What is the Role of Axial Magnification Correction in the

Measurement of Macular Microvascular Dimensions in Emmetropic

Eyes?
V. K. Viekasha, Janarthanam Jothi Balajib*, Vasudevan Lakshminarayananc
aDepartment of Instrumentation and Control Engineering, National Institute of Technology, Tiruchirappalli, Tamil Nadu, 620015,
India.
bDepartment of Optometry, Medical Research Foundation, Chennai - 600 006, India.
cTheoretical and Experimental Epistemology Lab, School of Optometry and Vision Science, University of Waterloo, Waterloo,

Ontario N2L 3G1, Canada.

ABSTRACT

The foveal avascular zone (FAZ), as visualized by optical coherence tomography angiography (OCTA), has distinct
parametric characteristics. These metrics can help us understand FAZ variations in various ophthalmic conditions such as
diabetic retina, retinopathy of prematurity, glaucoma, and pathological myopia. One of the several factors that influence
the accuracy of these measures is the eye’s axial length (AXL). Even though the OCTA is designed to image the retina
with a standard AXL of 23.95 mm, there is considerable variation even in normal healthy eyes; for example, the average
Indian's AXL is 23.34 ± 1.12 mm, which would result in retinal image magnification changes It has been reported that, if
the FAZ area is not corrected for AXL, there can be up to a 51.0 % deviation in the measured parameters. Bennett's
correction (and its variations) are commonly employed to determine axial magnification. This study compares the effects
of magnification in emmetropic Indian eyes with and without Bennett's correction. The FAZ dimensions were measured
in healthy normal Indian subjects with a mean ± SD of 27.38 ± 11.62 years, AXL 23.40 ± 0.88 mm, and mean spherical
equivalent of 0.08 ± 0.24 D using a newly designed automated image processing approach. Our results indicate no need
to correct axial length variations over a 23.18 to 24.01 mm range in emmetropic eyes. This implies that any AXL longer
than 24.01 mm and smaller than 23.18 mm may require axial magnification correction to precisely measure FAZ
parameters.
Keywords: Optical coherence tomography angiography, Foveal avascular zone, Bennett correction, Emmetropia, Axial
magnification, Retina

1. INTRODUCTION
Optical coherence tomography angiography (OCTA) is a non-invasive procedure that allows clinicians to visualize and
image retinal blood vessels up to the capillary level.1,2,3 OCTA produces depth-resolved images of blood flow in the
retina and choroid that are significantly more detailed than prior imaging methods.4 Practical OCTA of ocular circulation
is now available to clinicians, thanks to the introduction of high-speed OCT and efficient algorithms. This technique has
great potential for diagnosing and treating retinal vascular disease.5 The visualization of microvasculature leads to
quantification of various regions, including the foveal avascular zone (FAZ). It has been reported that that the FAZ
dimension parameters can be a retinal marker in ocular diseases such as diabetic retinopathy,6,7 retinopathy of
prematurity,8,9 glaucoma,10 and pathological myopia3,11,12 and can also help the clinician diagnose systemic conditions
such as stroke11 and Alzheimer's disease.13 Hence, it is critical to determine the precise dimensions of the FAZ for both
diagnostic and therapeutic purposes. If the chorioretinal artery is spared, the size of the FAZ fed by the choroidal
circulation affects the degree of vision maintained in central retinal artery occlusions. When treating near the fovea and
interpreting angiograms, it also defines the optimal size of the laser spot. The accuracy of these dimensions is influenced
by multiple factors, including the lateral scale of the FAZ en-face image.1,14 The axial length (AXL) is defined to be the
distance between the anterior corneal apex and the macula (retina) and is measured with an ocular biometer.15,16 The
AXL plays an essential role in the eye's refractive status in different age groups.16

*Author for correspondence: jothibalaji@gmail.com

Most axial length elongation occurs in humans in the first 3 to 6 months of life, followed by a progressive slowing of
development over the next two years until the adult size is reached.16 Even after emmetropization, the AXL varies
considerably even in normal healthy eyes.17 These variations lead to individual differences in the magnification of the
retinal image obtained by OCTA measurement.14 The OCTA is designed to image the retina with a standard defined
axial length (e.g., 23.95 mm.)1,14 It has been reported that multiple factors, including ethnicity, will influence AXL in
normal healthy eyes.18,19 For example, the average Indian has an AXL of 23.34 ± 1.12 mm.20

It is well known that the true size of the retinal area imaged is dependent on the combination of camera and ocular
magnification. Recent studies reported deviations of up to 51.0 % if the FAZ area is not corrected for AXL.14 To correct
the axial magnification, Bennett's corrections are generally used.21 Often these corrections are used only in myopic or
high myopic eyes.1 To the best of our knowledge, there is no published information on the impact of uncorrected
magnification in emmetropic eyes. The current study aims to report the effect of FAZ dimensions with and without
Bennett's correction in emmetropic eyes with varying AXL.

