ATYPICAL NERVE-FIBER LAYER DEFECTS IN HIGH MYOPES WITH HIGH-TENSION GLAUCOMA

The incidence of atypical optic nerve head and retinal nerve fiber layer defects was studied in 61 high myopic eyes (≥-5 diopters) and 91 emmetropic or hyperopic eyes (0 to +3 diopters) of 152 patients with chronic high-tension glaucoma, and in 45 control myopic eyes (≥-5 diopters). Horizontal ovalness or cyclotorsion, oblique insertion of the optic disc, and bean pot disc were more common in the high myopes. In the eyes with high myopia with glaucoma, inferior dominant nerve fiber layer defects, ectopic fiber defects, and multiple nerve fiber layer defects were common. The incidence of superior nerve fiber layer defects or superior-inferior equal nerve fiber layer defects was high in round or vertically oval discs and low in cyclotorted or horizontal oval discs. The oblique insertion of the discs correlated positively with a higher incidence of ectopic defects in high myopic eyes with glaucoma. The incidence of focal type nerve defects is higher in older patients and high myopes with oblique insertion of the optic disc. Atypical shape of the optic disc correlates positively with atypical retinal nerve fiber layer defects in eyes with high-tension glaucoma. © 1990, American Medical Association. All rights reserved.