Prevalence and associations of parapapillary scleral ridges: the Beijing Eye Study.

Br J Ophthalmol

Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China

Published: September 2024

AI Article Synopsis

  • The study investigates the occurrence and factors related to parapapillary scleral ridges (PSRs) in a population from the Beijing Eye Study, specifically focusing on individuals with different axial lengths of the eye.
  • Results show that PSR prevalence significantly increases with higher myopia, from 0% in non-myopic to 29.2% in highly myopic individuals, with age, female sex, and longer axial length being correlated factors.
  • The findings suggest that PSRs are common in highly myopic eyes, and their presence may result from biomechanical interactions involving the optic nerve and elongated eye structures.

Article Abstract

Purpose: To explore the prevalence and associated factors of parapapillary scleral ridges (PSRs).

Methods: Out of the cohort of the population-based Beijing Eye Study (n=3468 participants), the study included all eyes with an axial length of ≥25 mm and a randomised sample of eyes with an axial length of <25 mm. Using optical coherence tomographic (OCT) images and fundus photographs, we examined the presence and height of PSRs, defined as a ridge-like structure located on the OCT scans in the parapapillary region.

Results: The study cohort consisted of 366 eyes (314 individuals; mean age: 63.7±9.7 years). PSR prevalence increased from 0% in the non-myopic group to 3.8% (95% CI 0.3%, 7.3%) in moderately myopic group and 29.2% (95% CI 15.7%, 42.5%) in the highly myopic group. All PSRs were located in the temporal parapapillary gamma zone and corresponded to an ophthalmoscopically visible demarcation line running almost parallel to the optic disc border. Higher PRS prevalence correlated with longer axial length (OR 2.98; 95% CI 1.99, 4.46; p<0.001), female sex (OR 6.48; 95% CI 1.56, 27.0; p=0.01) and older age (OR 1.09; 95% CI 1.01, 1.18; p=0.02). Axial length had the strongest influence (beta: 0.48), followed by sex (beta: 0.20) and age (beta: 0.14). If age was dropped from the multivariable model, myopic maculopathy prevalence (OR 10.0; 95% CI 1.41,70.9; p=0.02) and stage (OR 3.57; 95% CI 1.21, 10.6; p=0.02) became significantly correlated with higher PSR prevalence.

Conclusions: With a PSR prevalence of >60% in eyes with an axial length of >28 mm, PSRs are a common morphological feature of high myopia, with age and female sex as additional associated factors. PSRs may be due to a biomechanical interplay between the optic nerve and the posterior ocular segment of markedly axially elongated eyes.

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http://dx.doi.org/10.1136/bjo-2024-325205DOI Listing

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