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Editors Selection IGR 16-4

Structure Tests and Anatomy: Stratus OCT in myopia

Comment by Jeffrey Liebmann & Sung-Chul Park on:

25633 Peripapillary retinal nerve fibre layer thickness profile in subjects with myopia measured using the Stratus optical coherence tomography, Kim MJ; Lee1 EJ; Kim T-W, British Journal of Ophthalmology, 2010; 94:115-120

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Kim et al. (206) investigated the peripheral retinal nerve fiber layer (RNFL) thickness profiles using Stratus OCT in subjects with various degree of myopia. The authors found that high myopes had thinner global RNFL than low myopes, confirming the results of previous reports, and also revealed that high myopes had thicker temporal quadrant RNFL than low myopes, despite the small sample size (n = 16 in each of the three groups: low, moderate, and high myopia). This finding is confirmed by a more recent report using spectral-domain OCT.¹ The authors' speculation on the temporal 'crowding' of retinal nerve fibers in high myopes is again supported by the locations of the peak superior and inferior RNFL thicknesses, which were closer to the temporal horizon than in low myopia. Based on the authors' findings, clinicians should be careful in using the current normative database in Stratus OCT when interpreting the OCT results of glaucoma patients with high myopia, and different normative database is required for patients with high myopia. Other retinal layers in high myopia compared to low myopia or normal subjects may be worthwhile to investigate regarding to the temporal crowding, since fine segmentation analysis of retinal layers is now possible using more sophisticated machines such as spectral-domain OCT.

The authors' results are not entirely consistent with those of a similar previous study using Stratus OCT,² which revealed high myopes had thinner RNFL at 12, 1, and 7 o'clock than low-to-moderate myopes (right eye orientation) with no significant difference in the temporal RNFL thickness between them. This discrepancy may be attributed to the different grouping criteria: low (-3 to 0 D), moderate (-6 to -3 D), and high (≥-6 D) myopia by Kim et al. vs. low-to-moderate (-6 to -0.5 D) and high (≥-6 D) myopia by Leung et al..

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