL/CR were measured and compared between the three groups. The association between AL and AL/CR of the eye and SE was analyzed by multiple linear regression. Also, the predictive ability of AL/CR for high myopia was investigated by ROC curve. Results There were no statistically significant differences in age, gender, or intraocular pressure between the three groups. The mean values of AL/CR in mild, moderate, and high myopia groups were 3.17 ± 0.06, 3.31 ± 0.08, and 3.43 ± 0.10, respectively, and the difference between the groups was statistically significant (P < 0.001). Linear regression analysis showed that both AL and AL/CR were strongly negatively correlated with SE (P < 0.05), while CR had a weak positive correlation with SE without statistically significant differences (P > 0.05). The adjusted linear regression equation shows that for every 0.1 unit increase in AL/CR, SE increases by 1.54 D. Compared with 0.830 (95% confidence interval: 0.769 to 0.900) for AL, the area under ROC curve of AL/CR was 0.896 (95% confidence interval: 0.851 to 0.941), indicating that the diagnostic value of AL/CR for high myopia was higher than that of AL (P < 0.01). When the Youden index reached its maximum (0.626), the AL/CR cutoff point was 3.309, and the sensitivity and specificity were 0.954 and 0.672, respectively. Conclusion This study showed that AL and AL/CR in adult myopia patients were significantly negatively correlated with SE, and the corralation between AL/CR and SE is greater than that between AL and SE. Therefore, AL/CR can be used to analyze the dynamic changes of SE in the development of adult myopia independently of optometry on a certain basis, and it is especially suitable for the diagnosis of high myopia in adults. This trial is registered with ChiCTR2300069070.
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Affiliation(s)
- Yanyun Fan
- Department of Ophthalmology, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China
| | - Yikeng Huang
- Department of Ophthalmology, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China
| | - Xionggao Huang
- Department of Ophthalmology, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China
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Jonas JB, Jonas RA, Bikbov MM, Wang YX, Panda-Jonas S. Myopia: Histology, clinical features, and potential implications for the etiology of axial elongation. Prog Retin Eye Res 2023; 96:101156. [PMID: 36585290 DOI: 10.1016/j.preteyeres.2022.101156] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/27/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022]
Abstract
Myopic axial elongation is associated with various non-pathological changes. These include a decrease in photoreceptor cell and retinal pigment epithelium (RPE) cell density and retinal layer thickness, mainly in the retro-equatorial to equatorial regions; choroidal and scleral thinning pronounced at the posterior pole and least marked at the ora serrata; and a shift in Bruch's membrane opening (BMO) occurring in moderately myopic eyes and typically in the temporal/inferior direction. The BMO shift leads to an overhang of Bruch's membrane (BM) into the nasal intrapapillary compartment and BM absence in the temporal region (i.e., parapapillary gamma zone), optic disc ovalization due to shortening of the ophthalmoscopically visible horizontal disc diameter, fovea-optic disc distance elongation, reduction in angle kappa, and straightening/stretching of the papillomacular retinal blood vessels and retinal nerve fibers. Highly myopic eyes additionally show an enlargement of all layers of the optic nerve canal, elongation and thinning of the lamina cribrosa, peripapillary scleral flange (i.e., parapapillary delta zone) and peripapillary choroidal border tissue, and development of circular parapapillary beta, gamma, and delta zone. Pathological features of high myopia include development of macular linear RPE defects (lacquer cracks), which widen to round RPE defects (patchy atrophies) with central BM defects, macular neovascularization, myopic macular retinoschisis, and glaucomatous/glaucoma-like and non-glaucomatous optic neuropathy. BM thickness is unrelated to axial length. Including the change in eye shape from a sphere in emmetropia to a prolate (rotational) ellipsoid in myopia, the features may be explained by a primary BM enlargement in the retro-equatorial/equatorial region leading to axial elongation.
