To evaluate diagnostic power to detect glaucoma in high myopic eyes with peripapillary atrophy among optical coherence tomography (OCT) parameters.

Fifty eyes of 31 glaucoma patients with myopia of -6.00 diopters or less and a peripapillary atrophy (PPA) were classified into a group with a PPA located beyond the circumpapillary OCT scan circle (group A) and a group with a PPA confined within the scan circle (group B). Circumpapillary retinal nerve fiber layer (cpRNFL), total macula (TM), and ganglion cell-inner plexiform layer (GCIPL) thickness were measured in each group and the diagnostic power of each measurement was compared by area under the receiver operating characteristic curve (AUC).

There were no significant differences in the age, gender, intraocular pressure, optic disc size, and mean deviation between the 2 groups. The spherical equivalent of group A was significantly larger than group B (mean -11.9 vs. -7.3 diopters, p = 0.002). In group A, the AUC of average GCIPL thickness was significantly higher than average cpRNFL and average TM thickness ( p < 0.05). Additionally, when comparing parameters that showed the highest AUC value in each method, the AUC of GCIPL thickness was significantly higher than cpRNFL thickness ( p = 0.046). In subgroup analysis of spherical equivalent matching between the 2 groups (subgroup A and B), the highest AUC value of GCIPL thickness was significantly higher than cpRNFL and TM thickness in subgroup A ( p < 0.05). In group B and subgroup B, there was no statistical significance among AUC values of the 3 different methods ( p > 0.05).

Assessment of GCIPL parameters is a useful technique for glaucoma diagnosis in patients with high myopia and PPA extending beyond circumpapillary OCT scan circle.