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Comparative Study
. 2024 Nov 4;65(13):54.
doi: 10.1167/iovs.65.13.54.

Comparing IOP-Induced Scleral Deformations in the Myopic and Myopic Glaucoma Spectrums

Affiliations
Comparative Study

Comparing IOP-Induced Scleral Deformations in the Myopic and Myopic Glaucoma Spectrums

Thanadet Chuangsuwanich et al. Invest Ophthalmol Vis Sci. .

Abstract

Purpose: To compare changes in macular curvature following acute IOP elevation across a range of myopic conditions.

Methods: We studied 328 eyes from 184 subjects, comprising 32 emmetropic controls (between +2.75 and -2.75 diopters), 50 eyes with high myopia (<-5 diopters; HM), 108 highly myopic with glaucoma (HMG) and 105 pathologic myopia (PM) eyes, and 33 PM with staphyloma (PM+S) eyes. For each eye, we imaged the macula using optical coherence tomography (OCT) under the baseline condition and under acute IOP elevation (to ∼40 mm Hg) achieved through ophthalmodynamometry. We manually aligned the scans (baseline and IOP elevation) using three vascular landmarks in the macula tissue. We then automatically segmented the sclera and the choroid tissues using a deep learning algorithm and extracted the sclera-choroid interface. We calculated the macula curvatures, determined by the radius of curvature of the sclera-choroid interface in the nasal-temporal and superior-inferior direction. Differences in macula curvatures between baseline and elevated IOP scans were calculated at corresponding locations, and the mean curvature difference was reported for each eye.

Results: IOP elevation resulted in a significantly higher macula curvature change along the nasal-temporal direction in the PM+S (13.5 ± 8.2 × 10-5 µm-1), PM (9.0 ± 7.9 × 10-5 µm-1), and HMG (5.2 ± 5.1 × 10-5 µm-1) eyes as compared to HM (3.1 ± 2.7 × 10-5 µm-1) eyes (all P < 0.05). Interestingly, HM and HMG eyes had the same curvature change in the nasal-temporal direction as emmetropic control eyes (4.2 ± 4.3 × 10-5 µm-1).

Conclusions: Our findings indicate that the macula in HMG, PM, and PM+S eyes showed greater curvature changes under IOP elevation compared to HM and emmetropic eyes. These preliminary results suggest that HM eyes with conditions such as glaucoma or staphyloma are more sensitive to acute IOP elevation.

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Conflict of interest statement

Disclosure: T. Chuangsuwanich, None; T.A. Tun, None; F.A. Braeu, None; R.S. Chong, None; X. Wang, None; C.-L. Ho, None; T. Aung, None; M.J.A. Girard, Abyss Processing Pte Ltd (O); Q.V. Hoang, None

Figures

Figure 1.
Figure 1.
(A) OCT scans of the macula region with coordinates definition and dimension. (B) Segmentation of prelamina tissue, choroid, and sclera from a single B-scan. (C) Extraction of choroid tissue from B-scans. (D) Projected choroidal image of baseline volume, showing blood vessels in black. (E) Projected choroidal image of IOP-elevated volume, showing blood vessels in black. Xn is the bifurcation that corresponds with X′n for each eye.
Figure 2.
Figure 2.
(A) Example of a segmentation from a B-scan (light blue region represents prelamina tissue, green represents choroid tissue, and yellow represents sclera tissue) and an example of the choroid–sclera boundary used to extract point clouds in red. (B) Point clouds from the choroid–sclera boundary of an eye. Blue represents the point cloud from the baseline volume, and red represents the point cloud from IOP-elevated volume. (C) Polynomial curves that are fitted to the point clouds in the nasal–temporal direction (green) and superior–inferior direction (blue).
Figure 3.
Figure 3.
(A) A violin plot presenting a comparison of mean macula curvature change in the (a) nasal–temporal direction and (b) superior–inferior direction (* denotes significant differences between two groups, P < 0.05). (B) Illustration of curvature changes for each diagnostic group. The central slices of the macula are depicted along the nasal–temporal direction. Blue lines represent baseline scans, while red lines represent IOP-elevated scans. Dotted lines indicate the segmented choroid–scleral interface, and solid lines represent the fitted polynomial curve.

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