Ya Xing Wang1, Hongli Yang2, Haomin Luo3, Seung Woo Hong4, Stuart K Gardiner5, Jin Wook Jeoung6, Christy Hardin2, Glen P Sharpe7, Kouros Nouri-Mahdavi8, Joseph Caprioli8, Shaban Demirel5, Christopher A Girkin9, Jeffrey M Liebmann10, Christian Y Mardin11, Harry A Quigley12, Alexander F Scheuerle13, Brad Fortune5, Balwantray C Chauhan7, Claude F Burgoyne14. 1. Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China. 2. Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA. 3. Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA; Department of Ophthalmology, Second Xiangya Hospital, Central South University, Hunan, China. 4. Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA; Department of Ophthalmology and Visual Sciences, Medical College, The Catholic University of Korea, Seoul, Korea. 5. Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA. 6. Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA; Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. 7. Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada. 8. Stein Eye Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA. 9. Department of Ophthalmology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA. 10. Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, USA. 11. Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen, Germany. 12. Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA. 13. Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. 14. Devers Eye Institute Optic Nerve Head Research Laboratory, Legacy Research Institute, Portland, Oregon, USA; Devers Eye Institute Discoveries in Sight Research Laboratories, Legacy Research Institute, Portland, Oregon, USA. Electronic address: cfburgoyne@deverseye.org.
Abstract
PURPOSE: To use optical coherence tomography (OCT) to 3-dimensionally characterize the optic nerve head (ONH) in peripapillary scleral bowing in non-highly myopic healthy eyes. DESIGN: Cross-sectional, multicenter study. METHODS: A total of 362 non-highly myopic (+6 diopters [D] > spherical equivalent > -6D) eyes of 362 healthy subjects from 20-90 years old underwent OCT ONH radial B-scan imaging. Bruch's membrane (BM), BM opening (BMO), anterior scleral canal opening (ASCO), and the peripapillary scleral surface were segmented. BMO and ASCO planes were fit, and their centroids, major axes, ovality, areas and offsets were determined. Peripapillary scleral bowing was characterized by 2 parameters: peripapillary scleral slope (ppSS) of 3 anterior peripapillary scleral segments (0-300, 300-700, and 700-1,000 μm from the ASCO centroid); and ASCO depth relative to a peripapillary scleral reference plane (ASCOD-ppScleral). Peripapillary choroidal thickness (ppCT) was calculated relative to the ASCO as the minimum distance between the anterior scleral surface and BM. RESULTS: Both ppSS and ASCOD-ppScleral ranged from slightly inward through profoundly outward in direction. Both parameters increased with age and were independently associated with decreased ppCT. CONCLUSIONS: In non-highly myopic healthy eyes, outward peripapillary scleral bowing achieved substantial levels, was markedly increased with age, and was independently associated with decreased peripapillary choroidal thickness. These findings provide a normative foundation for characterizing this anatomy in cases of high myopia and glaucoma and in eyes with optic disc tilt, torsion, and peripapillary atrophy.
PURPOSE: To use optical coherence tomography (OCT) to 3-dimensionally characterize the optic nerve head (ONH) in peripapillary scleral bowing in non-highly myopic healthy eyes. DESIGN: Cross-sectional, multicenter study. METHODS: A total of 362 non-highly myopic (+6 diopters [D] > spherical equivalent > -6D) eyes of 362 healthy subjects from 20-90 years old underwent OCT ONH radial B-scan imaging. Bruch's membrane (BM), BM opening (BMO), anterior scleral canal opening (ASCO), and the peripapillary scleral surface were segmented. BMO and ASCO planes were fit, and their centroids, major axes, ovality, areas and offsets were determined. Peripapillary scleral bowing was characterized by 2 parameters: peripapillary scleral slope (ppSS) of 3 anterior peripapillary scleral segments (0-300, 300-700, and 700-1,000 μm from the ASCO centroid); and ASCO depth relative to a peripapillary scleral reference plane (ASCOD-ppScleral). Peripapillary choroidal thickness (ppCT) was calculated relative to the ASCO as the minimum distance between the anterior scleral surface and BM. RESULTS: Both ppSS and ASCOD-ppScleral ranged from slightly inward through profoundly outward in direction. Both parameters increased with age and were independently associated with decreased ppCT. CONCLUSIONS: In non-highly myopic healthy eyes, outward peripapillary scleral bowing achieved substantial levels, was markedly increased with age, and was independently associated with decreased peripapillary choroidal thickness. These findings provide a normative foundation for characterizing this anatomy in cases of high myopia and glaucoma and in eyes with optic disc tilt, torsion, and peripapillary atrophy.
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