1
|
Zhao Q, Zhao X, Luo Y, Yang Z. Ultra-Wide-Field Optical Coherence Tomography and Gaussian Curvature to Assess Macular and Paravascular Retinoschisis in High Myopia. Am J Ophthalmol 2024; 263:70-80. [PMID: 38401851 DOI: 10.1016/j.ajo.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE To evaluate the severity and related factors of macular retinoschisis (MRS) and paravascular retinoschisis (PVRS) in high myopia (HM) using ultra-wide-field optical coherence tomography (UWF-OCT) and a novel Gaussian curvature (K). DESIGN A cross-sectional study. METHODS Patients diagnosed with HM in Peking Union Medical College Hospital were recruited between January 2022 and November 2022. The presence and severity of retinoschisis, along with the three highest K values, were assessed using UWF-OCT and en face images. Logistic regressions were employed to identify factors associated with MRS, PVRS, and the severity of retinoschisis in the 24 × 20 mm scan region. RESULTS A total of 108 HM eyes from 55 patients were recruited. The highest Gaussian curvature (K1) was predominantly found in the vascular arcade (43, 40%). Multivariable logistic regression found that age and PVRS were significant risk factors for MRS occurrence (P < .05), while MRS and higher K1 were significantly associated with the presence of PVRS in HM patients (P < .05). The axial length (AL) and spherical equivalent were associated with the severity of MRS, while AL and K1 values were associated with the severity of retinoschisis in the 24 × 20 mm scan region (P < .05). CONCLUSIONS An association existed between large Gaussian curvature and the presence of MRS and PVRS, as well as the severity of retinoschisis in a wide field of view. UWF-OCT, which enables visualization of the central and peripheral retinal areas, holds promise as an imaging technique for the early detection of extrafoveal retinoschisis.
Collapse
Affiliation(s)
- Qing Zhao
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xinyu Zhao
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yan Luo
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhikun Yang
- From the Department of Ophthalmology (Q.Z., X.Z., Y.L., Z.Y.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Key Laboratory of Ocular Fundus Diseases (Q.Z., X.Z., Y.L., Z.Y.), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| |
Collapse
|
2
|
Assi A, Charteris D. Proliferative vitreoretinopathy: a revised concept of retinal injury and response. Br J Ophthalmol 2024:bjo-2023-324417. [PMID: 38697801 DOI: 10.1136/bjo-2023-324417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/03/2024] [Indexed: 05/05/2024]
Abstract
Previous concepts for the pathogenesis of proliferative vitreoretinopathy (PVR) have focused on the central role of retinal pigment epithelium cells only, potentially contributing to the lack of clinical advances. More recent studies have demonstrated the essential role of retinal glial cells in the PVR healing response but failed to identify a consistent triggering mechanism.We propose a revised concept for the pathogenesis of PVR based on retinal injury and response. A posterior vitreous detachment (PVD) is invariably present in patients with rhegmatogenous retinal detachment and PVR. There is evidence to suggest that the shearing forces of acute PVD can cause mechanical injury to the inner retina and trigger a subsequent intraretinal glial healing response. That response is characterised by subclinical glial cell activation and proliferation that may then be amplified into full-blown PVR by coexisting pathology such as retinal breaks and detachment.Whether a PVD causes interface pathology depends on the plane of separation of the posterior vitreous and areas of increased vitreoretinal adhesions. If the vitreous separates in a plane or location that damages the inner retina then glial cell activation and proliferation are likely to develop. The severity of the subclinical inner retinal damage may then represent one of the missing links in our understanding of the pathogenesis of PVR and would explain many of the findings we encounter in clinical practice. Controlling the process of acute PVD and subsequent intraretinal response may be essential in the prevention and management of PVR.
Collapse
|
3
|
Takahashi H, Uramoto K, Ohno-Matsui K. NEODYMIUM-DOPED YTTRIUM ALUMINUM GARNET LASER ABLATION OF INTERNAL LIMITING MEMBRANE TO TREAT MYOPIC MACULAR RETINOSCHISIS: CASE SERIES. Retin Cases Brief Rep 2024; 18:24-28. [PMID: 36007186 DOI: 10.1097/icb.0000000000001311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of neodymium-doped yttrium aluminum garnet laser ablation of the internal limiting membrane (ILM) to treat myopic macular retinoschisis. METHODS Four patients with myopic myopic macular retinoschisis that extended out of the macular area were studied. All patients underwent yttrium aluminum garnet laser ablation of the detached ILM in the paramacular area, and the eyes were examined by ultra-widefield optical coherence tomography at the baseline and 6 months after the treatment. The measured outcomes were the foveal retinal thickness and the best-corrected visual acuity. RESULTS Neodymium-doped yttrium aluminum garnet laser was applied to the paramacular ILM in all four eyes. In each eye, the procedure failed to disrupt the ILM, and no significant changes were observed in foveal retinal thickness or best-corrected visual acuity subsequently. No serious adverse event occurred in all eyes. A transient intraretinal hemorrhage developed at the site of the application in two eyes but resolved within a week after the treatment. CONCLUSION Neodymium-doped yttrium aluminum garnet laser was applied to ILM in the peripheral macula in eyes with myopic macular retinoschisis. However, the lack of a reduction of the foveal thickness and improvement of the best-corrected visual acuity indicate that accurate focusing system is needed to treat eyes with myopic macular retinoschisis.
Collapse
Affiliation(s)
- Hiroyuki Takahashi
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University (TMDU) Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | | | | |
Collapse
|
4
|
Romero-Morales VA, Bousquet E, Abraham N, Santina A, Somisetty S, Peiris T, Lu A, Fogel Levin M, Sarraf D. EVALUATION OF PARAVASCULAR INNER RETINAL DEFECTS USING EN FACE OPTICAL COHERENCE TOMOGRAPHY. Retina 2023; 43:1644-1652. [PMID: 37433217 DOI: 10.1097/iae.0000000000003889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
PURPOSE To evaluate the prevalence and risk factors for development of paravascular inner retinal defects (PIRDs) using en face optical coherence tomography. METHODS This is a retrospective cross-sectional study. En face and cross-sectional optical coherence tomography images were reviewed (9 × 9 mm or 12 × 12 mm). Paravascular inner retinal defects were classified as either Grade 1 (i.e., paravascular inner retinal cysts) when the lesion was confined within the nerve fiber layer without any communication to the vitreous cavity or Grade 2 (i.e., paravascular lamellar hole) when the defects communicated to the vitreous. Paravascular inner retinal defect grading was correlated with presence of high myopia, stage of posterior vitreous detachment, and presence of epiretinal membrane and retinoschisis. RESULTS Of 1,074 patients (2,148 eyes), PIRDs were detected in 261 eyes with a prevalence of 261 per 2,148 eyes (12.2%) and 176 per 1,074 patients (16.4%). A total of 116 eyes (44.4%) displayed Grade 2 PIRDs while 145 eyes (55.6%) were Grade 1. In the multivariate logistic regression model, the presence of partial/complete posterior vitreous detachment, retinoschisis, and epiretinal membrane was significantly correlated with PIRDs (OR = 2.78 [1.7-4.4], P < 0.001; OR = 2.93 [1.7-5], P < 0.001; and OR = 25.9 [2.8-242.5], P < 0.001, respectively). The presence of partial/complete posterior vitreous detachment and epiretinal membrane was also significantly associated with Grade 2 PIRDs versus Grade 1 PIRDs ( P = 0.03 and P < 0.001). CONCLUSION Our results indicate that wide-field en face optical coherence tomography facilitates the identification of PIRDs over a large area of retina with a single capture. The presence of PIRDs was significantly associated with posterior vitreous detachment, epiretinal membrane, and retinoschisis, confirming the role of vitreoretinal traction in the pathogenesis of PIRDs.
