*Understanding and monitoring glaucoma progression has long been a challenge for clinicians, especially among patients with high myopia.
A groundbreaking study published in 2025 sheds light on how Optical Coherence Tomography Angiography (OCTA) is proving to be a superior tool compared to traditional methods.
This research highlights OCTA’s ability to detect subtle vascular changes in highly myopic eyes, which traditional structural imaging fails to identify, offering a new approach to clinical care for this complex patient population.*
What Makes Glaucoma Monitoring Difficult in High Myopia Patients?
*High myopia presents unique anatomical challenges, making glaucoma diagnosis and monitoring particularly tricky.
Myopic changes in the optic disc often resemble glaucomatous damage, blurring the lines for accurate diagnosis with conventional imaging methods.
Structural measurements such as peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness may fail to reveal significant changes as glaucoma progresses.*
Why Structural Imaging Falls Short
*The study demonstrated that patients in the progressive glaucoma group, characterized by worsening visual field tests, did not exhibit notable differences in pRNFL and mGCIPL thickness rates compared to the stable group.
Such limitations highlight the need for alternative approaches to gauge disease progression.*
Why OCTA Outperforms Traditional Techniques
*The game-changer in this study was OCTA, which evaluates vessel density in the macular and peripapillary regions.
Unlike structural imaging, OCTA detected significantly steeper declines in vessel density among the progressive group, showcasing its superior sensitivity.*
OCTA’s Edge in Stratified Measurements
*Even when patients were divided based on glaucoma severity—mild cases versus moderate-to-severe cases—the sensitivity of OCTA’s vessel density measurements held steady.
This reliability underscores OCTA’s ability to detect disease progression across various stages of glaucoma.*
Less Impact from Anatomical Variations
*An important advantage of OCTA is its resilience to anatomical variations commonly seen in highly myopic eyes.
This feature makes vessel density changes a more reliable biomarker for glaucoma progression, as distortions in eye structure are less likely to interfere with the results.*
Key Findings from the Study
*The study tracked 62 high myopia patients with glaucoma over three years, comparing those with stable visual fields to those exhibiting progressive deterioration. Researchers noted crucial differences at baseline and during follow-up testing:*
- Baseline Differences: Visual field defects, structural measurements, and vascular measurements were all worse in the progressive group.
- Progression Detection: Compared to structural imaging, vessel density declines measured by OCTA were better at identifying progression.
- Prediction of Changes: Vascular deterioration detected by OCTA preceded structural changes, suggesting it may serve as an early indicator.
Implications for Glaucoma Management
*These findings advocate for considering OCTA imaging as an essential tool in the management of glaucoma in patients with high myopia.
The ability to detect subtle vascular changes before structural damage appears could shift how clinicians monitor disease progression, allowing for earlier intervention and tailored care.*
Impact on Global Health
*The study’s insights take on added significance in regions like East Asia, where myopia rates are exceptionally high, and high myopia is a known risk factor for glaucoma.
Traditional glaucoma assessment methods often fall short due to anatomical complexities, leaving many patients underdiagnosed or improperly managed.
By integrating OCTA technology more broadly, clinicians in high-risk regions can enhance diagnostic accuracy and treatment outcomes.*
The Path Forward
*This landmark study serves as a call to action for ophthalmologists and researchers alike: embrace OCTA as part of routine glaucoma surveillance in high myopia patients. By detecting vascular changes early and reliably, OCTA can pave the way for improved patient care, better visual outcomes, and potentially slower disease progression.*
*With myopia rates continuing to rise globally, the need for advancements in glaucoma monitoring has never been more urgent.*
*Ultimately, the research reinforces OCTA’s role in revolutionizing ophthalmologic care—providing clinicians with the ability to see beyond structural changes and focus on vascular dynamics. As science advances, so too should our strategies for safeguarding vision and quality of life.*
Here is the source article for this story: Optical coherence tomography angiography compared with optical coherence tomography for detection of glaucoma progression with high myopia