Purpose

To delineate longitudinal changes in the optic nerve head (ONH) and peripapillary structure during myopia progression in childhood using spectral-domain (SD) OCT and to explore the factors associated with myopic ONH and peripapillary changes.

Design

Prospective cohort study.

Participants

Twenty-three healthy children with myopia (46 eyes).

Methods

The participants underwent fundus photography, SD OCT, and axial length (AXL) measurements every 6 months for 2 years. Based on the morphologic changes of the ONH and β-zone parapapillary atrophy (PPA), eyes were classified as group A (ONH unchanged without β-zone PPA; 11 eyes), group B (ONH changed without β-zone PPA at baseline; 10 eyes), group C (ONH changed with β-zone PPA at baseline; 15 eyes), and group D (ONH unchanged with β-zone PPA; 10 eyes). The configuration of the border tissue (BT) at the temporal margin of the ONH was assessed, and the ONH parameters, including Bruch's membrane opening distance (BMOD), border length (BL), and BT angle (BTA), were measured on horizontal SD OCT scans.

Main Outcome Measures

Changes in ONH parameters and associated factors.

Results

Group B showed the greatest AXL increase per year (group B > group C > group A = group D; P < 0.001). During the follow-up periods, the BT configuration initially was changed from internally oblique to externally oblique (group B) and was stretched, resulting in optic disc ovality and γ-zone PPA development (group C). In group C, BL was increased significantly nasally and BTA was decreased significantly, whereas BMOD remained stable (P < 0.001, P < 0.001, and P = 0.100, respectively). In the multivariate analysis using the generalized linear mixed-effect model, the changes of BL and BTA were associated with axial elongation (P = 0.028 and P = 0.010, respectively).

Conclusions

Development of myopic optic disc and γ-zone PPA during myopia progression was delineated using SD OCT images. During the ONH and peripapillary changes, the BL was increased nasally and the BTA was decreased, whereas the BMOD remained relatively stable. The association of axial elongation with ONH and peripapillary tissue changes may facilitate understanding of the relationship between myopia and glaucoma.

中文翻译：

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OCT儿童近视发展过程中视神经头和乳头周围结构的纵向变化

目的

使用光谱域（SD）OCT来描述儿童近视发展过程中视神经头（ONH）和角膜周围结构的纵向变化，并探讨与近视ONH和角膜周围变化相关的因素。

设计

前瞻性队列研究。

参加者

23名健康的近视儿童（46眼）。

方法

参与者每6个月进行一次眼底照相，SD OCT和轴向长度（AXL）测量，为期2年。根据ONH和β区乳头旁萎缩（PPA）的形态变化，将眼睛分为A组（ONH无β区PPA而无变化； 11只眼），B组（ONH无基线β区PPA而有变化）； 10眼），C组（基线时β-区PPA改变了ONH; 15眼）和D组（β-区PPA的ONH改变了; 10眼）。评估ONH颞缘的边界组织（BT）的配置，并在水平方向测量ONH参数，包括Bruch的膜张开距离（BMOD），边界长度（BL）和BT角（BTA） SD OCT扫描。

主要观察指标

ONH参数和相关因素的变化。

结果

B组显示每年最大的AXL增长（B组> C组> A组= D组；P  <0.001）。在随访期间，BT构型最初从内部倾斜变为外部倾斜（B组），并被拉伸，导致视盘卵圆形和γ区PPA显影（C组）。在C组中，鼻腔BL显着升高，BTA显着降低，而BMOD保持稳定（分别为P <0.001，P <0.001和P  = 0.100）。在使用广义线性混合效应模型进行的多元分析中，BL和BTA的变化与轴向伸长相关（分别为P  = 0.028和P  = 0.010）。

结论

使用SD OCT图像描绘了近视发展过程中近视视盘和γ区PPA的发育情况。在ONH和乳头周围改变期间，BL鼻增高，BTA降低，而BMOD保持相对稳定。轴向伸长率与ONH和乳头周围组织变化的关系可能有助于了解近视和青光眼之间的关系。