Collapse
Affiliation(s)
- Veronica A Romero-Morales
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Department of Retina, Instituto Mexicano de Oftalmología, Querétaro, México
| | - Elodie Bousquet
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Department of Ophthalmology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
| | - Neda Abraham
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Ahmad Santina
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Swathi Somisetty
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Timothy Peiris
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Anthony Lu
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
| | - Meira Fogel Levin
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel; and
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California
- Greater Los Angeles VA Healthcare Center, Los Angeles, California
| |
Collapse
|
5
|
Kudsieh B, Fernández-Vigo JI, Flores-Moreno I, Ruiz-Medrano J, Garcia-Zamora M, Samaan M, Ruiz-Moreno JM. Update on the Utility of Optical Coherence Tomography in the Analysis of the Optic Nerve Head in Highly Myopic Eyes with and without Glaucoma. J Clin Med 2023; 12:jcm12072592. [PMID: 37048675 PMCID: PMC10095192 DOI: 10.3390/jcm12072592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/11/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Glaucoma diagnosis in highly myopic subjects by optic nerve head (ONH) imaging is challenging as it is difficult to distinguish structural defects related to glaucoma from myopia-related defects in these subjects. Optical coherence tomography (OCT) has evolved to become a routine examination at present, providing key information in the assessment of glaucoma based on the study of the ONH. However, the correct segmentation and interpretation of the ONH data employing OCT is still a challenge in highly myopic patients. High-resolution OCT images can help qualitatively and quantitatively describe the structural characteristics and anatomical changes in highly myopic subjects with and without glaucoma. The ONH and peripapillary area can be analyzed to measure the myopic atrophic-related zone, the existence of intrachoroidal cavitation, staphyloma, and ONH pits by OCT. Similarly, the lamina cribosa observed in the OCT images may reveal anatomical changes that justify visual defects. Several quantitative parameters of the ONH obtained from OCT images were proposed to predict the progression of visual defects in glaucoma subjects. Additionally, OCT images help identify factors that may negatively influence the measurement of the retinal nerve fiber layer (RNFL) and provide better analysis using new parameters, such as Bruch’s Membrane Opening-Minimum Rim Width, which serves as an alternative to RNFL measurements in highly myopic subjects due to its superior diagnostic ability.
Collapse
Affiliation(s)
- Bachar Kudsieh
- Department of Ophthalmology, University Hospital Puerta De Hierro Majadahonda, 28220 Madrid, Spain
- Centro Internacional de Oftalmologia Avanzada, 28010 Madrid, Spain
- Correspondence: ; Tel.: +34-91-191-60-00
| | - José Ignacio Fernández-Vigo
- Centro Internacional de Oftalmologia Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Clinico San Carlos, Institute of Health Research (IdISSC), 28040 Madrid, Spain
| | - Ignacio Flores-Moreno
- Department of Ophthalmology, University Hospital Puerta De Hierro Majadahonda, 28220 Madrid, Spain
| | - Jorge Ruiz-Medrano
- Department of Ophthalmology, University Hospital Puerta De Hierro Majadahonda, 28220 Madrid, Spain
- Instituto de Microcirugia Ocular (IMO), 28035 Madrid, Spain
| | - Maria Garcia-Zamora
- Department of Ophthalmology, University Hospital Puerta De Hierro Majadahonda, 28220 Madrid, Spain
| | - Muhsen Samaan
- Barraquer Eye Clinic UAE, Dubai P.O. Box 212619, United Arab Emirates
| | - Jose Maria Ruiz-Moreno
- Department of Ophthalmology, University Hospital Puerta De Hierro Majadahonda, 28220 Madrid, Spain
- Instituto de Microcirugia Ocular (IMO), 28035 Madrid, Spain
| |
Collapse
|
6
|
Li M, Yu J, Chen Q, Zhou H, Zou H, He J, Zhu J, Fan Y, Xu X. Clinical characteristics and risk factors of myopic retinoschisis in an elderly high myopia population. Acta Ophthalmol 2023; 101:e167-e176. [PMID: 36004558 DOI: 10.1111/aos.15234] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/01/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the clinical characteristics, internal correlations and risk factors for different locations of retinoschisis (RS) in an elderly high myopia (HM) population. METHODS A total of 448 eyes (304 participants) were analysed and classified into no retinoschisis (no-RS), paravascular retinoschisis (PVRS), peripapillary retinoschisis (PPRS) and macular retinoschisis (MRS) groups. Each participant underwent comprehensive ophthalmic examinations, and posterior scleral height (PSH) was measured in swept-source optical coherence tomography images. PSH, vitreoretinal interface abnormities and myopic atrophy maculopathy (MAM) were compared among groups. RESULTS Retinoschisis was found in 195 (43.5%) eyes, among which 170 (37.9%) had PVRS, 123 (27.5%) had PPRS, and 103 (23.0%) had MRS. MRS was found to be combined with PVRS in 96 of 103 (93.2%) eyes. MAM was one of the risk factors for RS (odds ratio [OR], 2.459; p = 0.005). Higher nasal PSH was the only risk factor for PVRS (OR, 9.103; p = 0.008 per 1-mm increase). Elongation of axial length (AL) (OR, 1.891; p < 0.001 per 1-mm increase), higher PSH in nasal (OR, 5.059; p = 0.009 per 1-mm increase) and temporal (OR, 13.021; p = 0.012 per 1-mm increase), epiretinal membrane (ERM; OR, 2.841; p = 0.008) and vitreomacular traction (VMT; OR, 7.335; p = 0.002) were risk factors for MRS. CONCLUSIONS Paravascular retinoschisis is the most common type of RS in HM and MRS is mostly combined with PVRS. MAM is one of the risk factors for RS. In addition to longer AL and higher PSH, the presence of VMT and ERM also play an important role in the formation of MRS.
Collapse
Affiliation(s)
- Menghan Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.,Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jiayi Yu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.,Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Qiuying Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.,Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Hao Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Haidong Zou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.,Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jiangnan He
- Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jianfeng Zhu
- Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Ying Fan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.,Department of Preventative Ophthalmology, Shanghai Eye Diseases Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| |
Collapse
|
7
|
Postoperative large intraretinal cavity and schisis with paravascular inner break in high myopia. Jpn J Ophthalmol 2023; 67:66-73. [PMID: 36401116 DOI: 10.1007/s10384-022-00948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/19/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE To report distinct structural changes following surgery for myopic traction maculopathy (MTM). STUDY DESIGN A single-center, retrospective case series. METHODS Patients with MTM who underwent vitrectomy and had persistent large intraretinal cavities and schisis were reviewed. The pre- and postoperative clinical findings and optical coherence tomography characteristics are described. RESULTS Five eyes of five patients were included in the study. Three patients had prominent schisis, and four had retinal/foveal detachment before surgery. All patients underwent fovea-sparing internal limiting membrane peeling during vitrectomy and had improved vision at 3 months after surgery. Large intraretinal cavities were noted on optical coherence tomography at the first postoperative exam in three patients and 12 to 18 months postoperation in the other two. The median height of the postoperative intraretinal cavities was 704 μm (range, 445-1287 μm). Inner retinal breaks were identified in all eyes, of which four were located in the paravascular area. The intraretinal cavity and schisis remained stable during the initial follow-up for an average of 35 months; later on, at > 5 years after the initial presentation two patients developed retinal detachment and one patient underwent vitrectomy with the retina reattached postoperatively. CONCLUSION Large intraretinal cavities and schisis can be observed after MTM surgery, associated with paravascular inner breaks. The condition can progress after a long stable period; therefore, continuous follow-up is necessary.
