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ORIGINAL RESEARCH article

Front. Med.

Sec. Ophthalmology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1620968

This article is part of the Research TopicImaging in the Diagnosis and Treatment of Eye DiseasesView all 25 articles

The Role of Peripapillary Vessel Density and Retinal Nerve Fiber Layer Thickness in Diagnosing and Monitoring Myopic Glaucoma

Provisionally accepted
Qin  ChenQin Chen1Qingwei  MengQingwei Meng2Yijin  TaoYijin Tao3JIng  LiuJIng Liu1Zhu  ZengZhu Zeng1Ye  ShengYe Sheng3Wenyan  YangWenyan Yang3Qing  CunQing Cun3Xiaojun  LinXiaojun Lin3Xi  ChenXi Chen1Guangkun  HuangGuangkun Huang3Hua  ZhongHua Zhong3*
  • 1Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
  • 2Department of Ophthalmology, HeiLongJiang Red Cross Sengong General Hospital, Harbin, China
  • 3Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China

The final, formatted version of the article will be published soon.

Objective: To investigate changes in peripapillary vessel density (pVD) and retinal nerve fiber layer thickness (pRNFL) in highly myopic glaucoma patients compared to non-highly myopic glaucoma patients and healthy controls, and to evaluate their diagnostic capabilities using optical coherence tomography angiography (OCTA), and to explore the relationship between these biomarkers and visual function.Methods: A total of 382 eyes were recruited, including 101 highly myopic glaucoma eyes, 101 highly myopic control eyes, 90 non -highly myopic glaucoma eyes, and 90 non -highly myopic control eyes. Propensity score matching (PSM) was applied to balance age and axial length between groups. All subjects received comprehensive ophthalmic examinations. OCTA was used to measure pVD, spectral -domain OCT (SD -OCT) for pRNFL, and Humphrey 30 -2 SITA standard visual field (VF) testing was performed. pVD and pRNFL were measured across eight peripapillary sectors.Pearson correlation and linear regression analyses were used to assess the relationships between pVD, pRNFL, and visual field mean sensitivity (VFMS). Receiver operating characteristic (ROC) curve analyses were carried out to evaluate the diagnostic performance.Results: Both highly myopic glaucoma and non-highly myopic glaucoma groups exhibited significantly lower pVD, pRNFL, and VFMS compared to their respective controls (p < 0.001). In highly myopic glaucoma, average pVD was 37.66% versus 46.40% in controls (p < 0.001), and pRNFL was 71.13 μm versus 101.22 μm in controls (p < 0.001). pVD showed stronger correlations with VFMS than pRNFL in both glaucoma groups (highly myopic: r = 0.681 vs. r = 0.504; nonhighly myopic: r = 0.749 vs. r = 0.722; p < 0.001). ROC analysis demonstrated that the pRNFL and pVD have comparable diagnostic abilities in the early-stage of glaucoma (p > 0.05). Combining superior-temporal (ST) and inferior-temporal (IT) regions achieved the highest diagnostic accuracy (AUCpVD: 0.954 and 0.964; AUCpRNFL: 0.934 and 0.942) for both glaucoma groups. Conclusions: pVD and pRNFL are valuable diagnostic biomarkers for myopic glaucoma. pVD demonstrated a stronger correlation with visual function, making it a promising tool for early glaucoma diagnosis and monitoring in highly myopic patients. Integrating pVD with pRNFL enhances diagnostic precision, particularly in highly myopic patients.

Keywords: High myopia, Glaucoma, peripapillary vessel density (pVD), peripapillary retinal nerve fiber layer (pRNFL), Visual field mean sensitivity (VFMS)

Received: 30 Apr 2025; Accepted: 02 Jun 2025.

Copyright: © 2025 Chen, Meng, Tao, Liu, Zeng, Sheng, Yang, Cun, Lin, Chen, Huang and Zhong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Hua Zhong, Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China

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