Journal of Current Glaucoma Practice

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VOLUME 11 , ISSUE 2 ( May-August, 2017 ) > List of Articles


Assessment of Retinal Nerve Fiber Layer Changes by Cirrus High-definition Optical Coherence Tomography in Myopia

Reetika Sharma, Divya Singh, Esha Agarwal, Sanjay K Mishra

Citation Information : Sharma R, Singh D, Agarwal E, Mishra SK. Assessment of Retinal Nerve Fiber Layer Changes by Cirrus High-definition Optical Coherence Tomography in Myopia. J Curr Glaucoma Pract 2017; 11 (2):52-57.

DOI: 10.5005/jp-journals-10028-1223

License: CC BY 3.0

Published Online: 01-01-2015

Copyright Statement:  Copyright © 2017; The Author(s).



To evaluate the relationship between retinal nerve fiber layer (RNFL) thickness measured by Cirrus high-definition (HD) optical coherence tomography (OCT) and the axial length and refractive error of the eye.

Materials and methods

A total of 100 eyes of 100 healthy subjects (age 20-34 years with M/F ratio of 57/43), comprising 50 eyes with emmetropia [spherical equivalent (SE) 0 D], 25 eyes with moderate myopia (SE between -4 D and -8 D), and 25 eyes with high myopia (SE between -8 D and -12 D) were analyzed in this cross-sectional study. Average and mean clock hour RNFL thicknesses were measured by cirrus HD-OCT and compared between the three groups. Associations between RNFL measurements and axial length and SE were evaluated by linear regression analysis.


The average RNFL measurements were significantly lower in high myopia (78.68 +/- 5.67) and moderate myopia (83.76 +/- 3.44) group compared with emmetropia group (91.26 +/- 2.99), also in the superior and inferior mean clock hours. Significant correlations were evident between RNFL measurements and the SE and axial length. The average RNFL thickness decreased with increasing axial length (r = –0.8115) and negative refractive power (r = 0.8397). Myopia also affected the RNFL thickness distribution. As the axial length increased and the SE decreased, the thickness of the superior, inferior, and nasal peripapillary RNFL decreased.


The axial length/refractive error of the eye affected the average RNFL thickness and the RNFL thickness distribution. Analysis of RNFL thickness in the evaluation of glaucoma should always be interpreted with reference to the refractive status. When interpreting the RNFL thickness of highly myopic patients by OCT, careful attention must be given to the inherently thinner RNFL to avoid a false diagnosis of glaucoma.

How to cite this article

Singh D, Mishra SK, Agarwal E, Sharma R, Bhartiya S, Dada T. Assessment of Retinal Nerve Fiber Layer Changes by Cirrus High-definition Optical Coherence Tomography in Myopia. J Curr Glaucoma Pract 2017;11(2):52-57.

  1. The relationship between glaucoma and myopia: the Blue Mountains Eye Study. Ophthalmology 1999 Oct;106(10):2010-2015.
  2. High myopia and glaucoma susceptibility the Beijing Eye Study. Ophthalmology 2007 Feb;114(2):216-220.
  3. Optic disc morphology in myopic primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 1997 Oct;235(10):627-633.
  4. Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss. Arch Ophthalmol 1991 Jan;109(1):77-83.
  5. Chronic human glaucoma causing selectively greater loss of larger optic nerve fibers. Ophthalmology 1988 Mar;95(3):357-363.
  6. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol 1989 May;107(5):453-464.
  7. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study. Ophthalmology 2009 Jul;116(7):1257-1263.
  8. Retinal nerve fibre layer measurements in myopia: an optical coherence tomography study. Invest Ophthalmol Vis Sci 2006 Dec;47(12):5171-5176.
  9. Peri-papillary retinal nerve fiber layer thickness profile in subjects with myopia measured using optical coherence tomography. J Clin Ophthalmol Res 2014 Aug;2(3):131-136.
  10. The effect of myopia on retinal nerve fibre measurement: a comparative study of spectral domain optical coherence tomography and scanning laser polarimetry. Br J Ophthalmol 2011 Feb;95(2):255-260.
  11. Effect of myopia on thickness of retinal nerve fibre layer measured by Cirrus HD optical coherence tomography. Invest Ophthalmol Vis Sci 2010 Aug;51(8):4075-4083.
  12. Effect of refractive status on peripapillary retinal nerve fibre layer thickness: a study by RTVue spectral domain optical coherence tomography. Br J Ophthalmol 2013 Jan;97(1):75-79.
  13. Myopia affects retinal nerve fibre layer measurements as determined by optical coherence tomography. J Glaucoma 2009 Sep;18(7):501-505.
  14. Determinants of normal retinal nerve fibre layer thickness measured by Stratus OCT. Ophthalmology 2007 Jun;114(6):1046-1052.
  15. Peripapillary retinal nerve fibre layer thickness variations with myopia. Ophthalmology 2006 May;113(5):773-777.
  16. Thickness changes in the fovea and peripapillary retinal nerve fibre layer depend on the degree of myopia. Korean J Ophthalmol 2006 Dec;20(4):215-219.
  17. The influence of axial length on retinal nerve fibre layer thickness and optic-disc size measurements by spectral-domain OCT. Br J Ophthalmol 2012 Jan;96(1):57-61.
  18. Retinal thickness by OCT in subjects with emmetropia, hyperopia and myopia. Invest Ophthalmol Vis Sci 2002 Dec;43(13):2574.
  19. Comparison of optic disk and retinal nerve fiber layer thickness in nonglaucomatous and glaucomatous patients with high myopia. Am J Ophthalmol 2006 Nov;142(5):858–860.
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