Scleral thickness in highly myopic eyes measured by enhanced depth imaging optical coherence tomography

Purpose The purpose of this study was to determine the subfoveal scleral thickness in highly myopic eyes by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and to identify the ocular parameters significantly associated with the scleral thickness. Methods The subfoveal scleral thickness of myopic eyes (>= -8 diopters (D) or axial length >= 26.5mm) was examined by EDI-OCT. The correlations between the thickness and the best-corrected visual acuity (BCVA), refractive error, axial length (AL), the subfoveal retinal thickness, choroidal thickness, and posterior staphyloma height 2mm from the fovea were investigated. Results A total of 75 eyes of 54 patients (21 men, 33 women; mean age, 62.3 +/- 11.3 years; mean AL, 30.2 +/- 1.68mm) were studied. Eighteen eyes had no pathological retinochoroidal lesions, and 57 eyes had retinochoroidal lesion, that is, myopic schisis, choroidal neovascularization, and other retinochoroidal pathologies. The mean subfoveal scleral thickness was 284.0 +/- 70.4 mu m, and the thickness was significantly correlated negatively with the absolute value of the nasal and overall average posterior staphyloma height (P<0.05 and P<0.01, respectively). The subfoveal scleral thickness was also significantly correlated negatively with the relative value of the superior, nasal, and overall average posterior staphyloma height (P<0.05, P<0.01, and P<0.001, respectively). Stepwise analyses showed that the factor most significantly associated with the scleral thickness was the average relative posterior staphyloma height (F = 16.0, P<0.001). The scleral thickness was not significantly different between eyes with and without myopic retinochoroidal pathologies (P>0.05). Conclusion Posterior staphyloma formation was a key factor associated with a posterior scleral thinning in highly myopic eyes. Eye (2013) 27, 410-417; doi:10.1038/eye.2012.289; published online 11 January 2013