Collapse
|
8
|
Durrani AF, Hyde RA, Johnson MW. Large Internal Limiting Membrane Tears: Prevalence, Clinical Characteristics, and Surgical Utility. Am J Ophthalmol 2023; 245:115-125. [PMID: 36216160 DOI: 10.1016/j.ajo.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To describe the prevalence, clinical and imaging characteristics, and surgical utility of large internal limiting membrane (ILM) tears in eyes with epiretinal membrane (ERM). DESIGN Retrospective interventional case series. METHODS This was a single-institution study including 71 eyes of 70 consecutive patients that underwent ERM peeling by a single vitreoretinal surgeon between 2016 and 2019. Demographic and clinical data were collected from the medical record. ERMs and large ILM tears were identified and analyzed on multimodal imaging. The main outcome measures were the prevalence and characteristics of large ILM tears in eyes undergoing ERM peeling. RESULTS Large ILM tears were present in 23 of 71 eyes (32.4%) with ERM that underwent surgical management. A review of patients with ERM during the same period who did not undergo surgical management found large ILM tears in 8 of 100 eyes (8.0%). Large ILM tears were commonly associated with other signs of ERM-induced retinal traction, including retinal nerve fiber layer schisis in 20 of 23 eyes (87.0%), inner retinal dimpling in 8 of 23 eyes (34.8%), and discrete paravascular red lesions in 16 of 19 eyes (84.2%). In all eyes stained with brilliant blue G, the preoperative diagnosis of large ILM tear was confirmed and the scrolled ILM edge was used successfully to initiate ILM peeling. CONCLUSIONS Large ILM tears are often present in eyes undergoing surgery for ERM and are likely caused by ERM contracture. Careful preoperative identification of these tears is helpful for surgical planning because the scrolled flap of ILM provides a convenient and safe "handle" for initiating membrane peeling.
Collapse
Affiliation(s)
- Asad F Durrani
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert A Hyde
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Mark W Johnson
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA.
| |
Collapse
|
9
|
She X, Zhou C, Liang Z, Xie J, Zhao S, Tao J, Zhang Y, Mao J, Chen Y, Shen L. Hypodense regions in the peripapillary region increased the risk of macular retinoschisis detected by optical coherence tomography. Front Med (Lausanne) 2022; 9:1018580. [DOI: 10.3389/fmed.2022.1018580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022] Open
Abstract
PurposeThe purpose of the present study was to investigate the clinical features of peripapillary regions in patients with myopic macular retinoschisis (MRS) and its association with the development of retinoschisis (RS).MethodsIn this cross-sectional study, high-myopic patients with or without MRS were recruited, and the hypodense regions were analyzed in the peripapillary regions. The vitreoretinal adhesions around both macular and paravascular arcades were compared between groups. The risk factors for the development of MRS were analyzed by logistic regression.ResultsOf 88 myopic eyes, MRS was detected in 45 eyes (51%). The eyes with MRS showed a higher rate of peripapillary and paravascular retinoschisis (P < 0.001 and P = 0.006). Hypodense regions were detected in 25 eyes (20.35%). Higher rates of horizontal and vertical macular MRS were detected in the hypodense group (P = 0.012 and P = 0.002). Lower refractive error, longer axial length, and higher rates of outer retinoschisis both in horizontal and vertical macular regions were observed in the hypodense group (P = 0.012, P = 0.006, P = 0.038, and P = 0.034). Higher rates of inner and outer retinoschisis, vitreoschisis, and microfolds along superior vascular arcade were detected in the hypodense group (P = 0.005, P = 0.001, P = 0.014, and P = 0.014). Higher rates of internal limiting membrane (ILM) detachment, inner and outer RS were detected along the inferior vascular arcade in the hypodense group (P = 0.008, P = 0.001, and P = 0.028). Hypodense regions, the axial length and PICC (peripapillary intrachoroidal cavitation) were significantly correlated with the severity of MRS (Odds ratio = 0.207, P = 0.010; Odds ratio = 1.399, P = 0.016; Odds ratio = 0.142, P = 0.010).ConclusionsThe hypodense regions were likely to affect outer retinoschisis both in macular and paravascular regions. It was a risk factor for the development of MRS.
Collapse
|
10
|
Li M, Ye L, Hu G, Chen Q, Sun D, Zou H, He J, Zhu J, Fan Y, Xu X. Relationship Between Paravascular Abnormalities and Choroidal Thickness in Young Highly Myopic Adults. Transl Vis Sci Technol 2022; 11:18. [PMID: 35727187 PMCID: PMC9233291 DOI: 10.1167/tvst.11.6.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the clinical characteristics of paravascular abnormalities (PVAs) and retinoschisis, and their associations with choroidal thickness (ChT) in young highly myopic (HM) adults. Methods A total number of 645 eyes were included. Paravascular microfolds (PMs), paravascular cystoid spaces (PCs), paravascular lamellar holes (PLHs), and retinoschisis were detected using swept-source optical coherence tomography. Their associations with macular ChT and risk factors were analyzed. Results PMs, PCs, and PLHs were detected in 203 (31.5%), 141 (21.9%), and 30 (4.7%) eyes, respectively. Retinoschisis was found in 50 (7.8%) eyes, 43 (86.0%) of which were located around the retinal vessels surrounding the optic disc. A decreasing trend of macular ChT (P < 0.001) was observed in the eyes with PMs only, with both PCs and PMs, and with PLHs, PCs, and PMs. After adjustments for age, sex, and axial length (AL), the presence of PCs, PLHs, or retinoschisis around the optic disc was negatively associated with macular ChT (all P < 0.05). Eyes with longer AL, incomplete posterior vitreous detachment (PVD), and myopic atrophic maculopathy (MAM) were more likely to have PCs (all P < 0.01) and retinoschisis around the optic disc (all P < 0.05). Conclusions PVAs were observed in approximately one third of the young HM adults in this study. The presence of PCs, PLHs, or retinoschisis around the optic disc was associated with thinner macular ChT. Eyes with longer AL, incomplete PVD, and MAM may be at risk of developing PVAs and retinoschisis around the optic disc. Translational Relevance PCs, PLHs, and retinoschisis around the optic disc could serve as early indicators for myopia progression.
Collapse
Affiliation(s)
- Menghan Li
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Luyao Ye
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Guangyi Hu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Qiuying Chen
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Dandan Sun
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Haidong Zou
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jiangnan He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Jianfeng Zhu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China
| | - Ying Fan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xun Xu
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photo Medicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| |
Collapse
|
11
|
Choi KJ, Choi JE, Roh HC, Eun JS, Kim JM, Shin YK, Kang MC, Chung JK, Lee C, Lee D, Kang SW, Cho BH, Kim SJ. Deep learning models for screening of high myopia using optical coherence tomography. Sci Rep 2021; 11:21663. [PMID: 34737335 PMCID: PMC8568935 DOI: 10.1038/s41598-021-00622-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/13/2021] [Indexed: 12/02/2022] Open
Abstract
This study aimed to validate and evaluate deep learning (DL) models for screening of high myopia using spectral-domain optical coherence tomography (OCT). This retrospective cross-sectional study included 690 eyes in 492 patients with OCT images and axial length measurement. Eyes were divided into three groups based on axial length: a “normal group,” a “high myopia group,” and an “other retinal disease” group. The researchers trained and validated three DL models to classify the three groups based on horizontal and vertical OCT images of the 600 eyes. For evaluation, OCT images of 90 eyes were used. Diagnostic agreements of human doctors and DL models were analyzed. The area under the receiver operating characteristic curve of the three DL models was evaluated. Absolute agreement of retina specialists was 99.11% (range: 97.78–100%). Absolute agreement of the DL models with multiple-column model was 100.0% (ResNet 50), 90.0% (Inception V3), and 72.22% (VGG 16). Areas under the receiver operating characteristic curves of the DL models with multiple-column model were 0.99 (ResNet 50), 0.97 (Inception V3), and 0.86 (VGG 16). The DL model based on ResNet 50 showed comparable diagnostic performance with retinal specialists. The DL model using OCT images demonstrated reliable diagnostic performance to identify high myopia.
