Beta zone of peripapillary atrophy by optical coherence tomography as a biomarker of glaucoma associated with myopia
Svetlana Ivanovna ZHUKOVA1, Tat’yana Nikolaevna YUR’YEVA1,2,3, Irina Viktorovna POMKINA1, Anastasiya Sergeevna GRISHCHUK1,2,3
1S. Fyodorov Eye Microsurgery Federal State Institution of Minzdrav of Russia
2Irkutsk State Medical Academy of Postgraduate Education - Branch of the Russian Medical Academy of Continuing Professional Education of Minzdrav of Russia
3Irkutsk State Medical University of Minzdrav of Russia
Keywords: первичная открытоугольная глаукома, миопия, спектральная оптическая когерентная томография, перипапиллярная атрофия, гамма-зона, бета-зона, primary open-angle glaucoma, myopia, spectral domain optical coherence tomography, peripapillary atrophy, gamma zone, beta zone
Abstract
Purpose of the study was to assess changes in the peripapillary retina and in patients with glaucoma associated with myopia and uncomplicated myopia by spectral domain optical coherence tomography. Material and methods. We examined 26 patients (26 eyes) with a clinically advanced of primary open-angle glaucoma on eyes with high myopia and 30 people (30 eyes) with uncomplicated myopia. Spectral domain optical coherence tomography was included in the examination. Results and discussion. A reduction in the rim area in patients with glaucoma combined with myopia, compared with patients with uncomplicated myopia ( M ± SD , respectively, 1.03 ± 0.36 and 1.60 ± 0.42 mm2, p < 0.05) develops against the background of thinning of the choroid, mainly in the lower one (131.36 ± 41.98 and 226,5 ± 98.13 mm, respectively; p = 0.01) and nasal (57.63 ± 9.81 and 216 ± 122.4 mm, respectively; p = 0.0006) segments and is accompanied by an increase in the area of the peripapillary atrophy (1.94 ± 0,5 and 1.05 ± 0.15 mm, respectively; p = 0.005), which indicates the inconsistency of trophic and metabolic processes. In patients with myopia in peripapillary atrophy zone, a gamma zone was identified, in which sclera and RNFL were visualized. The Bruch’s border membrane, retinal pigment epithelium, photoreceptors, and choroid coincided. In myopia combined with glaucoma, along with the gamma zone, the beta zone was visualized, which is characterized by degenerative changes in RPE and photoreceptors against the background of choriocapillary obliteration. Conclusion. Choroidal changes and the presence of beta zone are differential diagnostic criteria for glaucoma associated with myopia and can be used for diagnosis of glaucoma in combination with myopia.
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