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Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Mannheim, Germany; Institute for Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany.
| | - Rahul A Jonas
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | | | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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Burgoyne CF, Wang YX, Jeoung JW, Hong S, Gardiner S, Reynaud J, Fortune B, Girard MJA, Sharpe G, Nicolela M, Chauhan BC, Yang H. OCT Optic Nerve Head Morphology in Myopia II: Peri-Neural Canal Scleral Bowing and Choroidal Thickness in High Myopia-An American Ophthalmological Society Thesis. Am J Ophthalmol 2023; 252:225-252. [PMID: 36906092 PMCID: PMC10492898 DOI: 10.1016/j.ajo.2023.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/16/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE To use optical coherence tomography (OCT) to characterize optic nerve head (ONH) peri-neural canal (pNC) scleral bowing (pNC-SB) and pNC choroidal thickness (pNC-CT) in 69 highly myopic and 138 healthy, age-matched, control eyes. DESIGN Cross-sectional, case control study. METHODS Within ONH radial B-scans, Bruch membrane (BM), BM opening (BMO), anterior scleral canal opening (ASCO), and pNC scleral surface were segmented. BMO and ASCO planes and centroids were determined. pNC-SB was characterized within 30° foveal-BMO (FoBMO) sectors by 2 parameters: pNC-SB-scleral slope (pNC-SB-SS), measured within 3 pNC segments (0-300, 300-700, and 700-1000 μm from the ASCO centroid); and pNC-SB-ASCO depth relative to a pNC scleral reference plane (pNC-SB-ASCOD). pNC-CT was calculated as the minimum distance between the scleral surface and BM at 3 pNC locations (300, 700, and 1100 μm from the ASCO). RESULTS pNC-SB increased and pNC-CT decreased with axial length (P < .0133; P < .0001) and age (P < .0211; P < .0004) among all study eyes. pNC-SB was increased (P < .001) and pNC-CT was decreased (P < .0279) in the highly myopic compared to control eyes, and these differences were greatest in the inferior quadrant sectors (P < .0002). Sectoral pNC-SB was not related to sectoral pNC-CT in control eyes, but was inversely related to sectoral pNC-CT (P < .0001) in the highly myopic eyes. CONCLUSIONS Our data suggest that pNC-SB is increased and pNC-CT is decreased in highly myopic eyes and that these phenomena are greatest in the inferior sectors. They support the hypothesis that sectors of maximum pNC-SB may predict sectors of greatest susceptibility to aging and glaucoma in future longitudinal studies of highly myopic eyes. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Affiliation(s)
- Claude F Burgoyne
- From the Devers Eye Institute Optic Nerve Head Research Laboratory (C.F., J.R., H.Y.), Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories (C.F.B., S.G., J.R., B.F., H.Y.), Legacy Research Institute, Portland, Oregon, USA.
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology (Y.X.W.), Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing, China
| | - Jin Wook Jeoung
- Department of Ophthalmology (J.W.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | | | - Stuart Gardiner
- Devers Eye Institute Discoveries in Sight Research Laboratories (C.F.B., S.G., J.R., B.F., H.Y.), Legacy Research Institute, Portland, Oregon, USA
| | - Juan Reynaud
- Devers Eye Institute Discoveries in Sight Research Laboratories (C.F.B., S.G., J.R., B.F., H.Y.), Legacy Research Institute, Portland, Oregon, USA
| | - Brad Fortune
- Devers Eye Institute Discoveries in Sight Research Laboratories (C.F.B., S.G., J.R., B.F., H.Y.), Legacy Research Institute, Portland, Oregon, USA
| | - Michaël J A Girard
- Ophthalmic Engineering & Innovation Laboratory (M.J.A.G.), Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Glen Sharpe
- Department of Ophthalmology and Visual Sciences (G.S., M.N., B.C.C.), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marcelo Nicolela
- Department of Ophthalmology and Visual Sciences (G.S., M.N., B.C.C.), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Balwantray C Chauhan
- Department of Ophthalmology and Visual Sciences (G.S., M.N., B.C.C.), Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hongli Yang
- Devers Eye Institute Discoveries in Sight Research Laboratories (C.F.B., S.G., J.R., B.F., H.Y.), Legacy Research Institute, Portland, Oregon, USA
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KhalafAllah MT, Fuchs PA, Nugen F, El Hamdaoui M, Levy A, Redden DT, Samuels BC, Grytz R. Longitudinal Changes of Bruch's Membrane Opening, Anterior Scleral Canal Opening, and Border Tissue in Experimental Juvenile High Myopia. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 37010856 PMCID: PMC10080949 DOI: 10.1167/iovs.64.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/08/2023] [Indexed: 04/04/2023] Open
Abstract
Purpose To investigate the relative positional changes between the Bruch's membrane opening (BMO) and the anterior scleral canal opening (ASCO), and border tissue configuration changes during experimental high myopia development in juvenile tree shrews. Methods Juvenile tree shrews were assigned randomly to two groups: binocular normal vision (n = 9) and monocular -10 D lens treatment starting at 24 days of visual experience to induce high myopia in one eye while the other eye served as control (n = 12). Refractive and biometric measurements were obtained daily, and 48 radial optical coherence tomography B-scans through the center of the optic nerve head were obtained weekly for 6 weeks. ASCO and BMO were segmented manually after nonlinear distortion correction. Results Lens-treated eyes developed high degree of axial myopia (-9.76 ± 1.19 D), significantly different (P < 0.001) from normal (0.34 ± 0.97 D) and control eyes (0.39 ± 0.88 D). ASCO-BMO centroid offset gradually increased and became significantly larger in the experimental high myopia group compared with normal and control eyes (P < 0.0001) with an inferonasal directional preference. The border tissue showed a significantly higher tendency of change from internally to externally oblique configuration in the experimental high myopic eyes in four sectors: nasal, inferonasal, inferior, and inferotemporal (P < 0.005). Conclusions During experimental high myopia development, progressive relative deformations of ASCO and BMO occur simultaneously with changes in border tissue configuration from internally to externally oblique in sectors that are close to the posterior pole (nasal in tree shrews). These asymmetric changes may contribute to pathologic optic nerve head remodeling and an increased risk of glaucoma later in life.
