This article is more than 5 years old. Information may no longer be current.
Progressive optic nerve head tilting, parapapillary atrophy correlate with myopic shift
Ophthalmology. 2012;119(1):21-26.
Click Here to Manage Email Alerts
Progressive tilting of the optic nerve head showed a strong association with development and enlargement of parapapillary atrophy in children with a myopic shift, a study found.
"These data suggest that the tilted disc in a myopic eye may be an acquired feature caused by scleral stretching in the parapapillary region," the study authors said. "The clinical implications of such changes, particularly with respect to glaucoma susceptibility, should be further evaluated."
The retrospective study included 118 eyes of 118 patients. Serial disc photography was used to assess eyes at minimum intervals of 1 year.
Measurements of the optic nerve head (ONH) and parapapillary atrophy (PPA) were used to calculate ratios of horizontal to vertical disc diameter (HVDR) and the maximum PPA width to vertical disc diameter (PVDR).
Best corrected visual acuity, cycloplegic refraction, slit-lamp biomicroscopy, Goldmann applanation tonometry and disc photography were also assessed.
Mean patient age was 7.3 years. Initial mean refractive error was -0.9 D. Mean follow-up was 38.1 months.
Study results showed changes in ONH appearance and development of PPA in 51 eyes; no changes were seen in 67 eyes.
HVDR was appreciably smaller in the ONH/PPA change group at final follow-up (P = .001). The degree of change in HVDR was significantly larger in the ONH/PPA change group (P < .001).
PVDR was significantly larger in the ONH/PPA change group (P < .001). The degree of change in PVDR was significantly larger in the ONH/PPA change group (P < .001).
Degree of myopic shift and change in the PVDR were significantly correlated (P < .001). Change in HVDR and change in the spherical equivalent refraction were insignificant, the authors said.