Comparison of Deep Optic Nerve Head Structures and Optic Disc Morphology in Unilateral Peripapillary Intrachoroidal Cavitation.

Purpose

To compare background characteristics, deep optic nerve head (ONH) structures, and optic disc morphology in participants with unilateral peripapillary intrachoroidal cavitation (PICC).

Design

Retrospective cross-sectional study.

Participants

One hundred six eyes of 53 participants with unilateral PICC determined on OCT.

Methods

Twelve ONH-centered OCT radial slices were used to manually measure Bruch membrane opening (BMO) area, BMO ovality, scleral flange opening (SFO) area, SFO ovality, and SFO/BMO offset magnitude which represents the degree of SFO/BMO centroid displacement and clinically corresponds to the peripapillary atrophy-gamma and delta zones. Optic disc tilt, rotation, area, and longest and shortest diameters were measured from line scanning laser ophthalmoscopy images.

Main outcome measures

Paired t tests and Wilcoxon signed-rank tests were used to compare background characteristics and obtained parameters between PICC eyes and their contralateral eyes. False discovery rate was controlled using the Benjamini-Hochberg method to account for multiple comparisons.

Results

Peripapillary intrachoroidal cavitation eyes showed significantly larger BMO area ( P < 0.001) and its ovality ( P = 0.020), larger SFO area ( P = 0.003), larger SFO/BMO offset magnitude ( P = 0.007), greater optic disc tilt ( P < 0.001), and smaller optic disc shortest diameter ( P = 0.010). There was no significant difference in axial length (AL) ( P = 0.081) and optic disc rotation ( P = 0.067).

Conclusions

Although AL was similar between PICC eyes and their contralateral eyes, significant intereye differences in deep ONH structures and optic disc morphology were observed. Peripapillary intrachoroidal cavitation eyes exhibited a more elliptically expanded BMO, larger SFO, greater SFO/BMO misalignment, and greater optic disc tilt, which are structural changes associated with border tissue elongation. Our findings indicate a strong association between the presence of PICC and myopia-related characteristic deep ONH remodeling, providing a foundation for understanding structural abnormalities in myopic eyes.

Financial disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.