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Affiliation(s)
- Mahmoud T. KhalafAllah
- Vision Science Graduate Program, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Ophthalmology, Menoufia University, Shebin Elkom, Menoufia, Egypt
| | - Preston A. Fuchs
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Fred Nugen
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Mustapha El Hamdaoui
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Alexander Levy
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - David T. Redden
- Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Brian C. Samuels
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Rafael Grytz
- Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, United States
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Rong H, Liu L, Liu Y, Fu W, Xu H, Yu D, Wu D, Du B, Zhang X, Zhang B, Wei R. Quantifying the morphology of eyeballs with posterior staphyloma with Zernike polynomials. Front Bioeng Biotechnol 2023; 11:1126543. [PMID: 36970611 PMCID: PMC10034088 DOI: 10.3389/fbioe.2023.1126543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Purpose: To quantify the morphology of eyeballs with posterior staphyloma (PS) with Zernike decomposition and to explore the association between Zernike coefficients with existing PS classification.Methods: Fifty-three eyes with high myopia (HM, ≤-6.00D) and 30 with PS were included. PS was classified with traditional methods based on OCT findings. Eyeballs’ morphology was obtained with 3D MRI, from which the height map of the posterior surface was extracted. Zernike decomposition was performed to derive the coefficients of the 1st-27th items, which were compared between HM and PS eyes with the Mann-Whitney-U test. Receiver operating characteristics (ROC) analysis was used to test the effectiveness of using Zernike coefficients to discriminate PS from HM.Results: Compared to HM eyeballs, PS eyeballs had significantly increased vertical and horizontal tilt, oblique astigmatism, defocus, vertical and horizontal coma, and higher order aberrations (HOA) (all Ps < 0.05). HOA was the most effective in PS classification with an area under the ROC curve (AUROC) value of 0.977. Among the 30 PS, 19 were the wide macular type with large defocus and negative spherical aberration; 4 were the narrow macular type with positive spherical aberration; 3 were inferior PS with greater vertical tilt, and 4were peripapillary PS with larger horizontal tilt.Conclusion: PS eyes have significantly increased Zernike coefficients, and HOA is the most effective parameter to differentiate PS from HM. The geometrical meaning of the Zernike components showed great accordance with PS classification.
