Spark QuizWise 28


Q. 1 – Which of the following about the optic disc in myopia is correct. 

  1. All optic discs in myopes  are larger than normal
  2. The optic disc in myopia  is always different from a normal optic  disc. 
  3. Gamma one is frequently found in myopia
  4. Beta zone is found more commonly in myopia

Q. 2 – Which of the following is false for the  retinal nerve fiber layer in myopia. 

  1. The RNFL may show macular thickening.
  2. The RNFL may show nasal thinning.
  3. The RNFL thinning is always associated with glaucoma in myopia
  4. When the RNFL circle passes over the area of gamma zone  the RNFL measurement may not be accurate

QuizWise responses

Answer 1: 3

3. Gamma Zone is frequently found in myopia is the correct answer.  The prevalence of gamma zone which is the distance  of the Bruch’s membrane opening from the clinical margin of the optic disc  increases with increasing axial length.   All optic discs in myopia are nor large. On several occasions one may find optic discs that are smaller than normal.  The Beta zone is found adjacent to the gamma zone more often but not always in patients of myopia with glaucoma.  It is less  likely to be seen in association with  a non glaucomatous  myopic disc

Answer 2: 3

3:  The RNFL  thinning  is not always associated with glaucoma and one must look at the clinical picture before  making a definitive diagnosis, specially with regard  to the optic disc appearance, axial length  and tilt of the disc.   When the RNFL circle passes over the gamma zone/parapapillary atrophy  one may be cautious in interpreting the results, because of the  changes in the histology in this area.  It may be good to take a RNFL scan  around the Bruchs membrane opening which may  help to get more accurate scans, specially if the machine marks the BMO accurately. 

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