High Myopia and OCT: Scanning Challenges and Care

High myopia and OCT (Optical Coherence Tomography)

Hello Doctor, I have high myopia with both eyes at -1600 diopters.
I am currently studying abroad.
Last month, I experienced persistent flashes in my vision, so I have been monitoring my fundus with examinations.
The doctor said everything looks fine and that I can continue to monitor it.
During my appointment today, I mentioned that I see straight lines as curved, and the doctor recommended an OCT scan.
However, the hospital's machine was unable to perform the scan, stating that my axial length is too long for it to capture.
The doctor informed me that there is currently no bleeding in the macula and that it is not serious, advising me not to worry and to return for a follow-up in a month.

I would like to ask, if I go back to Taiwan for an OCT, will I encounter the same issue? Is this problem common? Do I need further examinations and treatment? Thank you very much for your response; I am really very anxious.
Thank you.

jasshand, 30~39 year old female. Ask Date: 2015/12/17

Dr. Wang Zhishun reply Ophthalmology

Hello, the OCT in Taiwan is also imported from abroad, and it still has the same issues, although they are rare.
Most patients with an axial length greater than 30 mm can still be scanned.
I recommend that you check the Amsler grid daily; if you notice any changes, get checked earlier.
If there are no changes, return for a follow-up appointment in a month.

Reply Date: 2015/12/17

More Info

High myopia, often defined as a refractive error greater than -6.00 diopters, can lead to various ocular complications, particularly as the degree of myopia increases. In your case, with a prescription of -1600 degrees, you are classified as having high myopia, which can significantly affect the structure and function of your eyes. One of the common concerns associated with high myopia is the elongation of the eyeball, which can lead to changes in the retina and other ocular structures, making it essential to monitor your eye health regularly.

Optical Coherence Tomography (OCT) is a non-invasive imaging technique that provides high-resolution cross-sectional images of the retina. It is particularly useful for detecting early signs of retinal diseases, such as macular degeneration, retinal detachment, and other complications associated with high myopia. However, as you have experienced, the effectiveness of OCT can be limited in patients with very long axial lengths, which is often the case in high myopia. The difficulty in obtaining clear scans may be due to the anatomical changes in the eye, such as the thinning of the retina or the presence of other structural abnormalities.

Regarding your concern about whether you will face similar challenges when returning to Taiwan for an OCT scan, it is indeed possible. The ability to perform OCT scans can vary depending on the equipment used and the specific settings of the machine. Some OCT machines are designed to accommodate a wider range of eye shapes and sizes, while others may have limitations. However, it is not uncommon for patients with high myopia to encounter difficulties with OCT imaging, regardless of the location.

As for your current situation, it is reassuring that your doctor has indicated that there is no bleeding in the macula and that your condition is not severe. The fact that you are experiencing visual distortions, such as straight lines appearing curved, can be concerning, but it does not necessarily indicate a serious problem. These visual disturbances can sometimes be attributed to changes in the retina or the vitreous gel inside the eye, which are common in individuals with high myopia.

In terms of further evaluation and treatment, it is essential to maintain regular follow-ups with your eye care provider. If you continue to experience symptoms or if your vision deteriorates, additional tests may be warranted. These could include a more comprehensive eye examination, additional imaging studies, or even referral to a specialist in retinal diseases. It is crucial to communicate openly with your healthcare provider about your symptoms and any concerns you may have.

In conclusion, while the challenges you faced with OCT scanning are not uncommon in high myopia, it is vital to continue monitoring your eye health. Regular check-ups and open communication with your eye care provider will help ensure that any potential issues are addressed promptly. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for guidance. Your eye health is paramount, and staying informed and proactive is the best approach.

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