Comparison of Deep Optic Nerve Head Structures and Optic Disc Morphology in Unilateral Peripapillary Intrachoroidal Cavitation

IF 4.6 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-08-07 DOI:10.1016/j.xops.2025.100908

Kaho Akiyama MD , Shuichiro Aoki MD , Shiroaki Shirato MD, PhD , Rei Sakata MD, PhD , Megumi Honjo MD, PhD , Makoto Aihara MD, PhD , Hitomi Saito MD, PhD

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Abstract

Purpose

To compare background characteristics, deep optic nerve head (ONH) structures, and optic disc morphology in participants with unilateral peripapillary intrachoroidal cavitation (PICC).

Design

Retrospective cross-sectional study.

Participants

One hundred six eyes of 53 participants with unilateral PICC determined on OCT.

Methods

Twelve ONH-centered OCT radial slices were used to manually measure Bruch membrane opening (BMO) area, BMO ovality, scleral flange opening (SFO) area, SFO ovality, and SFO/BMO offset magnitude which represents the degree of SFO/BMO centroid displacement and clinically corresponds to the peripapillary atrophy–gamma and delta zones. Optic disc tilt, rotation, area, and longest and shortest diameters were measured from line scanning laser ophthalmoscopy images.

Main Outcome Measures

Paired t tests and Wilcoxon signed-rank tests were used to compare background characteristics and obtained parameters between PICC eyes and their contralateral eyes. False discovery rate was controlled using the Benjamini–Hochberg method to account for multiple comparisons.

Results

Peripapillary intrachoroidal cavitation eyes showed significantly larger BMO area (P < 0.001) and its ovality (P = 0.020), larger SFO area (P = 0.003), larger SFO/BMO offset magnitude (P = 0.007), greater optic disc tilt (P < 0.001), and smaller optic disc shortest diameter (P = 0.010). There was no significant difference in axial length (AL) (P = 0.081) and optic disc rotation (P = 0.067).

Conclusions

Although AL was similar between PICC eyes and their contralateral eyes, significant intereye differences in deep ONH structures and optic disc morphology were observed. Peripapillary intrachoroidal cavitation eyes exhibited a more elliptically expanded BMO, larger SFO, greater SFO/BMO misalignment, and greater optic disc tilt, which are structural changes associated with border tissue elongation. Our findings indicate a strong association between the presence of PICC and myopia-related characteristic deep ONH remodeling, providing a foundation for understanding structural abnormalities in myopic eyes.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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单侧乳头周围脉络膜内空化的深视神经头结构与视盘形态比较

目的比较单侧乳头周围脉络膜腔内空化（PICC）患者的背景特征、深视神经头（ONH）结构和视盘形态。设计：回顾性横断面研究。方法采用12张以onh为中心的OCT径向切片，人工测量Bruch膜开口（BMO）面积、BMO卵圆度、巩膜法兰开口（SFO）面积、SFO卵圆度和SFO/BMO偏移量，SFO/BMO偏移量代表SFO/BMO质心位移的程度，临床上对应于乳头周围萎缩- γ区和δ区。行扫描激光检眼镜图像测量视盘倾斜、旋转、面积、最长和最短直径。主要观察指标：采用呼吸t检验和Wilcoxon符号秩检验比较PICC眼与对侧眼的背景特征和参数。使用Benjamini-Hochberg方法控制错误发现率，以考虑多重比较。结果乳头状脉络膜内空化眼BMO面积（P < 0.001）和椭圆度（P = 0.020）显著增大，SFO面积（P = 0.003）显著增大，SFO/BMO偏置幅度（P = 0.007）显著增大，视盘倾斜较大（P < 0.001），视盘最短直径较小（P = 0.010）。视轴长度（AL）（P = 0.081）和视盘旋转（P = 0.067）差异无统计学意义。结论虽然PICC眼与对侧眼AL相似，但眼间深层ONH结构和视盘形态存在显著差异。乳突周围脉络膜内空化眼表现为BMO呈椭圆形扩张、SFO增大、SFO/BMO偏差增大、视盘倾斜增大，这些都是与边缘组织延伸相关的结构改变。我们的研究结果表明，PICC的存在与近视相关的特征深ONH重塑之间存在密切的联系，为理解近视眼睛的结构异常提供了基础。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

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