BMO-MRW Instrumental in Diagnosing Early Glaucoma in Myopic Eyes

close up head of young patient fix in Tomography in Optical Coherence
close up head of young patient fix in Tomography in Optical Coherence (OCT) equipment.
BMO-MWR experiences some loss in diagnostic performance in patients with large BMO.

Bruch membrane opening-minimum rim width (BMO-MRW) is a useful parameter for detecting early glaucoma in patients with myopia. However, its diagnostic power is reduced in myopic eyes with large BMO, according to a study published in the Journal of Glaucoma.

Researchers evaluated the diagnostic utility of BMO-MRW in detecting early glaucoma in patients with moderate to severe myopia in a retrospective, cross sectional study.  It included a total of 253 eyes (127 healthy eyes, 82 of glaucoma suspect, and 44 with early glaucoma). The mean age of the participants was 36.4±8.2 years and the mean refractive power was -5.9±2.7 D. All participants underwent visual acuity testing, refractive error assessment, slit-lamp inspection, intraocular pressure (IOP) measurement, fundus photography and perimetry assessment. Investigators used spectral-domain optical coherence tomography to obtain BMO-MRW and peripapillary retinal nerve fiber layer (pRNFL) thickness data. They calculated area under the receiver operating characteristic curves (AUC) for global and sectoral thickness parameters.

Researchers noted no significant differences in age, sex, IOP, spherical equivalent (SE), axial length, and central corneal thickness among the 3 study groups (all P >.05). Global analyses for the discrimination of early glaucoma in all patients with myopia revealed comparable AUCs between BMO-MRW and pRNFL thickness [AUC 0.952 (95% confidence interval, 0.918-0.975) and 0.934 (95% confidence interval, 0.896-0.961), respectively, P =.345]. However, BMO-MRW showed significantly better diagnostic performance compared with pRNFL thickness, except in the superotemporal sector, according to the sectoral analysis. 

Study limitations include a predominantly young population and a failure to consider ethnic differences in RNFL thickness and BMO-MRW measurements. 


Park DH, Kook KY, Kang YS, Piao H, Sung S, Park SW. Clinical utility of Bruch membrane opening-minimum rim width for detecting early glaucoma in myopic eyes. J Glaucoma. 2021;30(11):971-980. doi:10.1097/IJG.0000000000001934