Collapse
Affiliation(s)
- Kyung Jun Choi
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jung Eun Choi
- Medical AI Research Center, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Hyeon Cheol Roh
- Department of Ophthalmology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - Jun Soo Eun
- Department of Ophthalmology, Gil Medical Center, Gachon University, Incheon, Republic of Korea
| | | | - Yong Kyun Shin
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Min Chae Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Joon Kyo Chung
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Chaeyeon Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Dongyoung Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Baek Hwan Cho
- Medical AI Research Center, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. .,Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, 06351, Republic of Korea.
| | - Sang Jin Kim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, #81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| |
Collapse
|
12
|
Tian J, Qi Y, Lin C, Cao K, Wang N. The Association in Myopic Tractional Maculopathy With Myopic Atrophy Maculopathy. Front Med (Lausanne) 2021; 8:679192. [PMID: 34490288 PMCID: PMC8417530 DOI: 10.3389/fmed.2021.679192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the relationship between myopic tractional maculopathy (MTM) and myopic atrophy maculopathy (MAM). Method: Two hundred and six eyes with definitive myopic retinoschisis were assessed in the retrospective observational case series study and the atrophic and tractional features were further evaluated. Atrophic changes were analyzed according to the atrophic component in the ATN classification and the occurrence of gamma zones and delta zones. Tractional changes were evaluated based on different retinoschisis layers, the location and range of outer retinoschisis, retinal detachment, inner lamellar macular hole (ILMH), outer lamellar MH (OLMH), full-thickness MH (FTMH), and paravascular abnormalities. Results: Of all the eyes, 29.6, 42.7, 19.4, and 8.3% presented MAM grades with A1, A2, A3, and A4, respectively. The three layers of retinoschisis and the entire macular retinoschisis had the highest incidences in A2 (38.6%; 54.5%). The numbers of retinoschisis layers and the grades of outer retinoschisis had a weak negative correlation with MAM (r = −0.138, P = 0.048; r = −0.139, P = 0.047). All the eyes had gamma zones, and 82.52% of eyes also had delta zones. The incidence of retinal detachment and OLMH reached the peak in A2 and then decreased gradually. With MAM aggravation, the prevalence of ILMH decreased. Eyes with A1 and A2 were more likely to have OLMH, and those with A3 and A4 were more likely to have FTMH (P = 0.028; OR, 3.423; 95% CI, 1.144–10.236; P = 0.004; OR, 7.752; 95% CI, 1.951–30.803). With the MAM grades growing, the types of paravascular abnormalities increased (r = 0.165, P = 0.018). Conclusion: Diffuse chorioretinal atrophy was the dominant MAM grade in eyes with MTM. In the study, 72.3% of eyes with MTM presented with diffuse chorioretinal atrophy and a tessellated fundus. Over 80% of eyes with MTM had both gamma zones and delta zones. Diffuse chorioretinal atrophy might be a complicated stage for MTM with the highest rate of three layers of retinoschisis, the entire macular retinoschisis, RD, and OLMH. Atrophic progression might involve the development of MH. When MTM combines with well-defined atrophy, the occurrence of FTMH should be noted.
Collapse
Affiliation(s)
- Jiaxin Tian
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yue Qi
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Caixia Lin
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
13
|
Posterior vitreous detachment and paravascular retinoschisis in highly myopic young patients detected by ultra-widefield OCT. Sci Rep 2021; 11:17330. [PMID: 34462477 PMCID: PMC8405667 DOI: 10.1038/s41598-021-96783-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to determine the relationship between a posterior vitreous detachment (PVD) and retinoschisis (RS) in 73 highly myopic (HM) young patients age 16.4 ± 6.9 years and 24 non-HM children age 8.4 ± 1.5 years. The presence of the paravascular retinal abnormalities was determined in the images obtained by a ultra-widefield OCT (UWF OCT) instrument with an image field of 23 × 20 mm. The results showed that a partial PVD was detected in 15 (21%) of the HM patients, and the number increased significantly with increasing age (P = 0.02). PVDs of any type were not found in the non-HM eyes. The number of microvascular folds also increased with age in the HM patients (P = 0.03). Medium-reflective columnar tissues were present between the detached vitreous and inner retinal surface in 4 (5%) eyes of the HM patients. Myopic RS was found in 3 (4%) HM patients in the paravascular area but not in the macular area. These results suggest that early partial PVD may play a role in pathological and proliferative vitreous changes of HM eyes. An intense vitreoretinal traction with bridging tissues may cause the various paravascular retinal abnormalities. In HM eyes, paravascular RS is already present at an early age which may progress to macular RS with aging.
Collapse
|
14
|
Jiang X, Shen M, Gregori G, Rosenfeld PJ. Swept-Source OCT En Face Imaging of Paravascular Inner Retinal Defects. Ophthalmic Surg Lasers Imaging Retina 2021; 52:407-411. [PMID: 34309428 DOI: 10.3928/23258160-20210628-10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Widefield swept-source optical coherence tomography angiography (SS-OCTA) was performed on eyes with paravascular inner retinal defects (PIRDs) and the morphological alterations of PIRDs were described. Patients with PIRDs were imaged using 12 mm × 12 mm SS-OCTA scans. En face structural and angiographic images of the superficial retinal layers were reviewed along with retinal thickness maps. SS-OCTA en face structural images identified dark, scalloped regions along major retinal veins that corresponded to PIRDs on B-scans. The authors concluded that imaging with both structural and angiographic en face OCT was useful for the diagnosis and monitoring of patients with PIRDs. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:407-411.].
Collapse
|
15
|
Laíns I, Wang JC, Cui Y, Katz R, Vingopoulos F, Staurenghi G, Vavvas DG, Miller JW, Miller JB. Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Prog Retin Eye Res 2021; 84:100951. [PMID: 33516833 DOI: 10.1016/j.preteyeres.2021.100951] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
The advent of optical coherence tomography (OCT) revolutionized both clinical assessment and research of vitreoretinal conditions. Since then, extraordinary advances have been made in this imaging technology, including the relatively recent development of swept-source OCT (SS-OCT). SS-OCT enables a fast scan rate and utilizes a tunable swept laser, thus enabling the incorporation of longer wavelengths than conventional spectral-domain devices. These features enable imaging of larger areas with reduced motion artifact, and a better visualization of the choroidal vasculature, respectively. Building on the principles of OCT, swept-source OCT has also been applied to OCT angiography (SS-OCTA), thus enabling a non-invasive in depth-resolved imaging of the retinal and choroidal microvasculature. Despite their advantages, the widespread use of SS-OCT and SS-OCTA remains relatively limited. In this review, we summarize the technical details, advantages and limitations of SS-OCT and SS-OCTA, with a particular emphasis on their relevance for the study of retinal conditions. Additionally, we comprehensively review relevant studies performed to date to the study of retinal health and disease, and highlight current gaps in knowledge and opportunities to take advantage of swept source technology to improve our current understanding of many medical and surgical chorioretinal conditions. We anticipate that SS-OCT and SS-OCTA will continue to evolve rapidly, contributing to a paradigm shift to more widespread adoption of new imaging technology to clinical practice.
