Visual field defects and changes in macular retinal ganglion cell complex thickness in eyes with intrachoroidal cavitation are similar to those in early glaucoma

Abstract

Background/aimsTo examine the characteristics of visual field defects and optical coherence tomography (OCT) findings in eyes with intrachoroidal cavitation (ICC) and investigate the similarities between these results and glaucomatous changes.MethodsWe retrospectively analyzed patients diagnosed with ICC based on peripapillary radial cross-sectional scans performed with OCT. Visual field was measured with the Humphrey automated visual field analyzer SITA standard central 24-2 program, and macular ganglion cell complex (GCC) thickness was measured in 9×9 mm areas on OCT. The positive rates for the Anderson criteria, site of visual field defect, and mean GCC thickness in each quadrant were compared; the association between these results and ICC location was assessed.ResultsFifteen eyes from eleven patients (five males and six females; mean age, 54.6±10.7 years) were selected for investigation. ICC was detected in the inferior temporal side of the optic disc in all studied eyes. The positive rate for the Anderson criteria was 73.3% (11/15 eyes). Visual field defects were most commonly observed in the cluster that corresponded to the superior Bjerrum area (53.3%; 8/15 eyes). GCC thickness was significantly lower in the inferior side, where the ICC was located, than the superior side, where the ICC was absent (P=0.0001). GCC thinning that correlated with ICC was observed in 66.7% (10/15 eyes) of the ICC eyes.ConclusionVisual field and GCC findings on OCT in ICC eyes are extremely similar to those observed in superior visual field defect-type early glaucoma, indicating a possible difficulty in distinguishing the two conditions.

Exploration of peripapillary vessel density in highly myopic eyes with peripapillary intrachoroidal cavitation and its relationship with ocular parameters using optical coherence tomography angiography

“…reported that the deformation of the sclera can cause biomechanical stress in the area of a PICC that can ultimately lead to PICC and nerve fibre defects in the retina. Okuma et al . suggested that PICC may be a significant risk factor for RNFL defects and glaucomatous visual field defects.…”

“…Shimada et al . and Okuma et al . used a visual field test in highly myopic PICC eyes and observed that there was a significantly higher incidence of glaucomatous visual field defects in highly myopic eyes with PICC than in those without.…”

“…Spaide et al 13 reported that the deformation of the sclera can cause biomechanical stress in the area of a PICC that can ultimately lead to PICC and nerve fibre defects in the retina. Okuma et al 38 suggested that PICC may be a significant risk factor for RNFL defects and glaucomatous visual field defects. The defective RNFL observed in PICC eyes might lead to a decrease in oxygen and nutrient demands and a consequential reduction in vessel density.…”

“…Glaucomatous visual field defects have been recently reported in PICC eyes. 7,9 Shimada et al 8 and Okuma et al 38 used a visual field test in highly myopic PICC eyes and observed that there was a significantly higher incidence of glaucomatous visual field defects in highly myopic eyes with PICC than in those without. The authors suggested that the marked tilting of the optic disc observed in PICC eyes causes the distortions in the structure of the neurosensory retina, which may result in concomitant visual field defects.…”

Analysis of Peripapillary Intrachoroidal Cavitation and Myopic Peripapillary Distortions in Polar Regions by Optical Coherence Tomography

“…4,[13][14][15] Moreover, the dura 38 applies higher stress in its inner part, mechanically overloading 39 the lamina cribrosa which is the main site 42 of ON damage in glaucoma. This could explain some of the visual field defects found in PICC 1,43 as well as the high prevalence of glaucoma in myopic eyes. 44 Interestingly and supporting this hypothesis, strong adduction-induced strains on (peri)papillary structures have recently been demonstrated in glaucoma 19,45,46 and may therefore explain the pressure-independent component of visual field defects in glaucoma.…”