Progressive Optic Disc Tilt in Young Myopic Glaucomatous Eyes
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Purpose: To explore the progressive change and associated factors of optic disc tilt in young myopic glaucomatouseyes by analyzing long-term follow-up data. Methods: Optic disc images were obtained from spectral-domain optical coherence tomography enhanceddepth imaging from at least five different visits. At each visit, the disc tilt angle (DTA), defined as the angle betweenthe Bruch’s membrane opening plane and the optic canal plane, was estimated at the central frame thatpasses through the optic disc. Glaucoma progression was assessed on the basis of changes noted on serialoptic disc and retinal nerve fiber layer photographs or changes in the visual field (VF). A linear mixed effectmodel was used to assess the influence of parameters (age, sex, baseline and follow-up intraocular pressure,retinal nerve fiber layer thickness, VF mean deviation, axial length, central corneal thickness), and presence ofglaucomatous progression upon DTA change. Results: A total of 26 eyes of 26 young myopic primary open-angle glaucoma patients (axial length >24.0 mm;mean age, 25.1 ± 4.0 years; mean follow-up, 3.3 ± 0.9 years) were included. DTA was 7.0 ± 3.4 degrees atbaseline and 8.3 ± 3.8 degrees at last visit, which represents a significant difference (p < 0.001). Worse VFmean deviation (p < 0.001) and longer axial length (p = 0.006) were significantly associated with DTA increase. Conclusions: Young myopic glaucomatous eyes showed progressive optic disc tilting. Progressive optic disctilting in young myopic glaucomatous eyes may be related to either continuous axial myopic shift or glaucomatousstructural change.
Abstract
Purpose: To explore the progressive change and associated factors of optic disc tilt in young myopic glaucomatouseyes by analyzing long-term follow-up data. Methods: Optic disc images were obtained from spectral-domain optical coherence tomography enhanceddepth imaging from at least five different visits. At each visit, the disc tilt angle (DTA), defined as the angle betweenthe Bruch’s membrane opening plane and the optic canal plane, was estimated at the central frame thatpasses through the optic disc. Glaucoma progression was assessed on the basis of changes noted on serialoptic disc and retinal nerve fiber layer photographs or changes in the visual field (VF). A linear mixed effectmodel was used to assess the influence of parameters (age, sex, baseline and follow-up intraocular pressure,retinal nerve fiber layer thickness, VF mean deviation, axial length, central corneal thickness), and presence ofglaucomatous progression upon DTA change. Results: A total of 26 eyes of 26 young myopic primary open-angle glaucoma patients (axial length >24.0 mm;mean age, 25.1 ± 4.0 years; mean follow-up, 3.3 ± 0.9 years) were included. DTA was 7.0 ± 3.4 degrees atbaseline and 8.3 ± 3.8 degrees at last visit, which represents a significant difference (p < 0.001). Worse VFmean deviation (p < 0.001) and longer axial length (p = 0.006) were significantly associated with DTA increase. Conclusions: Young myopic glaucomatous eyes showed progressive optic disc tilting. Progressive optic disctilting in young myopic glaucomatous eyes may be related to either continuous axial myopic shift or glaucomatousstructural change.
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