Atypical nerve fiber layer defects in high myopes with high-tension glaucoma
E. Chihara and A. Sawada
Department of Ophthalmology, Faculty of Medicine, Kyoto University, Japan.
The incidence of atypical optic nerve head and retinal nerve fiber layer
defects was studied in 61 high myopic eyes (greater than or equal to -5
diopters) and 91 emmetropic or hyperopic eyes (0 to +3 diopters) of 152
patients with chronic high-tension glaucoma, and in 45 control myopic eyes
(greater than or equal to -5 diopters). Horizontal ovalness or
cyclotorsion, oblique insertion of the optic disc, and bean pot disc were
more common in the high myopes. In the eyes with high myopia with glaucoma,
inferior dominant nerve fiber layer defects, ectopic fiber defects, and
multiple nerve fiber layer defects were common. The incidence of superior
nerve fiber layer defects or superior-inferior equal nerve fiber layer
defects was high in round or vertically oval discs and low in cyclotorted
or horizontal oval discs. The oblique insertion of the discs correlated
positively with a higher incidence of ectopic defects in high myopic eyes
with glaucoma. The incidence of focal type nerve defects is higher in older
patients and high myopes with oblique insertion of the optic disc. Atypical
shape of the optic disc correlates positively with atypical retinal nerve
fiber layer defects in eyes with high-tension glaucoma.