Collapse
Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Jay C Wang
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Ying Cui
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Raviv Katz
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Filippos Vingopoulos
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Italy
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA.
| |
Collapse
|
16
|
Liu M, Wang P, Hu X, Zhu C, Yuan Y, Ke B. Myopia-related stepwise and quadrant retinal microvascular alteration and its correlation with axial length. Eye (Lond) 2020; 35:2196-2205. [PMID: 33087885 DOI: 10.1038/s41433-020-01225-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To investigate the characteristics of retinal vascular alterations in patients with varying degrees of myopia, and to determine correlated variables and alteration patterns over different retinal zones. METHODS A total of 208 right eyes of 208 patients with myopia were enrolled and divided into mild, moderate, high, and extreme myopia groups. The macular vasculature in superficial, deep, and whole retinal layers was imaged with optical coherence tomography angiography (OCTA). The vessel densities over the whole annular zone, four quadrants, and six annuli were quantified as fractal dimension using a customized software. Simple linear regressions and ridge regression were used to determine and compare explanatory variables of microvascular density. RESULTS The microvascular density within the superficial, deep and whole retinal layers was highest in mild myopia group, second highest in moderate myopia group, second lowest in high myopia group and lowest in extreme myopia group. Within the same layer, differences between any two groups were significant (all p < 0.05). Among the four quadrants, only the inferior nasal (IN) quadrant showed no difference in microvascular density between mild and moderate groups. Ridge regression indicated that microvascular density values in all three layers were more strongly correlated with axial length (AL) (scaled estimates -0.139, -0.103, -0.154; all p < 0.001) than with spherical equivalent (SE) (scaled estimates -0.052, -0.096, -0.057; all p < 0.05). CONCLUSIONS We characterized a stepwise and quadrant alteration of retinal microvascular density from mild to extreme myopia, which was more strongly affected by axial elongation, although both AL and SE were meaningful indicators.
Collapse
Affiliation(s)
- Mingming Liu
- Institution: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peng Wang
- Institution: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojun Hu
- Institution: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengcheng Zhu
- Institution: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Yuan
- Institution: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bilian Ke
- Institution: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
17
|
OBSERVATION OF VITREOUS FEATURES USING ENHANCED VITREOUS IMAGING OPTICAL COHERENCE TOMOGRAPHY IN HIGHLY MYOPIC RETINOSCHISIS. Retina 2020; 39:1732-1741. [PMID: 29912094 DOI: 10.1097/iae.0000000000002226] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To observe features of the posterior vitreous and vitreoretinal interface in highly myopic eyes with retinoschisis using enhanced vitreous imaging optical coherence tomography. METHODS Comprehensive ophthalmologic examination and enhanced vitreous imaging optical coherence tomography were performed in 77 eyes of 63 patients with highly myopic retinoschisis. Two different modes of spectral domain optical coherence tomography were employed to estimate retinoschisis and the posterior vitreous features in optical coherence tomography images, respectively. The types and distribution of vitreoretinal interface abnormalities were also analyzed. RESULTS Complete posterior vitreous detachment (PVD) was identified in 55 eyes (71.4%) with a Weiss ring. Residual cortex was found in 39 eyes (70.9%) with complete PVD. Vitreoretinal interface changes, including vitreoretinal adhesion and epiretinal membrane (ERM), most frequently appeared in the macular area (47.3%), followed by the inferior arched vessels region (34.5%). In partial PVD eyes, vitreoretinal traction, vitreoretinal adhesion, and epiretinal membrane tended to be observed in the inferior and superior arched vessels regions (54.5 and 40.9%, respectively). Among all types of vitreoretinal interface abnormalities, epiretinal membrane comprised the largest proportion (46.8%) despite the status of PVD. The presence of inner layers of retinoschisis connoted a relatively high possibility of vitreoretinal interface abnormalities occurring. CONCLUSION Enhanced vitreous imaging optical coherence tomography reveals a high prevalence of vitreoretinal interface abnormalities in highly myopic eyes with retinoschisis. Vitreous cortex tends to remain on the macular area in eyes with complete PVD. Our findings may lead to better guidance for the surgical treatment of highly myopic retinoschisis.
Collapse
|
18
|
Takahashi H, Tanaka N, Shinohara K, Uramoto K, Yokoi T, Yoshida T, Ohno-Matsui K. Importance of Paravascular Vitreal Adhesions for Development of Myopic Macular Retinoschisis Detected by Ultra-Widefield OCT. Ophthalmology 2020; 128:256-265. [PMID: 32663528 DOI: 10.1016/j.ophtha.2020.06.063] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To examine most postequatorial retina in eyes with myopic macular retinoschisis (MRS) by ultra-widefield (UWF) OCT and to determine whether paravascular vitreal adhesions play a role in the development of MRS. DESIGN Retrospective single-center observational case series. PARTICIPANTS One hundred fifty highly myopic participants who were older than 50 years with and without an MRS were studied. High myopia was defined as an eye with an axial length of more than 26.5 mm. METHODS All participants underwent UWF OCT imaging with a scan width of 23 mm and a depth of 5 mm using a prototype swept-source OCT device. The vitreoretinal adhesions to the foveal retina and retinal vessels and paravascular abnormalities, including paravascular retinal cysts, paravascular retinoschisis, and paravascular lamellar holes, were analyzed in the UWF OCT images. The findings in eyes with an MRS were compared with those in eyes without an MRS. MAIN OUTCOME MEASURES The relationships between MRS and vitreal adhesions to the retinal vessels or to the fovea were determined. RESULTS An MRS was found in 49 of the 150 eyes (33%). Vitreal adhesions to the retinal vessels were found more frequently in eyes with an MRS than in eyes without an MRS (63% vs. 44%; P = 0.04). In contrast, the number of eyes with adhesions to the fovea in eyes with an MRS was not significantly different from that in eyes without an MRS (57% vs. 59%). Paravascular lesions, for example, retinal cysts, retinoschisis, and lamellar holes, were more common in eyes with an MRS than in eyes without an MRS (71% vs. 36%, 61% vs. 17 %, and 20% vs. 8% [P < 0.001, P < 0.001, and P = 0.03], respectively). Multivariate analysis showed that the presence of paravascular vitreal adhesions was a significant predictor for MRS development (odds ratio, 2.56; P = 0.02). CONCLUSIONS Paravascular vitreal adhesions may be related to the development of the different types of paravascular lesions including retinal cysts and retinoschisis, and play a more important role in the development of an MRS than vitreal adhesions to the fovea.
Collapse
Affiliation(s)
- Hiroyuki Takahashi
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Noriko Tanaka
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kosei Shinohara
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kengo Uramoto
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tae Yokoi
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| |
Collapse
|
19
|
Jagadeesh D, Philip K, Fedtke C, Jong M, Ly A, Sankaridurg P. Posterior segment conditions associated with myopia and high myopia. Clin Exp Optom 2020; 103:756-765. [PMID: 32227385 DOI: 10.1111/cxo.13060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/29/2022] Open
Abstract
Myopia, and especially high myopia, is associated with a number of posterior segment changes that are considered to be mostly a consequence of the increased axial elongation. This can result in mechanical strain, attendant vascular changes, stretching and thinning of tissues, and atrophy/deformation of tissues in later or more advanced stages. Such myopia-related changes are observed as changes and/or abnormalities in the vitreous, choroid, retina and peripheral retina, sclera and/or optic disc. Although many of these changes are benign, at times they may be associated with significant vision impairment that either requires active intervention or may suggest future progression of the disease. This review systematically addresses the posterior segment conditions seen in myopic eyes, describes the features associated with the condition and details management pathways.
