Abstract
Purpose
To assess prevalence and associated factors of parapapillary gamma zone enlargement (GZE).
Methods
Using fundus photographs and optical coherence tomographic images of participants of the population-based Beijing Eye Study, we examined gamma zone changes in a 10-year follow-up.
Results
The study included 89 highly myopic eyes (61 participants; age: 65.0 ± 9.8 years) and 86 randomly selected non-highly myopic eyes. GZE prevalence was significantly higher in highly myopic eyes than non-highly myopic eyes (75/89; 84%; 95% CI: 77, 92 versus 18/86; 21%; 95% CI:12, 30; p < 0.001). None of the eyes showed a reduction in gamma zone size. Higher prevalence of segmental GZE without enlargement of Bruch’s membrane opening (BMO) (mean: 26/175; 14.9%; 95% CI: 9.5, 20.2) was associated with optic disc size reduction (OR: 43.3; 95% CI: 10.9, 172; p < 0.001), disc-fovea distance elongation (OR: 15.4; 95% CI: 3.12, 76.4; p = 0.001) and lower prevalence of high axial myopia (OR: 0.08; 95% CI: 0.01, 0.44; p = 0.001). Higher prevalence of circular GZE (mean: 38/175; 21.7%; 95% CI: 16, 28) was correlated with optic disc enlargement (OR: 4.30; 95% CI: 1.58, 11.7; p = 0.004), and higher prevalence of myopic maculopathy progression (OR: 4.04; 95% CI: 1.60, 10.2; p = 0.003), or alternatively, higher prevalence of high myopia (OR: 4.44; 95% CI: 1.76, 11.2; p = 0.002). Circular GZE or BMO enlargement was associated with lower prevalence of macular BM defect enlargement (p = 0.035). GZE occurred perpendicular to the orientation of myopic lacquer cracks in 12 out of 17 (71%; 95% CI: 46, 95) eyes with lacquer cracks. Segmental GZE occurred in 49 (89%) out of 55 eyes in the same direction as shortening of the disc diameter developed.
Conclusions
The observations support the possibility of a posterior myopic axial elongation-associated BMO shift, leading to a segmental GZE in non-highly myopic eyes, followed by a circular GZE in highly myopic eyes. Large gamma zone might be protective against macular Bruch’s membrane defects.
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Change history
28 February 2022
The figures were changed to color figures in pdf.
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National Natural Science Foundation of China (#81570835).
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JBJ and RAJ: European patent application 16 720 043.5 and US patent application US 2019 0085065 A1: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia). JBJ: Advisory Board Novartis; Patent holder with Biocompatibles UK Ltd. (Farnham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; Patent number: 20120263794), Patent application: Agents for the use in the therapeutic or prophylactic treatment of retinal pigment epithelium associated diseases. All other authors: None.
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Jonas, J.B., Zhang, Q., Xu, L. et al. Parapapillary gamma zone enlargement in a 10-year follow-up: the Beijing Eye Study 2001–2011. Eye 37, 524–530 (2023). https://doi.org/10.1038/s41433-022-01978-8
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DOI: https://doi.org/10.1038/s41433-022-01978-8