2. METHODOLOGY
2.1 Subjects
The FAZ dimensions were measured in healthy normal subjects using a recently developed automated image processing
method.22 Subjects who visited a tertiary eye care centre in South India between Jan 2019 and December 2019 had a
comprehensive eye examination, including OCTA was included in this retrospective study. The exclusion criteria
included any prior history or clinical evidence of retinal or systemic vascular disease, best-corrected visual acuity worse
than 6/9, any glaucoma, ocular hypertension, amblyopia, and any ocular surgery. The Mean Spherical Error (MSE) was
calculated from the manifest refraction during the ophthalmic evaluation.23 The best-corrected visual acuity (BCVA) was
converted from Snellen's visual acuity to LogMAR acuity.

2.2 Ocular biometry

All ocular biometry data were obtained using the high-resolution non-contact IOLMaster 700 (Carl Zeiss Meditec AG,
Jena, Germany). In addition to the overall AXL, the following parameters were given by the instrument. 1. Corneal
radius of curvature in dioptre (D) (CRC; Keratometry Reading), 2. Central corneal thickness (CCT) in microns, 3.
Anterior chamber depth (ACD; The it is total of CCT and ACD) in mm, 4. Lens thickness (LT) in mm and 5. White to
white (WTW) measurement gives the corneal diameter in mm. Using these parameters, the vitreous chamber depth
(VCD) is calculated by subtracting ACD, LT from the AXL. The AXL/CR ratio was calculated by the method given by
Badmus et al.23 A total of 32 OCTA en-face images with dimensions of 412 x 412 pixels corresponding to 6 mm x 6 mm
were included in the study. Six images were excluded due to the lack of AXL and/or poor-quality images.

2.3 Image specifications

A total of 27 OCTA images were used for the final analysis. The subjects were grouped according to the AXL. The
commercially available Spectral-Domain OCTA (Cirrus 5000, Carl Zeiss Meditec Inc., Dublin, CA) Angiography 6 x 6
mm program was used in image FAZ. While imaging the FAZ, all the images were aligned with the centre of the fovea.
All OCTA images were 8-bit grayscale images of 412 x 412 pixels corresponding to 6 mm x 6 mm.

2.4 Image processing techniques

A new method was employed for automatic quantification of the FAZ dimensions.22 First, the image was cropped
around the region of interest to remove most of the vascular structures around the FAZ region for precise detection of
FAZ boundaries and to avoid false-positive segmentations. The Prewitt edge detector to detect horizontal and vertical
edges, thus distinguishing the region of interest's boundary from its surroundings. Once the image's edges were
recognized, the noise due to adjacent vasculature, which might potentially impair segmentation resulting in false-positive
detection was reduced. A closure procedure, which involves erosion and dilatation, was used to remove the vascular
structure. Also, this procedure can aid in the creation of a FAZ zone that is accurately divided. In this study, a line-
shaped morphological feature was used to dilate the image at angles of 0o, 45o, and 90o. The angles chosen were evenly
spaced, which aids in the preservation of the FAZs' shape. Furthermore, a disk-shaped element was used to achieve
image closure and false-positive removal, which prevents the curvature of the FAZ boundary from being present. The
segmented FAZ region must be removed due to the risk of false positives because all false positives were significantly
smaller than the FAZs. FAZ zones were identified and segmented using two types of markings: infill and outline
segmentation.
In addition to assessing the FAZ using either of the three methods above, parametric measurements were made with axial
length magnification corrections. It is important to note that the calculated parametric measurements were first produced
concerning the image dimensions captured on the fundus camera film ( ) and not the real size of the retinal feature ( ).
As a result, a conversion method between these two measures, s and t is required for parametric measurements to be
presented concerning the . Bennett et al21 offer refinements to Littmann's fundus photography approach for measuring
the size of retinal features. One of these is the axial length utilized to scan the retinal features and it is necessary to
calculate the conversion between the variables s and t. The relationship between s and t is dependent on the axial length
x. The undetermined parameter , A function of x in equation 1 is a variable which id dependent on the dimensions of
the given eye, and is determined using equation 2.21
(1)

(2)

Fifteen different dimensions were calculated out of the en-face OCTA images. Bennett's correction was applied and the
most frequently reported dimensions of the FAZ, such as area (mm2) and perimeter (mm), were calculated, and the
percent change was obtained.

