Associated factors for visibility and width of retrobulbar subarachnoid space on swept-source optical coherence tomography in high myopia

Subarachnoid space (SAS) around optic nerve can be visible with swept-source optical coherence tomography (SS-OCT). However, the relevant factors for its visibility and width have not been reported. In this prospective study, 193 eyes with high myopia were evaluated by SS-OCT. The relationship between age, gender, axial length, optic disc area, parapapillary atrophy (PPA) area, peripapillary choroidal thickness with the visibility and width of SAS were assessed. The results showed that SAS was observed in 125 (64.8%) and not observed in 68 (35.2%) eyes. Visibility of SAS is associated with long axial length, high myopia, thin choroid, large PPA and large optic disc areas. Among these associations, PPA area was the only independent factor (b = 0.177, p < 0.001). The width of SAS was associated with thin choroid, long axial length, large optic disc area and large PPA area. Multivariant analysis showed that optic disc area and PPA area were independent factors for the width of SAS (b = 30.8, p = 0.016 and 16.2, p < 0.001 respectively). These results suggested that SAS was extended into the peripapillary region possibly due to extension of posterior sclera in high myopia.