Parapapillary Gamma Zone and Progression of Myopia in School Children: The Beijing Children Eye Study

Yin, Guisheng; Liu, Li Juan; Tang, Ping; Feng, Yi; Lv, Yan; Wu, Min; Xu, Liang; Jonas, Jost B.

doi:10.1167/iovs.17-21665

Cited by 32 publications

(26 citation statements)

References 26 publications

(28 reference statements)

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“…[3][4][5][6][7][8] Clinical and anatomical studies have shown that the optic nerve head undergoes various changes in the process of myopic axial elongation. [9][10][11][12] These changes include an enlargement of the optic disc, the borders of which were defined by the peripapillary border tissues; a rotation of the optic disc mostly around its vertical axis; and the development of parapapillary gamma zone as BM-free parapapillary region, located mostly at the temporal optic disc side. [13][14][15][16][17][18][19][20][21] The mechanism of the development of gamma zone and to which degree the BMO accompanies the myopic enlargement of the optic disc has remained unclear so far.…”

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confidence: 99%

Size and Shape of Bruch's Membrane Opening in Relationship to Axial Length, Gamma Zone, and Macular Bruch's Membrane Defects

Wei

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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confidence: 99%

Size and Shape of Bruch's Membrane Opening in Relationship to Axial Length, Gamma Zone, and Macular Bruch's Membrane Defects

Wei

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Subjects were excluded if they had any of the following: (1) a family history of glaucoma in a first-degree relative, (2) history of intraocular or refractive surgery, (3) pathologic myopia (patch chorioretinal atrophy, lacquer crack lesions, intrachoroidal cavitations, or choroidal neovascularization), (4) other evidence of retinal pathology, (5) opaque media, or (6) poor-quality OCT images because of irregular tear film or poor cooperation.…”

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confidence: 99%

Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Sung

Heo

Piao

et al. 2020

Sci Rep

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We investigated the relationship between microstructure of β-parapapillary atrophy (β-ppA) and morphologic features of optic nerve head (onH) and posterior pole in highly myopic eyes. eighty-nine highly myopic eyes were included in this study. Bruch's membrane opening (BMo) area, lamina cribrosa (Lc) thickness, anterior laminar depth, peripapillary and subfoveal choroidal thickness (ct), macular Bruch's membrane (BM) length, and width of β-ppA with and without Bruch's membrane (ppA +BM and ppA −BM ) were evaluated. The mean age and axial length of the included subjects were 26.88 ± 2.44 years and 27.03 ± 0.88 mm, respectively. The width of PPA −BM was larger with increasing BMo area (P = 0.001), whereas the BMO area was not associated with the width of PPA +BM . the large ppA +BM was significantly related to a thinner LC (P = 0.003), deeper anterior lamina surface (P < 0.001), longer macular BM length (P = 0.008), and thinner temporal peripapillary CT (P = 0.034). We found that the morphologic features of the ONH and posterior pole in highly myopic eyes were different based on the microstructure of β-ppA. Whether these features are linked to the development of glaucoma in myopic eyes should be investigated in future studies.Classic funduscopic β-parapapillary atrophy (β-PPA) is a region of visible large choroidal vessels and sclera due to the lack of retinal pigment epithelium (RPE). β-PPA can be histologically subclassified based on the presence or absence of Bruch's membrane (BM): β-PPA with BM (PPA +BM ; β zone) and β-PPA without BM (PPA −BM ; γ zone). It has been known that PPA +BM might be due to age-related atrophy of the RPE and associated with the development of glaucoma 1-4 . Whereas, PPA −BM has been considered as a result of mechanical stretching in the peripapillary sclera and border tissue during axial elongation; hence a significant association between axial length and PPA −BM width has been consistently reported 1-3,5 . However, we previously reported that PPA +BM was also found in 20-30-year-old myopia subjects and suggested that PPA +BM in young myopia patients might be related to axial elongation, not age-related atrophy 6 . In accordance with our report, Lee et al. 7 recently found an enlargement of PPA +BM as myopia progressed and proposed that PPA +BM found in children might be an entirely different entity from PPA +BM in elderly individuals, sharing an etiology with PPA −BM .Several factors might contribute to β-PPA development during axial elongation, but the etiology of PPA +BM and PPA −BM enlargement remains elusive so far. It is unclear why some myopia patients exhibit only PPA −BM , whereas others with a similar degree of myopia exhibit both PPA +BM and PPA −BM . In this study, we hypothesized that morphologic features of the optic nerve head (ONH) and the posterior pole might give clues to the mechanisms of differential developments of β-PPA in myopic eyes. Therefore, the purpose of this work was to investigate the relationship between microstructure of β-PPA and the morphologic featur...

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“…However, Yi Dai and associates [9] reported that β-PPA and γ-PPA were associated with vertical disc diameter, and the associations between β-PPA or γ-PPA and horizontal disc diameter were unclear and not significant. Conversely, Yin Guo et al [10] demonstrated that the horizontal and vertical disc diameters were positively related to the enlargement of the parapapillary gamma zone area [10]. Since there is an oblique angle in the transpupillary view the optic disc, this observation may be influenced by the vertical tilting of the ONH in myopia.…”

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confidence: 98%

Correlation between optic disc deformation and retinal vasculature in non-pathological high myopia

Sun

Wang

2019

Preprint

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Background: The aim of this study was to investigate the correlation between optic disc deformation and retinal vasculature in high myopia.Methods: One hundred and thirty eyes with non-pathological high myopia were included in this cross-sectional study. The optic disc tilt ratio, and horizontal and vertical disc diameters were analyzed using fundus color photography. A 3 × 3 mm2 grid and a 4.5 × 4.5 mm2 grid were used to scan parafoveal and peripapillary regions, respectively, using optical coherence tomography angiography. Vessel flow density (VFD) and fractal dimension of the retina and the foveal avascular zone (FAZ) were analyzed and quantified using en face projection images. Optic disc parameters that were associated with vascular changes were determined using multiple linear regression analysis.Results: Results from the multivariate analysis revealed that the tilt ratio (β = -2.291, p = 0.025) was negatively correlated with three sectors in the deep layer. Age was negatively correlated with the VFD of the retina (β = -2.161; p < 0.034). Additionally, FAZ was not significantly correlated with any factors in the current study. Further, there was a positive correlation between retinal nerve fiber layer thickness and VFD of the optic nerve head (β = -2.146, p = 0.035).Conclusions: Overall, our results demonstrated that optic disc deformation was negatively correlated with the retinal microvasculature in non-pathological high myopia. Therefore, optic disc deformation may be used to predict the retinal vasculature in high myopia.

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Parapapillary Gamma Zone and Progression of Myopia in School Children: The Beijing Children Eye Study

Cited by 32 publications

References 26 publications

Size and Shape of Bruch's Membrane Opening in Relationship to Axial Length, Gamma Zone, and Macular Bruch's Membrane Defects

Size and Shape of Bruch's Membrane Opening in Relationship to Axial Length, Gamma Zone, and Macular Bruch's Membrane Defects

Parapapillary atrophy and changes in the optic nerve head and posterior pole in high myopia

Correlation between optic disc deformation and retinal vasculature in non-pathological high myopia

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