2.5 Statistical analysis

All statistical analyses were performed using the SPSS version 20.0 (SPSS Inc., Chicago, Illinois, USA). The test for
normality was checked using the Kolmogorov-Smirnov test. The parametric statistical test was done since all the
parameters were normally distributed except the MSE and BCVA. A paired t-Test and a one-way analysis of variance
(ANOVA) were performed for comparison sub-groups based on their AXL magnification variation. A Pearson's
correlation coefficient was used to evaluate the correlation between AXL and the uncorrected and correct FAZ area. The p-
value <0.05 was considered significant for all the statistical tests.

3. RESULTS
The mean ± SD of the study subject's age, AXL, and MSE were 27.63 ± 11.47 years, 23.39 ± 0.87 mm, and 0.00 ± 0.00
D. Table 1 shows the study sample clinical and demographics data. Subjects were grouped based on magnification
alteration due to AXL. (Group 1: Axial magnification greater than 5 % with AXL <23.18 mm, 8 eyes, Group 2: Axial
magnification less than or equal to 5 % with AXL between 23.18 to 24.01 mm, 15 eyes. Group 3: Axial magnification
greater than 5 % with AXL >24.01 mm. 4 eyes)

Table 1: Study subjects clinical and demographic details.

Groups Group 1 Group 2 Group 3 Overall p-value
(Sample size) (8) (15) (4) (27)
Age (years) 29.50 ± 14.05 25.87 ± 11.44 30.50 ± 5.69 27.63 ± 11.47 0.682*
AXL (mm) 22.47 ± 0.53 23.49 ± 0.28 24.84 ± 0.63 23.39 ± 0.87 <0.000*
CCT (mm) 0.52 ± 32.50 0.53 ± 28.77 0.52 ± 24.40 0.52 ± 28.56 0.780*
VCD (mm) 14.78 ± 0.50 15.73 ± 0.55 17.15 ± 0.75 15.66 ± 0.94 <0.000*
CRC (D) 44.37 ± 0.98 43.14 ± 0.71 40.58 ± 2.12 43.13 ± 1.59 <0.000*
MSE (D)† 0.00 (0.00 – 0.00) 0.00 (0.00 – 0.00) 0.00 (0.00 – 0.25) 0.00 (0.00 – 0.00) 0.443**
BCVA (logMAR)† 0.00 (-0.08 – 0.00) 0.00 (-0.08 – 0.00) 0.00 (-0.04 – 0.00) 0.00 (-0.08 – 0.00) 0.727**
AXL/CRC‡ 2.95 ± 0.06 3.00 ± 0.06 2.98 ± 0.10 2.98 ± 0.07 0.220*
†Median (IQR), ‡Dimensionless, *One-Way ANNOVA, **Kruskal Wallis
The mean ± SD of the uncorrected FAZ area, perimeter and circularity index was calculated to be 0.29 ± 0.08 mm2, 2.08
± 0.33 mm and 0.82 ± 0.09 respectively. The axial magnification corrected FAZ area, and perimeter was determined to
be 0.28 ± 0.08 mm2 and 2.05 ± 0.33 mm. Table 2 Displays the FAZ dimensions area (mm2) and perimeter (mm) before
and after applying the correction. The mean comparison using the paired t-Test did not show any statistical significance
(Table 2).

Table 2: A comparison table shows the difference before and after correcting the axial magnification.
Uncorrected Corrected p-Value*
FAZ area (mm2) 0.29 ± 0.08 0.28 ± 0.08 0.180
FAZ perimeter 2.08 ± 0.33 2.05 ± 0.33 0.133
(mm)
*Paired t-Test

Table 3 shows the Pearson's correlation coefficient between AXL and FAZ dimensions with and without axial
magnification correction. The uncorrected axial magnification FAZ dimension showed almost no correlation (FAZ area
r = -0.148; p=0.470 & FAZ perimeter r = -0.080; p=0.698). After correcting for axial magnification the FAZ area alone
showed a better correlation (r = 0.203; p=0.715). It should be noted that it is a weak positive correlation.

