Non Glaucomatous Optic Nerve Atrophy Is Highly Prevalent in High Myopia

Nearly one-third of eyes with high myopia may have non glaucomatous optic nerve atrophy, according to a study published in Ophthalmology. This relatively high prevalence increases with longer axial length and wider temporal parapapillary gamma zone, according to the report.

Researchers included individuals from the population-based Ural Eye and Medical Study in the investigation and examined the prevalence of non glaucomatous optic nerve atrophy among individuals with high myopia and available fundus photography and optical coherence tomography (OCT) imaging (n=116; mean age, 57.8 years; 57.8% women). Study participants underwent ophthalmic examination, detailed interviews during which they provided investigators with demographic and lifestyle data, and anthropometry and blood pressure measurements. Investigators determined non glaucomatous optic nerve atrophy prevalence and degree among the cohort.

Overall, the disorder’s prevalence was 29.3% (95% CI, 21.0-38.0) among study participants, and its mean degree was 1.7 units, the report shows. A higher prevalence of the disorder was significantly associated with longer axial length (odds ratio [OR]; P =.002), wider temporal parapapillary gamma zone (OR, 6.98; P <.001), and higher systolic blood pressure (OR, 1.05; P =.02). Similarly, a higher non glaucomatous optic nerve atrophy degree was significantly associated with longer axial length (P =.007) and wider temporal parapapillary gamma zone width (P <.001), in addition to a higher prevalence of diabetes (P =.005) and higher systolic blood pressure (P = .03).

“The axial elongation-associated and gamma zone-related increase in the distance between the retinal ganglion cells and the optic disc may lead to a lengthening and stretching of the retinal ganglion cell axons and may pathogenetically be of importance,” the study authors explain. “In highly myopic eyes, [non glaucomatous optic nerve atrophy] may be a reason for visual field and central visual acuity loss, unexplainable by myopic macular pathologies.”

Study limitations include an inability to quantify visual field loss or rule out other causes of optic neuropathy among study participants diagnosed with non glaucomatous optic nerve atrophy.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.