Progression of Glaucoma in Highly Myopic Eyes with Paravascular Inner Retinal Defects

Purpose: To report a case of glaucoma progression in highly myopic eyes with paravascular inner retinal defects.Case summary: Retinal nerve fiber layer (RNFL) defects with cleavage-like irregular margins and internal areas were found around the retinal vessels in highly myopic eyes of a 17-year-old female. On suspicion of paravascular inner retinal defect (PIRD) instead of glaucomatous RNFL defect, observation without treatment was recommended. After 10 years of follow-up, RNFL de-fects and neuroretinal rim thinning were found around the pre-existing PIRD on fundus photographs. Optical coherence tomog-raphy also revealed decreased RNFL thickness.Conclusions: Glaucomatous changes progressed around the pre-existing PIRD area over the 10-year follow-up. This indicates the need for caution when assessing glaucoma in highly myopic eyes with PIRD.