Table 3: Correlation between AXL and uncorrected and correct FAZ area.
Correlation p-Value
(r)*
Uncorrected FAZ area -0.148 0.470
Corrected FAZ area 0.203 0.321
Uncorrected FAZ perimeter -0.080 0.698
Corrected FAZ perimeter 0.075 0.715
*Pearson's correlation coefficient

Figure 1 shows the box plot of FAZ dimensions after correcting for axial magnification and grouped based on percentage
changes. The FAZ area showed a statistically significant variation between the groups. This implies that any AXL
ranging between 23.18 - 24.01 mm may not require axial magnification correction. An AXL higher or lower than this
range requires correction to get the precise measurement of FAZ dimensions.

Figure 1: Boxplot showing the variation between AXL and Magnification corrected FAZ area and perimeter.
 4. DISCUSSION AND CONCLUSION
To understand the nature of various ocular diseases and conditions, OCTA is employed which enables clinicians to study
the retinal microvasculature noninvasively.24 It also helps in reporting potential retinal markers for various systemic
conditions.1,13,25 Hence, the information obtained from OCTA studies must be accurate. One of the critical factors
affecting the accuracy of these measurements is the axial length of the participant.1 Often it differs from that assumed by
the model eye of the device (AXL = 23.95 mm).1,26 Multiple reports have shown variation in AXL, even in clinically
emmetropic subjects. However currently available commercial OCTA devices do not take into consideration axial length
variations and therefore the resultant image size magnification done and the measured image parameters.14

To the best of our knowledge this is the first report to discuss the impact of uncorrected magnification in emmetropic
eyes to the best of our knowledge. The current study using Bennett’s correction21 demonstrates that showed axial
magnification correction is a required requirement even for in emmetropic eyes. Past studies have discussed showed the
impact of correction for magnification error on the interpretation of OCT images in various retinal disease conditions.
The effect of axial length on peripapillary retinal nerve fiber layer (RNFL) thickness in ametropic and emmetropic eyes
has been investigated using different commercially available OCTs.27,28,29 It has been found that after correcting for
image magnification, the RNFL thickness significantly varied between myopic, hyperopic, and emmetropic eyes in both
adults and children. 14,21

Interestingly after correcting the axial magnification using the modified Bennett formula21 these differences were
insignificant. Similarly, Leung et al.30 studied the optic nerve head dimension and axial length relationship. Correcting
for the axial length magnification using Littmann's formula, study's results in an increase of the optic nerve head area
(mm2) with increases in axial length and myopic refractive error. A study by Sampson et al.14 demonstrated the impact of
image magnification due to axial length variation on superficial retinal vessel density and foveal avascular zone area
measured using OCTA. Also The study cautioned that large errors in these parameters can arise in the absence of image
size correction in both superficial retinal vessel density as well as the FAZ area.14 A significant limitation of the present
study is the small sample size due to which low power was found in the statistical analysis. Further studies with more
number of healthy subjects, encompassing a wider range of axial lengths, age, and gender, is necessary to fully evaluate
vessel density and FAZ area as a biomarker of retinal health. Second, the current study used only the superficial retinal
layer images, and did not examine the impact of magnification on deep retinal layer parameters.

In conclusion, to precisely measure FAZ dimensions, ocular biometry measurement is mandatory before the OCTA
investigation irrespective of their refractive error state. Axial length corrections are needed for AXL longer than 24.01
mm and shorter than 23.18 mm. No axial magnification corrections are needed for axial lengths between 23.18 mm and
24.01 mm. However, this values are subject to change depending on the OCTA standard length used by the
manufacturer.
ACKNOWLEDGEMENTS
The authors would like to thank the subjects for agreeing to report the clinical data. This work was partly supported by a
DISCOVERY Grant from Canada's Natural Sciences and Engineering Research Council to VL.