Collapse
Affiliation(s)
- Divya Jagadeesh
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Krupa Philip
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia
| | - Cathleen Fedtke
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Monica Jong
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
| | - Angelica Ly
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.,Centre for Eye Health, Sydney, Australia
| | - Padmaja Sankaridurg
- Research and Development Group, Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| |
Collapse
|
20
|
Takahashi H, Tanaka N, Shinohara K, Yokoi T, Yoshida T, Uramoto K, Ohno-Matsui K. Ultra-Widefield Optical Coherence Tomographic Imaging of Posterior Vitreous in Eyes With High Myopia. Am J Ophthalmol 2019; 206:102-112. [PMID: 30902693 DOI: 10.1016/j.ajo.2019.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the morphological changes of posterior vitreous in highly myopic (HM) eyes of patients 50 years of age and older. DESIGN Retrospective, observational case series. METHODS Ultra-widefield swept-source OCT (UWF-OCT) examinations were performed on 768 eyes of 448 HM patients (50-89 years of age) and 54 eyes of 52 non-HM subjects with scan widths of 23 mm and depths of 5 mm. HM was defined as an axial length longer than 26.5 mm. The area and morphology of the posterior vitreous detachments (PVDs) and adhesions onto retinal vessels were examined for in 167 HM eyes and in 11 non-HM eyes in which the vitreal images were clear. RESULTS Paramacular PVD, perifoveal PVD, peripapillary PVD, and complete PVD were found in 9%, 47%, 41%, and 3% of the 167 HM eyes, respectively, and in 37%, 45%, 18%, and 0% of the 11 non-HM eyes, respectively. In eyes with vitreofoveal adhesions, the PVDs were more commonly asymmetrical relative to the fovea in the HM eyes than in the non-HM eyes (94% vs. 44%, respectively; P < .001). The area of the PVD corresponded with the area where the sclera protruded posteriorly. A thickened vitreous was observed to adhere to the retinal vessels at multiple points and was accompanied by paravascular abnormalities including lamellar holes in HM eyes. A total of 54 of the 167 HM eyes had macular retinoschisis, and the eyes commonly had vitreal traction on retinal vessels compared to HM eyes without macular retinoschisis (P = .031). CONCLUSIONS PVD progressed asymmetrically and were associated with scleral curvature in HM eyes. Vitreous traction spanning a wide distance may lead to myopic traction maculopathy.
Collapse
Affiliation(s)
- Hiroyuki Takahashi
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Noriko Tanaka
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Kosei Shinohara
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Tae Yokoi
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Takeshi Yoshida
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Kengo Uramoto
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.
| |
Collapse
|
21
|
Anatomical and functional changes in paravascular abnormalities after epiretinal membrane removal. Graefes Arch Clin Exp Ophthalmol 2019; 257:1823-1829. [PMID: 31154470 DOI: 10.1007/s00417-019-04376-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To investigate the anatomical and functional changes in areas containing paravascular abnormalities (PVA) in eyes with epiretinal membrane (ERM) after surgery. METHODS Twenty-eight eyes with concurrent idiopathic ERM and PVA were enrolled in this prospective study. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and areas of PVA in the superficial and deep capillary levels detected on en face optical coherence tomography were measured preoperatively and 1, 3, and 6 months postoperatively. Retinal sensitivity in selected PVA lesions was evaluated by microperimetry preoperatively and 1 and 6 months postoperatively. RESULTS The areas of PVA at the superficial capillary level before and 1, 3, and 6 months after surgery measured 1.65 ± 1.27, 0.44 ± 0.62, 0.40 ± 0.64, and 0.38 ± 0.62 mm2, respectively, while those at the deep capillary level measured 0.27 ± 0.57, 0.10 ± 0.26, 0.09 ± 0.29, and 0.05 ± 0.15 mm2, respectively. The areas of PVA in the superficial and deep capillary levels were significantly smaller postoperatively (all p < 0.001 at the superficial capillary level and p = 0.010 at the deep capillary level). Average retinal sensitivity values in the PVA lesions before and 1 and 6 months after surgery were 11.2 ± 3.5, 12.9 ± 3.2, and 13.2 ± 2.7 dB, respectively; the values at postoperative months 1 and 6 were significantly improved (p = 0.045 and p < 0.001, respectively). BCVA and CMT were significantly improved postoperatively. CONCLUSION PVA not only improves anatomically but also functionally after ERM surgery. Vitrectomy can improve not only central vision but also retinal sensitivity in areas of PVA.
Collapse
|
22
|
Retinal detachment due to paravascular abnormalities-associated breaks in highly myopic eyes. Eye (Lond) 2018; 33:572-579. [PMID: 30385882 DOI: 10.1038/s41433-018-0255-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/12/2018] [Accepted: 08/26/2018] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To describe the characteristics of a novel type of retinal detachment (RD) due to paravascular abnormalities (PVAs) associated breaks in highly myopic eyes. METHODS We retrospective recruited eight eyes with RD due to PVA-associated breaks. The clinical features and surgical results were evaluated. RESULTS All eyes were highly myopic with a mean axial length of 31.31 ± 2.86 mm (27.51-36.52 mm). Two of the eight eyes had multiple paravascular retinal breaks associated with PVAs, four had a single paravascular break with PVAs nearby, and two had multiple paravascular breaks along the same vessels. All breaks were round or oval-shaped, and only three eyes (37.5%) had their breaks located over patchy chorioretinal atrophy. Two of the eight eyes had the breaks outside the arcades, five had their breaks within the arcades, and one had a break within the arcade as well as breaks outside the arcade. Vitrectomy and epiretinal and internal limiting membrane peeling were performed in all cases, with inverted or free internal limiting membrane flap insertions for the perifoveal breaks and endolaser for the more peripheral breaks. All eyes had retinal reattachment after one single operation. CONCLUSION RD due to PVA-associated breaks represented a distinct entity. PVAs and the associated breaks should be searched in RD without macular hole or obvious breaks in highly myopic eyes. It may be treated as RD caused by peripheral breaks or as macular hole associated RD depending on the location of the breaks.
Collapse
|
23
|
Long-term follow-up of retinal nerve fiber layer cleavages in glaucoma patients and suspects. Graefes Arch Clin Exp Ophthalmol 2018; 256:1945-1952. [PMID: 29959507 DOI: 10.1007/s00417-018-4043-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 05/18/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To investigate the structural and functional characteristics and change of the retinal nerve fiber layer cleavages (RNFLCs) in glaucoma patients and suspects in long-term follow-up. METHODS This is a retrospective longitudinal study. Within 43 eyes of 30 subjects, 62 RNFLC locations were detected on color fundus photography. Basic ophthalmic examinations, color fundus photography, optical coherence tomography (OCT), and visual field (VF) test were performed in 6-month intervals. Clinical characteristics and the structural and functional changes of the cleaved areas were analyzed. RESULTS RNFLC and localized vitreoretinal traction occurred most commonly along the superotemporal retinal vessel arcade. Nine locations had corresponding defects on OCT deviation map, while 31 locations were associated with defects on OCT deviation map. Three locations had corresponding VF defects. More of the non-highly myopic eyes had lamellar hole than the highly myopes (p = 0.038). The RNFLC lesions in glaucomatous eyes were more frequently associated with OCT defects on deviation map (p = 0.021). There was no difference in the presence of lamellar hole or the number of RNFLCs between the glaucomatous and non-glaucomatous eyes. During a 66.8 ± 37.8-month follow-up, there was no structural or functional progression of the RNFLCs as determined by color fundus photography, VF test, and GPA of OCT interpreted by three ophthalmologists. There was no statistically significant change of RNFLC area (p = 0.268). CONCLUSIONS RNFLC did not show detectable functional or structural change in early glaucoma patients and suspects after long-term follow-up.
