Peripapillary Optical Coherence Tomography Artifacts in Pathologic Myopia: Prevalence and Impact on Glaucoma Diagnosis.

PRCIS: Peripapillary retinal nerve fiber layer thickness (pRNFLT) artifacts were more prevalent than Bruch membrane opening-minimum rim width (BMO-MRW) artifacts in pathologic myopia (PM). Considering artifacts, the diagnostic performance of pRNFLT and BMO-MRW was comparable.

PURPOSE: To investigate the prevalence of pRNFLT and BMO-MRW artifacts in PM and the impact of artifacts on the diagnostic ability for open angle glaucoma (OAG).

METHODS

This cross-sectional study was conducted at Zhongshan Ophthalmic Center. PM eyes were divided into 2 groups based on OAG diagnosis. Artifacts of pRNFLT and BMO-MRW were classified, and their prevalences were compared. The diagnostic ability of pRNFLT and BMO-MRW for OAG was compared before and after the inclusion of eyes with artifacts.

RESULTS

A total of 136 participants with PM were included from July 2023 to January 2025, with a median (interquartile range) age of 49 (16) years and a mean (SD) axial length of 28.03 (2.01) mm. Seventy-four (54.4%) eyes were diagnosed as OAG. Seven and 3 types of pRNFLT and BMO-MRW artifacts were observed, respectively. Presence of pRNFLT artifacts was identified in 74.2% of eyes in the PM group and 63.5% of eyes in the PM with OAG (PMG) group, which was more prevalent than BMO-MRW artifacts (27.4% in the PM group and 4.1% in the PMG group, both P <0.001). Before and after including eyes with artifacts, the area under the receiver operating characteristic curve (AUC) of global RNFLT decreased from 0.927 to 0.869, and the AUC of global BMO-MRW slightly decreased from 0.884 to 0.882.

CONCLUSION

Artifacts of pRNFLT were more complex and prevalent than those of BMO-MRW. In PM, the diagnostic ability of pRNFLT and BMO-MRW was comparable when artifacts were considered.