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Affiliation(s)
- Hua Rong
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Lin Liu
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuling Liu
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | | | - He Xu
- Department of Radiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Danyang Yu
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Di Wu
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xuejun Zhang
- Department of Radiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Davie, FL, United States
- *Correspondence: Bin Zhang, ; Ruihua Wei,
| | - Ruihua Wei
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
- *Correspondence: Bin Zhang, ; Ruihua Wei,
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Oh R, Lee KM, Kim M, Oh S, Kim SH. Hemisphere opposite to central retinal vascular trunk deviation is earlier affected by glaucomatous damage in primary angle-closure glaucoma. Acta Ophthalmol 2023; 101:e252-e260. [PMID: 36134905 DOI: 10.1111/aos.15258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/15/2022] [Accepted: 09/03/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of the study was to investigate whether the position of the central retinal vascular trunk (CRVT), as a surrogate for lamina cribrosa (LC) offset, is associated with the dominant hemisphere of visual field defect in primary angle-closure glaucoma (PACG) eyes. METHODS Central retinal vascular trunk deviation was measured from Bruch's membrane opening (BMO) centre, which was delineated by OCT imaging, using the horizontal midline as a reference. The dominant hemisphere developing visual field defect was defined as three connected abnormal points (having a p-value < 5% probability of being normal) appearing in only one hemisphere or each point of the hemisphere having a statistically worse value compared with its mirrored point in the opposite hemisphere on pattern deviation plots. RESULTS One hundred five (80%) of 132 eyes with PACG had dominant hemisphere of visual field defect initially: 70 eyes (67%) in the superior and 35 eyes (33%) in the inferior hemisphere. The CRVT was located superiorly in the dominant superior visual field defect group (p < 0.001). A logistic regression analysis revealed that superior deviation of the CRVT was the only factor associated with dominant superior visual field defect (p < 0.001). Externally oblique border (EOB) presence was associated with larger BMO (p = 0.005) and angular deviation of CRVT (p = 0.002). CONCLUSIONS Central retinal vascular trunk deviation was associated with the dominant hemisphere of visual field defect in PACG eyes. This finding implies that the LC position relative to the BMO centre (LC/BMO offset) may incur structural vulnerability in the optic nerve head of PACG eyes.
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Affiliation(s)
- Richul Oh
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Martha Kim
- Department of Ophthamology, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, South Korea
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10
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Wang X, Chen Y, Wang Z, Li H, He Q, Rong H, Wei R. Assessment of macular structures and vascular characteristics in highly myopic anisometropia using swept-source optical coherence tomography angiography. Front Physiol 2022; 13:918393. [PMID: 36045745 PMCID: PMC9421159 DOI: 10.3389/fphys.2022.918393] [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: 04/12/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study aimed to explore the macular structures and vascular characteristics of more myopic (MM) and contralateral eyes with highly myopic anisometropia.Methods: Comprehensive ophthalmic examinations were performed for 33 patients with highly myopic anisometropia. Macular structures (total retinal layer [TRL], ganglion cell and inner plexiform layer [GCIPL], inner nuclear layer [INL], outer retinal layer [ORL], nerve fiber layer [NFL], choroidal layer [CHL]) and vascular characteristics (superficial vascular complex density [SVD], deep vascular complex density [DVD], choriocapillaris perfusion area [CCPA]) were assessed using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). Macular structures and vascular characteristics of each subregion were compared to those of the Early Treatment of Diabetic Retinopathy Study (ETDRS).Results: With highly myopic anisometropia, the thicknesses of the TRL, GCIPL, INL, and ORL in MM eyes were smaller than those in contralateral eyes in at least one quadrant of the perifoveal and parafoveal circles (all p < 0.05), with no changes in the foveal and temporal quadrants of perifoveal regions (all p > 0.05). A thicker NFL (p = 0.018) was found in MM eyes than in contralateral eyes in the superior perifoveal quadrant. The CHL (all p < 0.05) in MM eyes was thinner in all regions than in the contralateral eyes according to the ETDRS. There were no statistical differences in the SVD, DVD, and CCPA of MM and contralateral eyes (all p > 0.05).Conclusion: All retinal layers, except the NFL, tended to be thinner in all subregions, except the temporal perifoveal and foveal quadrants in MM eyes, and choroidal thickness was thinned in all areas.
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11
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Hwang HB, Yeon JS, Moon GS, Jung HN, Kim JY, Jeon SH, Yoon JM, Kim HW, Kim YC. 3D Reconstruction of a Unitary Posterior Eye by Converging Optically Corrected Optical Coherence and Magnetic Resonance Tomography Images via 3D CAD. Transl Vis Sci Technol 2022; 11:24. [PMID: 35895054 PMCID: PMC9344223 DOI: 10.1167/tvst.11.7.24] [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] [Indexed: 12/02/2022] Open
Abstract
Purpose In acquiring images of the posterior eye, magnetic resonance imaging (MRI) provides low spatial resolution of the overall shape of the eye while optical coherence tomography (OCT) offers high spatial resolution of the limited range. Through the merger of the two devices, we attempted to acquire detailed anatomy of the posterior eye. Methods Optical and display distortions in OCT images were corrected using the Listing reduced eye model. The 3.0T orbital MRI images were placed on the three-dimensional coordinate system of the computer-aided design (CAD) program. Employing anterior scleral canal opening, visual axis, and scleral curvature as references, original and corrected OCT images were ported into the CAD application. The radii of curvature of the choroid–scleral interfaces (Rc values) of all original and corrected OCT images were compared to the MRI images. Results Sixty-five eyes of 33 participants (45.58 ± 19.82 years) with a mean Rc of 12.94 ± 1.24 mm on axial MRI and 13.66 ± 2.81 mm on sagittal MRI were included. The uncorrected horizontal OCT (30.51 ± 9.34 mm) and the uncorrected vertical OCT (34.35 ± 18.09 mm) lengths differed significantly from the MRI Rc values (both P < 0.001). However, the mean Rc values of the corrected horizontal (12.50 ± 1.21 mm) and vertical (13.05 ± 1.98 mm) images did not differ significantly from the Rc values of the corresponding MRI planes (P = 0.065 and P = 0.198, respectively). Conclusions Features identifiable only on OCT and features only on MRI were successfully integrated into a unitary posterior eye. Translational Relevance Our CAD-based converging method may establish the collective anatomy of the posterior eye and the neural canal, beyond the range of the OCT.
