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Evaluation of the Optic Nerve and Retinal Nerve Fibre Layer in Myopic Individuals

Published Online: January 23rd 2013 European Ophthalmic Review, 2012;6(5):280-282 DOI: http://doi.org/10.17925/EOR.2012.06.05.280
Authors: Ahmad A Aref
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Abstract

Clinical discrimination between myopic tilted optic discs and glaucomatous optic neuropathy is often challenging, especially when

Abstract

Clinical discrimination between myopic tilted optic discs and glaucomatous optic neuropathy is often challenging, especially when
considering that myopia is a risk factor for the development of glaucoma. Myopic tilted discs are usually larger than average, with associated relative cupping and thinner neuroretinal rim tissue. Histopathological study has revealed thinner parapapillary retinal tissue in these eyes. Optical coherence tomography (OCT)-measured average retinal nerve fibre layer (RNFL) thickness has been found to decrease with longer axial length and higher myopic refractive error. Parapapillary RNFL quadrant and clock-hour analyses result in a higher false-positive rate in myopic eyes. Careful slit-lamp examination, quality baseline stereoscopic disc photographs and frequent serial visual field testing are essential to the follow-up of myopic individuals with suspected glaucoma. A novel diagnostic parameter, OCT-derived ganglion cell analysis, may prove to be useful in the diagnosis and follow-up of these individuals.

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