REFERENCES
[1] Llanas, S., Linderman, R. E., Chen, F. K. and Carroll, J., “Assessing the Use of Incorrectly Scaled Optical
Coherence Tomography Angiography Images in Peer-Reviewed Studies.” JAMA Ophthalmol. 138(1), 86 (2020).
[2] Shahlaee, A., Pefkianaki, M., Hsu, J. and Ho, A. C., “Measurement of Foveal Avascular Zone Dimensions and
its Reliability in Healthy Eyes Using Optical Coherence Tomography Angiography.” Am. J. Ophthalmol. 161,
50-55.e1 (2016). doi:10.1016/j.ajo.2015.09.026
[3] Jothi Balaji, J., Agarwal, A., Raman, R., and Lakshminarayanan, V., “Comparison of foveal avascular zone in
diabetic retinopathy, high myopia, and normal fundus images.” in Ophthalmic Technologies XXX Proc. SPIE
11218, (2020). doi:10.1117/12.2544817.
[4] Arya, M., Rashad, R., Sorour, O., Moult, E. M., Fujimoto, J. G., et al., “Optical coherence tomography
 angiography (OCTA) flow speed mapping technology for retinal diseases.” Expert Rev. Med. Devices 15(12),
875–882 (2018).
[5] Eladawi, N., ElTanboly, A., Elmogy, M., Ghazal, M., Fraiwan, L., et al., “Diabetic retinopathy early detection
based on OCT and OCTA feature fusion.” Proc. - Int. Symp. Biomed. Imaging, 587–591 (2019). doi:
10.1109/ISBI.2019.8759269.
[6] Sandhu, H.S., Elmogy, M., Sharafeldeen, A.T., Elsharkawy, M., El-Adawy, N., et al. “Automated Diagnosis of
Diabetic Retinopathy Using Clinical Biomarkers, Optical Coherence Tomography, and Optical Coherence
Tomography Angiography.” Am. J. Ophthalmol. 216, 201–206 (2020).
[7] Durbin, M.K., An, L., Shemonski, N.D., Soares, M., Santos, T., et al. “Quantification of retinal microvascular
density in optical coherence tomographic angiography images in diabetic retinopathy.” JAMA Ophthalmol.
135(4), 370–376 (2017).
[8] Ishii, H., Shoji, T., Yoshikawa, Y., Kanno, J., Ibuki, H. and Shinoda, K., “Automated Measurement of the Foveal
Avascular Zone in Swept-Source Optical Coherence Tomography Angiography Images.” Transl. Vis. Sci.
Technol. 8(3), 28 (2019).
[9] Falavarjani, K.G., Iafe, N.A., Velez, F.G., Schwartz, S.D., Sadda, S.R., et al. “Optical coherence tomography
angiography of the fovea in children born preterm.” Retina 37(12), 2289–2294 (2017).
[10] De Carlo, T. E., Romano, A., Waheed, N. K., and Duker, J. S. “A review of optical coherence tomography
angiography (OCTA).” Int. J. Retin. Vitr. 1(1), 1–15 (2015).
[11] Li, M., Yang, Y., Jiang, H., Gregori, G., Roisman, L., et al. “Retinal Microvascular Network and
Microcirculation Assessments in High Myopia.” Am. J. Ophthalmol. 174, 56–67 (2017).
[12] Leng, Y., Tam, E. K., Falavarjani, K. G., and Tsui, I., “Effect of age and myopia on retinal microvasculature.”
Ophthalmic Surg. Lasers Imaging Retin. 49(12), 925–931 (2018).
[13] Yoon, S.P., Grewal, D.S., Thompson, A.C., Polascik, B.W., Dunn, C., et al. “Retinal Microvascular and
Neurodegenerative Changes in Alzheimer’s Disease and Mild Cognitive Impairment Compared with Control
Participants.” Ophthalmol. Retin. 3(6), 489–499 (2019).
[14] Sampson, D.M., Gong, P., An, D., Menghini, M., Hansen, A., et al. “Axial Length Variation Impacts on
Superficial Retinal Vessel Density and Foveal Avascular Zone Area Measurements Using Optical Coherence
Tomography Angiography.” Investig. Opthalmology Vis. Sci. 58(7), 3065 (2017).
[15] Szigeti, A., Schneider, M., Ecsedy, M., Nagy, Z. Z. and Récsán, Z. “Association between retinal vein occlusion,
axial length and vitreous chamber depth measured by optical low coherence reflectometry.” BMC Ophthalmol.
