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Clinical features of high myopia with optic nerve head prelaminar schisis: Wuhan high myopia study

Eye volume 39, pages 2787–2792 (2025) Cite this article

Subjects

Abstract

Background

The global prevalence of high myopia is rising, posing a significant public health concern. Limited research exists on risk factors for prelaminar schisis (PLS) and its impact on visual field changes in highly myopic eyes. Herein, we investigated clinical features of prelaminar schisis (PLS) in highly myopic eyes.

Methods

This cross-sectional study included 245 eyes with high myopia and 64 eyes with emmetropia and low myopia. PLS was classified on a 3-point scale (0–2), and clinical characteristics were compared between two groups and three sub-groups. Factors associated with PLS presence and severity were evaluated in highly myopic eyes.

Results

Highly myopic eyes had a higher frequency (P = 0.008) and severity (P = 0.001) of PLS than controls. Among them, 33.47% (82/245) had Grade 0, 56.33% (138/245) had Grade 1, and 10.20% (25/245) had Grade 2. The presence of Bergmeister papilla (OR = 2.181, 95% CI: 1.080–4.406, P = 0.030), larger Bruch’s membrane opening (BMO) (OR = 1.927, 95% CI: 1.279–2.904, P = 0.002) and longer axial length (OR = 1.723, 95% CI: 1.186–2.499, P = 0.004) correlated with PLS severity. Eyes with Grade 2 PLS were more prone to visual field defect than eyes with Grade 0 (P = 0.005) and Gade 1 (P = 0.013) PLS.

Conclusion

Bergmeister papilla presence, larger BMO, and longer axial length were associated with the PLS severity, suggesting ONH prelaminar schisis may indicate traction and myopic deformation of the ONH. PLS with peripapillary retinoschisis suggests a possibility of functional damage.

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Fig. 1: Grading of prelaminar schisis (PLS) in highly myopic eyes.
The alternative text for this image may have been generated using AI.
Fig. 2: Bergmeister papilla, BMO and peripapillary retinoschisis.
The alternative text for this image may have been generated using AI.

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Data availability

The data pertaining to this manuscript are included in the article and supplemental materials. Additional data can be obtained from the corresponding author upon reasonable request, pending compliance with institutional data governance protocols.

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Acknowledgements

The authors are grateful to all the participants in the cohort study for their invaluable contributions and commitment.

Funding

This study was supported by research grants from the National Natural Science Foundation of China (Grant No. 82101115) and the Natural Science Foundation of Hubei Province (2023AFB214).

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Author notes

  1. These authors contributed equally: Qiuyan Wu, Ruihan Hu.

Authors and Affiliations

  1. Eye Center, Renmin Hospital of Wuhan University, Wuhan, China

    Qiuyan Wu, Ruihan Hu, Qihong Liu, Lhamo Tsering, Di Xiao, Sawut Abdulla, Zuohuizi Yi, Jiajia Yuan & Changzheng Chen

  2. Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China

    Fang Li & Min Ke

  3. School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China

    Yilei Shao & Meixiao Shen

Authors
  1. Qiuyan Wu
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  4. Fang Li
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Contributions

QYW, RHH and QHL were responsible for design of the study, collection and analysis of data, and writing the manuscript. FL, TL, DX, and AS were responsible for collection and analysis of data. ZHZY and JJY were responsible for analysis of data and funding acquisition. YLS and MXS were responsible for review and editing of the manuscript. CZC and MK were responsible for review, editing and final approval of the manuscript.

Corresponding authors

Correspondence to Min Ke or Changzheng Chen.

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Wu, Q., Hu, R., Liu, Q. et al. Clinical features of high myopia with optic nerve head prelaminar schisis: Wuhan high myopia study. Eye 39, 2787–2792 (2025). https://doi.org/10.1038/s41433-025-03939-3

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