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Affiliation(s)
- Hyung Bin Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | | | | | | | - Seung Hee Jeon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joon Myoung Yoon
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Won Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Yong Chan Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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12
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Deep CNN with Hybrid Binary Local Search and Particle Swarm Optimizer for Exudates Classification from Fundus Images. J Digit Imaging 2022; 35:56-67. [PMID: 34997375 PMCID: PMC8854611 DOI: 10.1007/s10278-021-00534-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/04/2021] [Accepted: 11/03/2021] [Indexed: 02/03/2023] Open
Abstract
Diabetic retinopathy is a chronic condition that causes vision loss if not detected early. In the early stage, it can be diagnosed with the aid of exudates which are called lesions. However, it is arduous to detect the exudate lesion due to the availability of blood vessels and other distractions. To tackle these issues, we proposed a novel exudates classification from the fundus image known as hybrid convolutional neural network (CNN)-based binary local search optimizer-based particle swarm optimization algorithm. The proposed method from this paper exploits image augmentation to enlarge the fundus image to the required size without losing any features. The features from the resized fundus images are extracted as a feature vector and fed into the feed-forward CNN as the input. Henceforth, it classifies the exudates from the fundus image. Further, the hyperparameters are optimized to reduce the computational complexities by utilization of binary local search optimizer (BLSO) and particle swarm optimization (PSO). The experimental analysis is conducted on the public ROC and real-time ARA400 datasets and compared with the state-of-art works such as support vector machine classifiers, multi-modal/multi-scale, random forest, and CNN for the performance metrics. The classification accuracy is high for the proposed work, and thus, our proposed outperforms all the other approaches.
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Zhang L, Liu K, Nie F, Duan X. Research advance in optic disc tilt and rotation in high myopia and its implications for glaucoma and visual field defects. Eur J Ophthalmol 2021; 32:2505-2514. [PMID: 34859716 DOI: 10.1177/11206721211063716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
High myopia is of worldwide concern due to its high prevalence, and myopia is an independent risk factor for glaucoma. The purpose of this paper is to review the mechanism and clinical manifestations of optic disc tilt and rotation in high myopia and its relationship with glaucoma, to provide clues for monitoring fundus changes in high myopia and the early diagnosis of high myopia with glaucoma.
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Affiliation(s)
- Lurong Zhang
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ke Liu
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fen Nie
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xuanchu Duan
- Department of Ophthalmology, 70566The Second Xiangya Hospital of Central South University, Changsha, China.,159368Central South University, Aier School of Ophthalmology, Aier Eye Hospital, Changsha, China
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Lee KM, Ahn HJ, Kim M, Oh S, Kim SH. Offset of openings in optic nerve head canal at level of Bruch's membrane, anterior sclera, and lamina cribrosa. Sci Rep 2021; 11:22435. [PMID: 34789748 PMCID: PMC8599705 DOI: 10.1038/s41598-021-01184-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/27/2021] [Indexed: 01/31/2023] Open
Abstract
We compared the central retinal vascular trunk (CRVT) position, as a surrogate of lamina cribrosa (LC) offset, with the anterior scleral opening (ASCO) offset from the Bruch’s membrane opening (BMO). Based on the BMO-centered radial scans, the BMO and ASCO margins were demarcated, and each center was determined as the center of the best-fitted ellipse for each margin. The ASCO/BMO offset was defined as the offset between each center. Angular deviations and the extent of ASCO and CRVT offsets from the BMO center were compared directly. Incomplete demarcation of ASCO was found in 20%, which was associated with a larger BMO area and a larger ASCO offset from the BMO. The angular deviation of ASCO offset was associated with that of CRVT offset and that of the longest externally oblique border. The ASCO offset was smaller than the CRVT offset, and, unlike the CRVT offset, it was rarely deviated to the inferior side. The complete ASCO margin might not be demarcatable when determined on BMO-centered radial scans in the presence of an offset. Also, the ASCO, which reflects only the superficial scleral layer, might not reflect the LC position, because the LC might be shifted further from the ASCO.
