Diagnostic capability of peripapillary retinal nerve fiber layer parameters in time-domain versus spectral-domain optical coherence tomography for assessing glaucoma in high myopia

AIM： To evaluate and compare the diagnostic capabilities of peripapillary retinal nerve fiber layer（p-RNFL） parameters of Spectralis optical coherence tomography（OCT） versus Stratus OCT to detect glaucoma in patients with high myopia. METHODS： This is a retrospective, cross-sectional study. Sixty highly myopic eyes of 60 patients were enrolled, with 30 eyes in the glaucoma group and 30 eyes in the control group. All eyes received peripapillary imaging of the optic disc using Stratus and Spectralis OCT. Areas under the receiver operating characteristic curve（AUROC） and the sensitivity at specificity of 〉80% and 〉95% for p-RNFL parameters obtained using the two devices to diagnose glaucoma were analysed and compared. RESULTS： In Spectralis OCT, p-RNFL thickness parameters with the largest AUROC were the temporal-inferior sector（0.974） and the inferior quadrant（0.951）, whereas in Stratus OCT, the best parameters were the 7-o＇clock sector（0.918） and the inferior quadrant（0.918）. Compared to the Stratus OCT parameters, the Spectralis OCT parameters demonstrated generally higher AUROC; however, the difference was not statistically significant. CONCLUSION： The best p-RNFL parameters for diagnosing glaucoma in patients with high myopia were the temporal-inferior sector on Spectralis OCT and the 7-o＇clock sector on Stratus OCT. There were no significant differences between the AUROCs for Spectralis OCT and Stratus OCT, which suggest that the glaucoma diagnostic capabilities of these two devices in patients with high myopia are similar.

Myopia prevention in Taiwan

Complications of myopia have become an important public health issue with serious socio-economic burdens.Prevention and treatment are both important.The Taiwan Student Vision Care Program(TSVCP)promoted by Ministry of Education(MOE)has been carried out for 3 decades in Taiwan.The myopia prevalence has increased rapidly to a high level and therefore myopia prevention has continued to be the most important item in the program.Therefore,TSVCP aims to decrease the prevalence of myopia,in order to decrease the high myopia related blindness in the future.Recently,outdoor activity has been found to be an important protective factor for myopia and was implemented in TSVCP since 2010.Afterwards,the nationwide vision impairment rate(uncorrected vision 20/25 or less)of elementary school students declined unprecedentedly and continuously in recent years.Evidence-based protective and risk factors for myopia are now clearer.Widespread acknowledgement of myopic disease,preventing the onset of myopia,prompt diagnosis,and early treatment to control progression are all important.