Variabilidad del espesor de la capa de fibras nerviosas peripapilares entre grupos según severidad de miopía y grupo control

Gabriela Patricia Amadeo Oreggioni; Verónica Elisa Castillo; María Andrea Cardozo; Diógenes Cibils

doi:10.18004/anales/2019.052.03.59-068

Authors

Gabriela Patricia Amadeo Oreggioni Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Hospital de Clínicas, Cátedra de Oftalmología. San Lorenzo, Paraguay.
Verónica Elisa Castillo Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Hospital de Clínicas, Cátedra de Oftalmología, Departamento de Retina y Vítreo. San Lorenzo, Paraguay.
María Andrea Cardozo Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Hospital de Clínicas, Cátedra de Oftalmología. San Lorenzo, Paraguay
Diógenes Cibils Universidad Nacional de Asunción, Facultad de Ciencias Médicas, Hospital de Clínicas, Cátedra de Oftalmología. San Lorenzo, Paraguay.

DOI:

https://doi.org/10.18004/anales/2019.052.03.59-068

Keywords:

optical coherence tomography, peripapillary nerve fiber layer, myopia, Paraguay

Abstract

Introduction: Myopia is one of the most prevalent refractive errors, globally 28.3%. The morphological appearance of the optic disc in myopia with the variations of the condition make clinical diagnosis and monitoring of glaucoma progression very difficult. Recently, new high resolution imaging modalities were developed to give us more information and help in the detection of micro anatomic changes of the optic nerve head. Objective: To determine the thickness variability of the peripapillary nerve fiber (RNFL) layer measured with optical coherence tomography (OCT) between the different groups according to myopia severity and control group. Methodology: This is an observational, descriptive, cross-sectional study. Non-probabilistic sampling of consecutive cases. With analytical component. Results: A total of 144 eyes were analyzed, approximately two thirds of the subjects studied were female (n: 97 eyes). The average age of the subjects studied was 30.68 +/- 11.58. 50 (34.7%) emmetropic eyes were studied as a control group, among the different groups according to severity of myopia 27 (18.8%) eyes with mild myopia were studied, 33 (22.9%) with moderate myopia and 34 (23.6%) eyes with severe myopia. The mean axial length found was 23.12 +/- 0.81mm for the control group (emétropes); 23.72 +/- 0.76mm for the group with mild myopia; 25.11 +/- 0.79mm for the group with moderate myopia and 26.42 +/- 1.45mm for the group with severe myopia, with statistically significant differences between these groups with a greater axial length for the group with severe myopia. Statistically significant differences were found between the groups studied, for differences found in the average thickness and in the thickness of the upper, lower and temporal quadrants. The differences found in the thickness of the nasal quadrant were not significant. Conclusion: Despite the limitations, this study clearly demonstrates that eyes with severe myopia have a smaller thickness in the peripapillary RNFL than the emmetropic eyes in the upper and lower quadrants. An increase in thickness was found in the temporal and nasal quadrant, being statistically significant in the temporal quadrant. On the one hand this thinning could be a risk factor for the development of glaucoma since variations in the arrangement of the nerve fibers of the optic nerve head are postulated that make the myopic eye more susceptible to glaucomatous damage. For clinical relevance, we must take into account the differences of myopia to make the correct diagnosis in cases of suspected glaucoma and evaluate progression with OCT. Thus it would also be ideal to group according to age range due to the differences of this variable that could have influenced the interpretation of the results.

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