title: Macular imaging in highly myopic eyes with and without glaucoma.
abstract: OBJECTIVE
  To determine how evaluations of macular structures on spectral-domain optical coherence tomography compare with those of the optic disc and circumpapillary retinal nerve fiber layer (RNFL) in discriminating between highly myopic eyes with and without glaucoma.
  
  
  METHODS
  Retrospective, comparative study.
  
  
  METHODS
  The appearances of ganglion cell layer and RNFL on Spectralis macular scans (Heidelberg Engineering) and optic disc on photographs were evaluated by 2 observers. The receiver operating characteristic regression was conducted for macular ganglion cell complex and circumpapillary RNFL measurements on RTVue-100 (Optovue).
  
  
  RESULTS
  Ninety highly myopic eyes (-6.0 to -15.0 diopters; mean deviation [MD], -5.6 ± 5.1 dB) and 91 non-highly myopic eyes (1.0 to -5.5 diopters; MD, -4.9 ± 5.7 dB) were enrolled. In highly myopic eyes (<-6 diopters), the Cohen κ for qualitative decisions by observers was 0.363 for photographs and 0.946 for Spectralis macular scans, and observers' evaluations of Spectralis macular scans were more accurate (94.5% and 94.5%, respectively; P < .0001) than their evaluations of photographs (71.4% and 80.2%, respectively). In the receiver operating characteristic regression analyses assessing the influences of age, sex, MD, and axial length, the better MD (P = .002 to .016) and longer axial length (P = .031 to .041) were associated significantly with diagnostic performances for all or some spectral-domain optical coherence tomography parameters. The receiver operating characteristic curves of average macular ganglion cell complex and circumpapillary RNFL thicknesses were comparable at low MD.
  
  
  CONCLUSIONS
  In high myopes, observers' assessments of the spectral-domain optical coherence tomography macular scans may agree better and be more accurate than observers' optic disc assessments. Glaucoma diagnostic performance of the macular ganglion cell complex may be less affected by axial length compared with that of circumpapillary RNFL.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Nakano
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: hangai@kuhp.kyoto-u.ac.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Hangai
authors.affiliation: The Institute of Statistical Mathematics, Tokyo, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Noma
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nukada
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mori
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morooka
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Takayama
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hanako Ohashi
authors.initials: HO
authors.lastname: Ikeda
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Tadamichi
authors.initials: T
authors.lastname: Akagi
authors.affiliation: Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Nagahisa
authors.initials: N
authors.lastname: Yoshimura
mesh_terms: D000328:Adult; D001369:Axons / Q000473:pathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography; D005901:Glaucoma / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000503:physiopathology; D012372:ROC Curve; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology