{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T21:54:02Z","timestamp":1774475642262,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2023-00247504"],"award-info":[{"award-number":["RS-2023-00247504"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["HC19C0276"],"award-info":[{"award-number":["HC19C0276"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Patient-Centered Clinical Research Coordinating Center","award":["RS-2023-00247504"],"award-info":[{"award-number":["RS-2023-00247504"]}]},{"name":"Patient-Centered Clinical Research Coordinating Center","award":["HC19C0276"],"award-info":[{"award-number":["HC19C0276"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to develop a new index, the average curvature ratio (ACR), to represent the optic nerve head (ONH) tilting and investigate its clinical relevance. Myopic eyes were included and divided into two subgroups: flat ONH (ACR &lt; 1.0) and convex ONH (ACR \u2265 1.0). The occurrences of central and peripheral visual field (VF) defects were compared between the two groups. A total of 375 myopic eyes were recruited, and 231 and 144 eyes were included in the flat and convex ONH groups, respectively. Central scotoma occurred more frequently in the flat ONH group. According to the Patella\u2013Anderson criteria, the number of eyes with central scotoma was 103 (44.6%) in the flat and 44 (30.6%) in the convex ONH groups (p = 0.009). According to Kook\u2019s criteria, the number of eyes with central scotoma was 122 (52.8%) in the flat and 50 (34.7%) in the convex ONH groups (p &lt; 0.001). Peripheral scotoma was not significantly different between the groups. In the correlation analysis, the ACR was positively correlated with spherical equivalence, but not with axial length or central corneal thickness. The ACR reflects the degree of the ONH tilt and is a good index for estimating central VF damage in myopic eyes.<\/jats:p>","DOI":"10.3390\/jcm13020596","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T11:04:57Z","timestamp":1705662297000},"page":"596","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Optic Nerve Head Curvature Flattening Is Associated with Central Visual Field Scotoma"],"prefix":"10.3390","volume":"13","author":[{"given":"Keunheung","family":"Park","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Busan Medical Center, Busan 47527, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6715-0447","authenticated-orcid":false,"given":"Jinmi","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Clinical Trial Center, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiwoong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Pusan National University College of Medicine, Busan 50612, Republic of Korea"},{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1016\/j.ophtha.2011.03.012","article-title":"Myopia as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis","volume":"118","author":"Marcus","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2010","DOI":"10.1016\/S0161-6420(99)90416-5","article-title":"The Relationship between Glaucoma and Myopia: The Blue Mountains Eye Study","volume":"106","author":"Mitchell","year":"1999","journal-title":"Ophthalmology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1167\/iovs.63.5.26","article-title":"Ocular and Hemodynamic Factors Contributing to the Central Visual Function in Glaucoma Patients with Myopia","volume":"63","author":"Hong","year":"2022","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"599","DOI":"10.2147\/OPTH.S131370","article-title":"Is High Myopia a Risk Factor for Visual Field Progression or Disk Hemorrhage in Primary Open-Angle Glaucoma?","volume":"11","author":"Nitta","year":"2017","journal-title":"Clin. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/01.APO.0000578944.25956.8b","article-title":"Myopia: Anatomic Changes and Consequences for Its Etiology","volume":"8","author":"Jonas","year":"2019","journal-title":"Asia-Pac. J. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101156","DOI":"10.1016\/j.preteyeres.2022.101156","article-title":"Myopia: Histology, Clinical Features, and Potential Implications for the Etiology of Axial Elongation","volume":"96","author":"Jonas","year":"2023","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1016\/j.ajo.2013.01.016","article-title":"Myopia-Related Fundus Changes in Singapore Adults with High Myopia","volume":"155","author":"Chang","year":"2013","journal-title":"Am. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1038\/eye.2016.270","article-title":"Ocular Characteristics Associated with the Location of Focal Lamina Cribrosa Defects in Open-Angle Glaucoma Patients","volume":"31","author":"Park","year":"2017","journal-title":"Eye"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1001\/jamaophthalmol.2014.1056","article-title":"Optic Disc Characteristics in Patients with Glaucoma and Combined Superior and Inferior Retinal Nerve Fiber Layer Defects","volume":"132","author":"Choi","year":"2014","journal-title":"JAMA Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1038\/s41598-020-58829-3","article-title":"Association between Myopia and Peripapillary Hyperreflective Ovoid Mass-like Structures in Children","volume":"10","author":"Lyu","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1167\/iovs.15-18263","article-title":"Parapapillary Gamma Zone and Axial Elongation\u2013Associated Optic Disc Rotation: The Beijing Eye Study","volume":"57","author":"Jonas","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yamashita, T., Sakamoto, T., Yoshihara, N., Terasaki, H., Tanaka, M., Kii, Y., and Nakao, K. (2017). Correlations between Local Peripapillary Choroidal Thickness and Axial Length, Optic Disc Tilt, and Papillo-Macular Position in Young Healthy Eyes. