The Analysis Of The Visual Field And Retinal Nerve Fiber Layer Measurement Using Optical Coherence Tomography In High Myopia

Objective:(1) To explore the characteristics of visual filed defects in high myopia, using optical coherence tomography (OCT) to measure the thickness of the retinal nerve fiber layer, compare and analyse those records, observe the changing regularity of them.(2) To compare the different changes of the visual filed and retinal nerve fiber layer between high myopia and primary open-angle glaucoma, to supply the parameters of OCT for early differential diagnosis of complicated glaucoma in high myopia.Methods:(1) Collected40subjects (48eyes) of high myopia eyes (Diopters≥-6.00D), and divided them into two groups according to their spherical equivalent (SE):group A (6.00D-9.00D) with25eyes of21subjects, group B (9.00D-18.00D) with23eyes of19subjects, and20subjects (20eyes) of normal eyes (bare eye sight over1.0, diopters between+/-0.50D). Given the visual field examinations to all participants by the same medical technician, to understand the characteristics of visual field defects by comparing their total error probability figure, the extend and distribution of early visual field defects. Furthermore, select20subjects (20eyes) for group D who have been diagnosed with early primary open-angle glaucoma.(3)The total, superior, inferior, nasal and temporal quadrants average RNFL thickness in the high myopia patients was measured and analyzed using the Stratus-OCT, and we try to find the regularity of them.Results:(1) The general reduction of sensitivity of high myopia and super-high myopia in total deviation probability figure was remarkable, their mean sensitivity and mean deviation were significantly higher than that in normnal group.(2) The forms of visual field defects in high myopia were multiple, the main visual field defects in high myopia group was focal, but in super-high myopia group showed extensive damage.(3) The average RNFL thickness in the four groups:The superior and inferior quadrants were the thickest, the next was the temporal quadrant, and the nasal quadrant was the thinnest one.(4) The total average RNFL thickness in the super-high myopia group became thinner than those in the normal control group (P<0.0001). Both in the high myopia group and super-high myopia group, the total, superior, inferior, nasal and temporal quadrants average RNFL thickness became thinner than those in the normal control group, but the comparison was no significantly difference (P>0.05).(5) The superior and inferior quadrants average RNFL thickness in the early primary open-angle glaucoma group became thinner (P<0.0001).Conclusion: The threshold program center visual field examination had important direct sense to the mass screening, diagnosing and evaluating of complicated glaucoma in high myopia. The changes of RNFL in high myopia could be objectively quantified by OCT. In our clinical practice, we should seriously observe the characteristics of RNFL thickness change in high myopia, as it could be used for early diagnosis of complicated glaucoma.