Interplay Between γ-Zone Peripapillary Atrophy and Optic Disc Parameters in Central Visual Field Impairment in Highly Myopic Eyes.

Purpose: The purpose of this study was to investigate the association between the development of glaucoma-like central visual field (VF) defects and γ-zone peripapillary atrophy (γPPA) in eyes with high myopia (HM). Methods: This retrospective study measured γPPA length, prelaminar tissue (PLT) thickness, and lamina cribrosa (LC) defects' width in HM eyes with central VF defects by swept-source optical coherence tomography (OCT). The central VF was assessed by using the Humphrey Field Analyzer 10-2 program, and average light sensitivity in the papillomacular bundle region (C1 region) and mean deviation (MD) values were calculated. Interactions among the central VF and structural abnormalities were analyzed using correlation tests and linear regression. Results: Forty-five eyes from 45 patients were included. PLT thickness was positively associated with light sensitivity in the C1 region and MD values, whereas γPPA was associated only with MD values. LC defects showed no association with either the C1 region or MD values. LC defects' width was negatively correlated with γPPA length. Stratified analysis showed that in the group with γPPA length ≥763 µm, PLT thickness was positively associated, and γPPA length was negatively associated with the C1 region and MD values. No such associations were found when the γPPA length was <763 µm. The association between LC defects with central VF remained nonsignificant. Conclusions: Our findings identified γPPA length and PLT thickness as risk factors of glaucoma-like central VF defects in HM, particularly when γPPA length exceeds 763 µm. We suggest that HM eyes with larger γPPA and thinner PLT should be paid special attention for early detection of central VF defects.