Collapse
|
24
|
Li T, Wang X, Zhou Y, Feng T, Xiao M, Wang F, Sun X. Paravascular abnormalities observed by spectral domain optical coherence tomography are risk factors for retinoschisis in eyes with high myopia. Acta Ophthalmol 2018; 96:e515-e523. [PMID: 29171725 DOI: 10.1111/aos.13628] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 10/01/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the retinal features and distribution of paravascular abnormalities (PVAs) and their relationship with retinoschisis in eyes with high myopia. METHODS One hundred and fifty-two eyes of 88 patients with high myopia [refractive error greater than -6 dioptres (D) or axial length (AL) ≥26.5 mm] who had undergone comprehensive ophthalmic examinations were evaluated in this cross-sectional study. Multiple optical coherence tomography (OCT) scans were performed to study the microstructural alterations adjacent to the retinal vascular arcades and the entire macular area. The presence and distribution patterns of various PVAs, retinoschisis and the association between these parameters were analysed. RESULTS Of the 152 highly myopic eyes, PVAs were detected by OCT in 126 eyes (82.9%), including paravascular microfolds in all 126 eyes, paravascular cysts in 109 eyes (71.7%) and paravascular lamellar holes in 44 eyes (28.9%). All three types of PVAs were observed more frequently along the temporal vascular arcades than along the nasal vascular arcades (p < 0.005). Seventy-eight eyes (51.3%) were identified with retinoschisis at retinal vascular arcades, most frequently in the inner plexiform layer (IPL) and along temporal arcades. Eyes with all three types of PVAs (microfolds, cysts and lamellar holes) had the highest incidence of retinoschisis at vascular arcades (p < 0.001). Multivariate analysis indicated that age, the AL, presence of paravascular microfolds and cysts, and simultaneously existence of all three types of PVAs were associated with an increased risk for retinoschisis at vascular arcades. Macular retinoschisis was detected in 25 eyes (19.8%) and presented with splitting of the outer retina in all cases. All seven eyes with entire macular area retinoschisis (S4 grade) were accompanied by retinoschisis at vascular arcades within multiple layers, including outer retinoschisis, IPL schisis and inner limiting membrane (ILM) detachment. CONCLUSION Our findings indicated that all three types of PVAs and different types of retinoschisis were most frequently observed along the temporal vascular arcades. Eyes with paravascular microfolds and cysts, and those with all three paravascular lesions may in risk of developing retinoschisis at vascular arcades.
Collapse
Affiliation(s)
- Tong Li
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Xiaohan Wang
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Yanping Zhou
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Tonghui Feng
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Meichun Xiao
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Fenghua Wang
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
- Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai China
| | - Xiaodong Sun
- Department of Ophthalmology; Shanghai General Hospital (Shanghai First People's Hospital); Shanghai Jiao Tong University School of Medicine; Shanghai China
- Shanghai Engineering Center for Visual Science and Photomedicine; Shanghai China
- Shanghai Key Laboratory of Fundus Diseases; Shanghai China
| |
Collapse
|
25
|
Pan T, Su Y, Yuan ST, Lu HC, Hu ZZ, Liu QH. Optic disc and peripapillary changes by optic coherence tomography in high myopia. Int J Ophthalmol 2018; 11:874-880. [PMID: 29862190 DOI: 10.18240/ijo.2018.05.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/18/2018] [Indexed: 11/23/2022] Open
Abstract
Myopia, a worldwide condition, is a multifactorial disease resulting in many ocular complications. Early onset of myopia has a great tendency to develop high myopia and pathological myopia later in life. The pathophysiology and progression of myopia is still unclear. Owing to its involving in visual function, optic disc and peripapillary change in high myopia can't be neglected, and it may help in better understanding of the pathophysiology or mechanism of myopia progression. Recently, advanced imaging techniques have been developed, such as optical coherence tomography (OCT), allowing for better detecting of optic disc and peripapillary change. OCT is a high-resolution and noninvasive measurement for detection of ocular structure. Herein, we provide an updated review of optic disc and peripapillary change in OCT image, including its characteristics and clinical significance. We also propose some problems needed further investigation.
Collapse
Affiliation(s)
- Ting Pan
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Yun Su
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Song-Tao Yuan
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Hang-Cheng Lu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Zi-Zhong Hu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Qing-Huai Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| |
Collapse
|
26
|
Gentle endodiathermy of retinal vessels to mark paravascular posterior retinal breaks in highly myopic eyes. Eur J Ophthalmol 2017; 28:344-346. [PMID: 29077189 DOI: 10.5301/ejo.5001057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To show a new method to highlight posterior paravascular retinal breaks, responsible for posterior retinal detachment in highly myopic eyes, by gentle endodiathermy on the nearby retinal vessel, in areas of patchy chorioretinal atrophy. METHODS A standard 25-gauge (25-G) 3-port pars plana vitrectomy with internal limiting membrane (ILM) peeling was performed. A gentle endodiathermy was applied on the vessel close to the retinal break until a clear withe spot became visible. This spot was used as a landmark to identify the retinal break after fluid-air exchange. RESULTS The retina was attached after a single operation and no retinal redetachment was reported. A complete blood flow restoration in the treated vessel was documented with fluorescein angiography after 5 days. CONCLUSIONS This simple technique may help the vitreoretinal surgeon to identify paravascular retinal breaks after fluid-air exchange. No damage to the retinal vessels undergoing endodiathermy was observed.
Collapse
|
27
|
Yokota R, Hirakata A, Hayashi N, Hirota K, Rii T, Itoh Y, Orihara T, Inoue M. Ultrastructural analyses of internal limiting membrane excised from highly myopic eyes with myopic traction maculopathy. Jpn J Ophthalmol 2017; 62:84-91. [PMID: 29071469 DOI: 10.1007/s10384-017-0542-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the ultrastructure of the internal limiting membranes (ILMs) excised during vitrectomy from highly myopic eyes with myopic traction maculopathy (MTM). The clinical findings before and after the vitrectomy were compared. METHODS Seven eyes of 7 patients with macular retinoschisis were studied. Four of these eyes also had a foveal detachment but without a retinal break. All the eyes underwent vitrectomy with the creation of a posterior vitreous detachment and ILM peeling. The excised ILMs were examined by transmission electron microscopy (TEM). RESULTS The retinas were reattached in all eyes after the vitrectomy. No retinal breaks including macular holes were identified intraoperatively. Transmission electron microscopy showed glial cells in 4 eyes, retinal pigment epithelium-like cells in 4 eyes, and myofibroblast-like cells in 4 eyes on the excised ILMs. A newly produced basement membrane appeared to merge with the ILM in 5 eyes. Thick collagen was seen in 2 eyes, and fibrous long-spacing collagen in the newly synthesized collagen fibers was seen in 3 eyes. The cellular components of the glial cells appeared to have migrated through the thinner parts of the retina or through a defect of the ILM in 2 eyes. CONCLUSIONS Cells that migrate onto the surface of the ILM synthesize new collagen, which can create tangential traction. This may explain the success of vitrectomy with ILM peeling in treating MTM in highly myopic eyes.
