Tomoko Hasegawa1, Tadamichi Akagi2, Masanori Hangai1,3, Hiroshi Yamada1, Kenji Suda1, Yugo Kimura1, Hideo Nakanishi1, Hanako Ohashi Ikeda1,4, Nagahisa Yoshimura1. 1. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shougoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 2. Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shougoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. akagi@kuhp.kyoto-u.ac.jp. 3. Department of Ophthalmology, Saitama Medical University, Saitama, Japan. 4. Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
Abstract
PURPOSE: To investigate the dissociation of the Bruch's membrane opening (BMO) from the scleral canal opening (SO) of the optic disc. METHODS: In this prospective, cross-sectional, observational study, 101 eyes from 101 patients or suspected subjects of primary open angle glaucoma were included. Enhanced depth imaging spectral domain optical coherence tomography images along the long axis of the optic disc were used to visualize better the deep structures around the optic disc on both the temporal and nasal sides. The distances between the BMO and SO were measured at the temporal and nasal sides of the optic disc, and their correlations with age, axial length, intraocular pressure, disc size, disc ovality index, disc torsion degree, and visual field mean deviation were investigated. RESULTS: The temporal and nasal distances of BMO from SO correlated significantly with each other (R = 0.632, P < 0.0001). By multiple linear regression analysis, significant correlations were found for disc ovality index (temporal: β = -0.691, P < 0.0001; nasal: β = -0.420, P < 0.0001) and axial length (temporal: β = 0.224, P = 0.002; nasal: β = 0.310, P = 0.001). The other factors did not show any significant correlation. CONCLUSION: Locations of the SO at not only the temporal, but also the nasal side of the optic disc are nasally shifted from the BMO with optic disc tilting and axial length elongation in glaucomatous eyes, and are significantly correlated to each other. The nasal shift of the deep structures of the optic disc should be considered especially when assessing myopic eyes with optic disc tilt.
PURPOSE: To investigate the dissociation of the Bruch's membrane opening (BMO) from the scleral canal opening (SO) of the optic disc. METHODS: In this prospective, cross-sectional, observational study, 101 eyes from 101 patients or suspected subjects of primary open angle glaucoma were included. Enhanced depth imaging spectral domain optical coherence tomography images along the long axis of the optic disc were used to visualize better the deep structures around the optic disc on both the temporal and nasal sides. The distances between the BMO and SO were measured at the temporal and nasal sides of the optic disc, and their correlations with age, axial length, intraocular pressure, disc size, disc ovality index, disc torsion degree, and visual field mean deviation were investigated. RESULTS: The temporal and nasal distances of BMO from SO correlated significantly with each other (R = 0.632, P < 0.0001). By multiple linear regression analysis, significant correlations were found for disc ovality index (temporal: β = -0.691, P < 0.0001; nasal: β = -0.420, P < 0.0001) and axial length (temporal: β = 0.224, P = 0.002; nasal: β = 0.310, P = 0.001). The other factors did not show any significant correlation. CONCLUSION: Locations of the SO at not only the temporal, but also the nasal side of the optic disc are nasally shifted from the BMO with optic disc tilting and axial length elongation in glaucomatous eyes, and are significantly correlated to each other. The nasal shift of the deep structures of the optic disc should be considered especially when assessing myopic eyes with optic disc tilt.
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