Relationships of Paracentral Scotoma With Structural and Vascular Parameters in Highly Myopic Eyes With Early Open-angle Glaucoma

Abstract

Prcis: This study revealed the prevalence of paracentral scotoma in highly myopic eyes with early open-angle glaucoma, and highlighted structural and vascular parameters associated with paracentral scotoma, which may facilitate the assessment of central visual function.

Purpose: To investigate the prevalence and associated factors of paracentral scotoma in patients with high myopia and early open-angle glaucoma (OAG).

Methods: In this cross-sectional study, myopic eyes with early OAG (mean deviation of visual field> -6 dB) were categorized into the high myopia group and the low-to-moderate myopia group. Paracentral scotoma was defined as a visual field defect in one hemifield within 10 degrees of fixation. The prevalence of paracentral scotoma was compared between the two groups. Association between structural and vascular factors and paracentral scotoma were investigated by logistic regression analysis.

Results: A total of 220 myopic eyes with early OAG were enrolled, including 136 highly myopic eyes, and 84 low-to-moderate myopic eyes. Paracentral scotoma was more prevalent in the high myopia group (39.7% vs. 22.6%, P = 0.012). Multivariate logistic regression analysis showed that thinner circumpapillary retinal nerve fiber layer (cpRNFL) thickness in inferior-temporal and temporal-upper sectors, thinner inferior ganglion cell complex (GCC) thickness, lower radial peripapillary capillary (RPC) vessel density in inferior-temporal and temporal-lower sectors, lower inferior perifoveal vessel density were significantly associated with paracentral scotoma in highly myopic eyes with early OAG (all P < 0.05).

Conclusions: Compared with low-to-moderate myopia, highly myopic eyes with early OAG were more likely to develop paracentral scotoma. The measurement of cpRNFL thickness and RPC vessel density in the temporal and inferior-temporal sectors, GCC thickness and perifoveal vessel density in the inferior sector may help assessment of central visual function in highly myopic eyes with early OAG.

Keywords: high myopia; open-angle glaucoma; paracentral scotoma; visual field.