• Courtesy of Richard F. Spaide, MD.
    File Size: 115 KB
    Related: optic nerve, myopia

    Optic nerve changes in pathologic myopia. A, The optic nerve head seen in the color fundus photograph does not accurately show the size of the Bruch membrane opening. B, The enhanced depth imaging OCT shows the actual Bruch membrane opening (arrows). Note how far Bruch membrane extends into what appears to be the nerve (left arrow). C, A vertical section through (C) in the color photograph shows the extent of Bruch membrane. The arrow shows Bruch membrane extending into the nerve tissue. The nerve fibers have to arch nasally under Bruch membrane to reach the lamina cribrosa (yellow arrow). D, A vertical section through (D) in the color photograph shows 2 dehiscences (arrowheads) in the lamina cribrosa. Although this is a common finding in both glaucoma and pathologic myopia, it is not known whether every patient with a lamina defect in high myopia also has glaucoma. When an eye with glaucoma develops a Drance hemorrhage, there is typically an appearance of a lamina cribrosa dehiscence; however, in pathologic myopia dehiscences in the lamina are not typically seen to have any associated hemorrhage.