advertisement
Abstract #47630 Published in IGR 13-4
Optic Disc Change with Incipient Myopia of Childhood
Kim T-W; Kim M; Weinreb RN; Woo SJ; Park KH; Hwang J-MOphthalmology 2011;
See also comment(s) by Franz Grehn •
Purpose: To describe progressive tilting of the optic nerve head (ONH) and development/enlargement of parapapillary atrophy (PPA) observed in children with incipient myopia and to investigate factors associated with such changes. Design: Retrospective, observational study. Participants: This study included 118 eyes of 118 Korean children who were assessed by serial disc photography at intervals of 1 year or more. Methods: All disc photographs were reviewed by 2 experienced ophthalmologists, and eyes were classified into 2 groups with respect to the change in the ONH appearance and development/enlargement of (beta)-zone PPA: (1) ONH/PPA changed group and (2) ONH/PPA unchanged group. To quantify the ONH/PPA changes, the ratio of the horizontal to vertical disc diameter (HVDR) and the ratio of the maximum PPA width to vertical disc diameter (PVDR) were measured. Factors associated with ONH/PPA changes were evaluated using logistic regression analysis. Refractive errors were measured with cycloplegic refraction. Main Outcome Measures: Morphologic changes of the ONH/PPA as observed in serial disc photographs and its association with myopic shift. Results: Mean subject age and refractive error at the time of initial fundus examination were 7.3(plus or minus)3.7 years (range, 1-17 years) and -0.9(plus or minus)1.9 diopters (range, -5.9 to +3.0 diopters), respectively. Mean follow-up period was 38.1(plus or minus)19.6 months (range, 12-88 months). Fifty-one eyes (43%) were classified as the ONH/PPA change group. In the ONH/PPA change group, HVDR decreased from the initial value of 0.92(plus or minus)0.08 to the final value of 0.86(plus or minus)0.11, and the PVDR increased from the initial value of 0.08(plus or minus)0.07 to the final value of 0.20(plus or minus)0.11. The ONH/PPA changes were most remarkable in subjects between 7 and 9 years of age (odds ratio [OR] = 6.698; 95% confidence interval [CI], 2.296-19.546) and were associated with greater myopic shift during the follow-up period (OR = 0.483; 95% CI, 0.345-0.676). Conclusions: We demonstrate progressive tilting of the ONH, which was observed with development/enlargement of PPA in children who exhibited myopic shift. These findings suggest that tilted disc, as well as PPA, may be an acquired feature in myopic eyes, arising from scleral stretching. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. (copyright) 2011 American Academy of Ophthalmology.
T.-W. Kim. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National Universit, . Email: twkim7@snu.ac.kr
Classification:
8.1 Myopia (Part of: 8 Refractive errors in relation to glaucoma)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