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Affiliation(s)
- Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.,Department of Ophthalmology, Seoul National University Boramae Medical Center, 39 Boramae Road, Dongjak-gu, Seoul, 07061, Korea
| | - Hyoung Jun Ahn
- Department of Mathematical Modeling, Mind Flow Lab, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. .,Department of Ophthalmology, Seoul National University Boramae Medical Center, 39 Boramae Road, Dongjak-gu, Seoul, 07061, Korea.
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Vertical Position of the Central Retinal Vessel in the Optic Disc and Its Association With the Site of Visual Field Defects in Glaucoma. Am J Ophthalmol 2021; 229:253-265. [PMID: 34048804 DOI: 10.1016/j.ajo.2021.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/03/2021] [Accepted: 05/12/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE The purpose of this study was to investigate the association between the vertical position of the central retinal vessel (CRV) within the optic nerve head (ONH) and the site of visual field defects (VFDs) in glaucoma. DESIGN Cross-sectional study. METHODS The vertical position of the CRV was identified in 134 glaucoma eyes and 61 normal eyes at the point at which CRV exited the lamina cribrosa (LC) onto the ONH surface, by using spectral-domain optical coherence tomography (exit position). The position was also identified at the entry point into the LC from the retrolaminar ONH region (entry position), which was little influenced by glaucomatous LC deformation, therefore close to the original position before the glaucoma development. Positions were compared among glaucoma eyes with different sites of VFDs, and between glaucoma and normal eyes. RESULTS In glaucoma eyes, the entry position of the CRV was in the superior ONH region in 63.0% of eyes with superior VFDs and in the inferior ONH region in 97.8% of eyes with inferior VFDs (P < .0001). The exit position exhibited a similar percentage. The vertical CRV positions were not significantly different between glaucoma and normal eyes, both at the entry and exit positions. CONCLUSIONS Eyes with CRVs in the superior ONH region were significantly more likely to form VFDs in the superior hemifields and vice versa. The vertical position of the CRV was little altered by the development of glaucoma. The original position of the CRV before the development of glaucoma may influence regional susceptibility to glaucomatous stress and may be useful in predicting initial sites of VFDs.
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Choung HK, Kim M, Oh S, Lee KM, Kim SH. Central retinal vascular trunk deviation in unilateral normal-tension glaucoma. PLoS One 2021; 16:e0254889. [PMID: 34283884 PMCID: PMC8291707 DOI: 10.1371/journal.pone.0254889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/07/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate whether the position of the central retinal vascular trunk (CRVT), as a surrogate of lamina cribrosa (LC) offset, was associated with the presence of glaucoma in normal-tension glaucoma (NTG) patients. Methods The position of the CRVT was measured as the deviation from the center of the Bruch’s membrane opening (BMO), as delineated by spectral-domain optical coherence tomography imaging. The offset index was calculated as the distance of the CRVT from the BMO center relative to that of the BMO margin. The angular deviation of CRVT was measured with the horizontal nasal midline as 0° and the superior location as a positive value. The offset index and angular deviation were compared between glaucoma and fellow control eyes within individuals. Results NTG eyes had higher baseline intraocular pressure (P = 0.001), a larger β-zone parapapillary atrophy area (P = 0.013), and a larger offset index (P<0.001). In a generalized linear mixed-effects model, larger offset index was the only risk factor of NTG diagnosis (OR = 31.625, P<0.001). A generalized estimating equation regression model revealed that the offset index was larger in the NTG eyes than in the control eyes for all ranges of axial length, while it was the smallest for the axial length of 23.4 mm (all P<0.001). Conclusions The offset index was larger in the unilateral NTG eyes, which fact is suggestive of the potential role of LC/BMO offset as a loco-regional susceptibility factor.
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Affiliation(s)
- Ho-Kyung Choung
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Martha Kim
- Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Kyoung Min Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
- * E-mail:
| | - Seok Hwan Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University Boramae Medical Center, Seoul, Korea
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