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0186453"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Sawada, Y., Hangai, M., Ishikawa, M., and Yoshitomi, T. (2016). Association of Myopic Optic Disc Deformation with Visual Field Defects in Paired Eyes with Open-Angle Glaucoma: A Cross-Sectional Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0161961"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/IJG.0000000000001182","article-title":"The Effects of Optic Nerve Head Tilt on Visual Field Defects in Myopic Normal Tension Glaucoma: The Intereye Comparison Study","volume":"28","author":"Choi","year":"2019","journal-title":"J. Glaucoma"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1016\/j.ophtha.2011.02.040","article-title":"Myopia-Related Optic Disc and Retinal Changes in Adolescent Children from Singapore","volume":"118","author":"Samarawickrama","year":"2011","journal-title":"Ophthalmology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ophtha.2011.07.051","article-title":"Optic Disc Change with Incipient Myopia of Childhood","volume":"119","author":"Kim","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/IJG.0000000000000635","article-title":"Relationship between Anterior Lamina Cribrosa Surface Tilt and Glaucoma Development in Myopic Eyes","volume":"26","author":"Lee","year":"2017","journal-title":"J. Glaucoma"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1016\/j.ophtha.2018.02.002","article-title":"Positional Change of Optic Nerve Head Vasculature during Axial Elongation as Evidence of Lamina Cribrosa Shifting: Boramae Myopia Cohort Study Report 2","volume":"125","author":"Lee","year":"2018","journal-title":"Ophthalmology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.ophtha.2007.03.075","article-title":"Refractive Errors in an Elderly Japanese Population: The Tajimi Study","volume":"115","author":"Sawada","year":"2008","journal-title":"Ophthalmology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1016\/j.ophtha.2005.05.015","article-title":"Refractive Error in Urban and Rural Adult Chinese in Beijing","volume":"112","author":"Xu","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1016\/j.ophtha.2017.04.035","article-title":"Evidence-Based Criteria for Assessment of Visual Field Reliability","volume":"124","author":"Yohannan","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_24","unstructured":"Anderson, D.R. (1999). Automated Static Perimetry, Mosby-Year Book."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1167\/iovs.16-21079","article-title":"Alterations of the Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography in Glaucoma Patients with Central Visual Field Defects","volume":"58","author":"Kwon","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1097\/00006324-198012000-00004","article-title":"Mechanical Considerations in Myopia: Relative Effects of Accommodation, Convergence, Intraocular Pressure, and the Extraocular Muscles","volume":"57","author":"Greene","year":"1980","journal-title":"Optom. Vis. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1167\/iovs.15-18718","article-title":"Optic Nerve Sheath as a Novel Mechanical Load on the Globe in Ocular Duction","volume":"57","author":"Demer","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6472","DOI":"10.1167\/iovs.12-10319","article-title":"Retinal Nerve Fiber Layer Defects in Highly Myopic Eyes with Early Glaucoma","volume":"53","author":"Kimura","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.ajo.2004.08.076","article-title":"Optic Disk Ovality as an Index of Tilt and Its Relationship to Myopia and Perimetry","volume":"139","author":"Tay","year":"2005","journal-title":"Am. J. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3341\/kjo.1992.6.1.32","article-title":"Optic Disc of the Myopic Eye: Relationship between Refractive Errors and Morphometric Characteristics","volume":"6","author":"Hyung","year":"1992","journal-title":"Korean J. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1136\/bjo.2008.139113","article-title":"Corneal Biomechanics, Thickness and Optic Disc Morphology in Children with Optic Disc Tilt","volume":"92","author":"Lim","year":"2008","journal-title":"Br. J. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2695","DOI":"10.1167\/iovs.17-21791","article-title":"The Characteristics of Deep Optic Nerve Head Morphology in Myopic Normal Tension Glaucoma","volume":"58","author":"Han","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1167\/iovs.63.6.20","article-title":"Characteristics of the Optic Nerve Head in Myopic Eyes Using Swept-Source Optical Coherence Tomography","volume":"63","author":"Cheng","year":"2022","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1167\/iovs.15-17510","article-title":"Analysis of Peripapillary Geometric Characters in High Myopia Using Swept-Source Optical Coherence Tomography","volume":"57","author":"Asai","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/596\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:46:14Z","timestamp":1760103974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,19]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13020596"],"URL":"https:\/\/doi.org\/10.3390\/jcm13020596","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,19]]}}}