Evaluation of Retinal Nerve Fiber Layer, Ganglion Cell-Inner Plexiform Layer, and Optic Nerve Head in Glaucoma Suspects With Varying Myopia

Precis: Myopic glaucoma suspects, particularly with high myopia, experience thinning of nontemporal parameters of retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), without change in optic nerve head (ONH) parameters. Purpose: The aim was to assess the effect of myopia on RNFL, GCIPL, and ONH parameters in glaucoma suspects. Materials and Methods: Seventy-six eyes of glaucoma suspects studied with Cirrus high definition optical coherence tomography were divided into low (n=27), moderate (n=25), and high myopia (n=24) groups. Optical coherence tomography parameters were correlated with spherical equivalent (SE) and evaluated with areas under the receiver operating characteristic curve for quantifying diagnostic ability to differentiate high myopia from nonhigh myopia. Results: In high myopia, SE was positively correlated with thinning of average, minimum, and nontemporal GCIPL and thinning of average and nontemporal RNFL (P<0.05 for all), but not for inferior RNFL (P=0.28). In moderate myopia, SE was correlated with thinning of inferonasal and minimum GCIPL as well as superior and inferior RNFL (P<0.05 for all). SE was not correlated with ONH parameters in moderate or high myopia (P>0.05). The largest areas under the receiver operating characteristic curve for RNFL and GCIPL parameters were for superior (0.82) and superonasal (0.80) regions, respectively, with comparable diagnostic ability (P=0.74). Conclusion: High myopia, in particular, is associated with thinning of average RNFL, average and minimum GCIPL, and nontemporal parameters of both RNFL and GCIPL, warranting consideration of refractive status in glaucoma suspects.