15(1), 45 (2015).
[16] Bhardwaj, V., and Rajeshbhai, G.P., “Axial Length, Anterior Chamber Depth-A Study in Different Age Groups
and Refractive Errors.” J. Clin. Diagnostic Res. 7(10), 2211–2212 (2013).
[17] Bekerman, I., Gottlieb, P., and Vaiman, M. “Variations in Eyeball Diameters of the Healthy Adults.” J.
Ophthalmol. 2014, (2014). doi:10.1155/2014/503645
[18] Ip, J.M., Huynh, S.C., Robaei, D., Kifley, A., Rose, K.A., et al. “Ethnic differences in refraction and ocular
biometry in a population-based sample of 11–15-year-old Australian children.” Eye 22(5), 649–656 (2008).
[19] Garner, L. F., Meng, C. K., Grosvenor, T. P., and Mohidin, N., “Ocular dimensions and refractive power in
Malay and Melanesian children.” Ophthalmic Physiol. Opt. 10(3), 234–238 (1990).
[20] Natung, T., Shullai, W., Nongrum, B., Thangkhiew, L., Baruah, P. and Phiamphu, M.L., “Ocular biometry
characteristics and corneal astigmatisms in cataract surgery candidates at a tertiary care center in North-East
India.” Indian J. Ophthalmol. 67(9), (2019).
[21] Bennett, A. G., Rudnicka, A. R., and Edgar, D. F., “Improvements on Littmann’s method of determining the size
of retinal features by fundus photography.” Graefe’s Arch. Clin. Exp. Ophthalmol. 232(6), 361–367 (1994).
[22] Agarwal, A., Jothi Balaji, J., and Lakshminarayanan, V., “A new technique for estimating the foveal avascular
 zone dimensions.” in Ophthalmic Technologies XXX, Proc. SPIE 112181R, (2020). doi:10.1117/12.2543906.
[23] Badmus, S., Ajaiyeoba, A., Adegbehingbe, B., Onakpoya, O., and Adeoye, A., “Axial length/corneal radius of
curvature ratio and refractive status in an adult Nigerian population.” Niger. J. Clin. Pract. 20(10), 1328–1334
(2017).
[24] Kashani, A.H., Chen, C.L., Gahm, J.K., Zheng, F., Richter, G.M., et al. “Optical coherence tomography
angiography: A comprehensive review of current methods and clinical applications.” Prog. Retin. Eye Res. 60,
66–100 (2017). doi: 10.1016/j.preteyeres.2017.07.002
[25] Takase, N., Nozaki, M., Kato, A., Ozeki, H., Yoshida, M. and Ogura, Y., “Enlargement of foveal avascular zone
in diabetic eyes evaluated by en face optical coherence tomography angiography.” Retina 35(11), 2377–2383
(2015).
[26] Linderman, R., Salmon, A.E., Strampe, M., Russillo, M., Khan, J. and Carroll, J., “Assessing the Accuracy of
Foveal Avascular Zone Measurements Using Optical Coherence Tomography Angiography: Segmentation and
Scaling.” Transl. Vis. Sci. Technol. 6(3), 16 (2017).
[27] Kang, S. H., Hong, S. W., Im, S. K., Lee, S. H., and Ahn, M. D., “Effect of Myopia on the Thickness of the
Retinal Nerve Fiber Layer Measured by Cirrus HD Optical Coherence Tomography.” Investig. Opthalmology
Vis. Sci. 51(8), 4075 (2010).
[28] Savini, G., Barboni, P., Parisi, V., and Carbonelli, M., “The influence of axial length on retinal nerve fibre layer
thickness and optic-disc size measurements by spectral-domain OCT.” Br. J. Ophthalmol. 96(1), 57–61 (2012).
[29] Aykut, V., Öner, V., Taş, M., Işcan, Y., and Aǧaçhan, A., “Influence of axial length on peripapillary retinal
nerve fiber layer thickness in children: A study by RTVue spectral-domain optical coherence tomography.” Curr.
Eye Res. 38(12), 1241–1247 (2013).
[30] Leung, C.K.S., Cheng, A.C.K., Chong, K.K.L., Leung, K.S., Mohamed, S., et al. “Optic Disc Measurements in
Myopia with Optical Coherence Tomography and Confocal Scanning Laser Ophthalmoscopy.” Investig.
Opthalmology Vis. Sci. 48(7), 3178 (2007).