The goal of this study was to determine changes in optical coherence tomography (OCT) color codes after applying a myopic normative database. The diagnostic performance of the retinal nerve fiber layer analysis improves with the usage of this database. To evaluate the peripapillary retinal nerve fiber layer (pRNFL) OCT color codes based on a newly produced myopic normative database in contrast to the built-in normative database. A total of 371 people participated in this validation study in an attempt to establish a myopic normative database. About 80 myopic glaucomatous and 80 myopic healthy eyes were analyzed to determine the diagnostic performance of this database. The distribution of the color codes was analyzed across the groups with reference to the built-in and myopic normative databases, and the 2 databases were compared in terms of anomalous color code frequency. The diagnostic performance of the myopic database was shown with sensitivity, specificity, and area under the receiver operating characteristic curve values. The agreement between the databases reduced with increasing myopia degree. The distribution of the color codes of the built-in software considerably differed among the study groups in all sectors (P=0.009 for the temporal sector and P<0.001 for the remaining sectors). When the myopic database was used, there were no longer significant differences across the groups for the temporal superior, temporal inferior, temporal, and nasal sectors (P=0.561, 0.299, 0.201, and 0.089, respectively). After using the myopic normative database, the specificity of the pRNFL color codes increased from 70.1% to 90.2%, and the area under the receiver operating characteristic curve value increased from 0.851 to 0.945. Using a myopic normative database for pRNFL using SD-OCT considerably minimized variations among myopia severity groups and may help more consistently detect glaucoma in myopic eyes.