Collapse
Affiliation(s)
- Reiji Yokota
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
| | - Akito Hirakata
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan.
| | - Nobutsugu Hayashi
- Department of Ophthalmology, Satsukikai Suzaki Kuroshio Hospital, Kochi, Japan
| | - Kazunari Hirota
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
| | - Tosho Rii
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
| | - Yuji Itoh
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
| | - Tadashi Orihara
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
| | - Makoto Inoue
- Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
| |
Collapse
|
28
|
Chan LW, Hsieh YT, Hsu WC, Cheng HC, Shen EP. Optic Disc Parameters of Myopic Children with Atropine Treatment. Curr Eye Res 2017; 42:1614-1619. [PMID: 28937823 DOI: 10.1080/02713683.2017.1359846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To characterize optic disc parameters, retinal nerve fiber layer thickness (RNFLT), and the intraocular pressure (IOP) of myopic children under continual topical 0.25% atropine treatment. METHODS From October 1, 2010 to September 31, 2011, 67 eyes of 35 myopic children were recruited. The children were treated with 0.25% atropine nightly for myopia control. Visual acuity, refraction, IOP, axial length (AL, IOL Master), RNFLT, and optic disc parameters (Stratus OCT) were measured at enrollment and every 2 months. All patients had at least 1 year of follow-up. RESULTS Enrolled children had a mean age of 10.3 ± 2.4 years (5-15 years). Of the 67 studied eyes, the mean spherical equivalent (SE) was -2.60 ± 1.58 diopters (D) (-6.75--0.5 D). Under the treatment of 0.25% atropine, myopia increased by 0.53 ± 0.10D per year (P < 0.0001), and AL elongated by 0.245 ± 0.042 mm per year (P < 0.0001). No significant change was noted in the IOP and optic nerve parameters including peripapillary RNFLT, areas of optic disc, cup and rim, or cup/disc ratio over the follow-up period during atropine treatment (P > 0.05). CONCLUSIONS 0.25% Atropine treatment for myopia control did not significantly affect the IOP, optic nerve parameters, and RNFLT in children over a mean of 15.2 ± 2.4 months treatment and follow-up. 0.25% Atropine is a relatively safe option for myopia control.
Collapse
Affiliation(s)
- Li-Wei Chan
- a Department of Ophthalmology , Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation , Taipei , Taiwan
| | - Yi-Ting Hsieh
- a Department of Ophthalmology , Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation , Taipei , Taiwan
| | - Wei-Cherng Hsu
- a Department of Ophthalmology , Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation , Taipei , Taiwan
| | - Han-Chih Cheng
- a Department of Ophthalmology , Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation , Taipei , Taiwan
| | - Elizabeth P Shen
- a Department of Ophthalmology , Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation , Taipei , Taiwan
| |
Collapse
|
29
|
Paravascular inner retinal abnormalities in healthy eyes. Graefes Arch Clin Exp Ophthalmol 2017; 255:1743-1748. [PMID: 28669042 DOI: 10.1007/s00417-017-3717-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 06/01/2017] [Accepted: 06/05/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To investigate the prevalence and characteristics of paravascular inner retinal abnormalities in healthy eyes. MATERIALS AND METHODS In this prospective observational case series, we included 178 healthy eyes (178 patients) with no ocular diseases. Eyes with co-existing ocular diseases, e.g., epiretinal membrane, glaucoma, or high myopia, were excluded from the current study. The posterior pole and paravascular areas of the temporal arcade vessels were comprehensively examined by dense radial scanning of optical coherence tomography (OCT) with the extended field imaging technique. RESULTS On fundus photography, no inner retinal abnormalities were detected along the temporal arcade vessels. On OCT sections, paravascular inner retinal abnormalities were seen in 77 (43.3%) eyes. In 71 (39.9%) eyes, inner retinal cystoid or fissure-like spaces that had no connection to the vitreous cavity were seen adjacent to the temporal arcade vessels. Most of these lesions were detected only on several consecutive OCT sections. In four (2.2%) eyes, inner retinal cleavages with openings to the vitreous cavity were seen adjacent to the temporal arcade vessels. These lesions were more frequently detected in the inferior hemisphere and along the major retinal veins. No eyes showed typical broad defects of the inner retinal tissue. There were no significant differences in age, gender, visual acuity, refractive error, or axial length between eyes with or without paravascular inner retinal abnormalities. CONCLUSIONS Paravascular cystoid or fissure-like spaces were frequently seen in the inner retina of healthy eyes. However, we detected no typical paravascular inner retinal defects in healthy eyes.
Collapse
|
30
|
POSTOPERATIVE INNER NUCLEAR LAYER MICROCYSTS AFFECTING LONG-TERM VISUAL OUTCOMES AFTER EPIRETINAL MEMBRANE SURGERY. Retina 2016; 36:2377-2383. [DOI: 10.1097/iae.0000000000001100] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
31
|
Grabowska A, Li JPO, Mateo C, da Cruz L. Myopic traction maculopathies and their treatments. EXPERT REVIEW OF OPHTHALMOLOGY 2016. [DOI: 10.1080/17469899.2016.1226803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
32
|
Sun CB, You YS, Liu Z, Zheng LY, Chen PQ, Yao K, Xue AQ. Myopic Macular Retinoschisis in Teenagers: Clinical Characteristics and Spectral Domain Optical Coherence Tomography Findings. Sci Rep 2016; 6:27952. [PMID: 27294332 PMCID: PMC4904792 DOI: 10.1038/srep27952] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 05/26/2016] [Indexed: 11/09/2022] Open
Abstract
To investigate the morphological characteristics of myopic macular retinoschisis (MRS) in teenagers with high myopia, six male (9 eyes) and 3 female (4 eyes) teenagers with typical MRS identified from chart review were evaluated. All cases underwent complete ophthalmic examinations including best corrected visual acuity (BCVA), indirect ophthalmoscopy, colour fundus photography, B-type ultrasonography, axial length measurement, and spectral-domain optical coherence tomography (SD-OCT). The average age was 17.8 ± 1.5 years, average refractive error was -17.04 ± 3.04D, average BCVA was 0.43 ± 0.61, and average axial length was 30.42 ± 1.71 mm. Myopic macular degenerative changes (MDC) by colour fundus photographs revealed Ohno-Matsui Category 1 in 4 eyes, and Category 2 in 9 eyes. Posterior staphyloma was found in 9 eyes. SD-OCT showed outer MRS in all 13 eyes, internal limiting membrane detachment in 7 eyes, vascular microfolds in 2 eyes, and inner MRS in 1 eye. No premacular structures such as macular epiretinal membrane or partially detached posterior hyaloids were found. Our results showed that MRS rarely occurred in highly myopic teenagers, and was not accompanied by premacular structures, severe MDC, or even obvious posterior staphyloma. This finding indicates that posterior scleral expansion is probably the main cause of MRS.
Collapse
Affiliation(s)
- Chuan-Bin Sun
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Yong-Sheng You
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zhe Liu
- Eye Center, Zhejiang Provincial People's Hospital, Hangzhou 310015, China
| | - Lin-Yan Zheng
- Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Pei-Qing Chen
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Ke Yao
- Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - An-Quan Xue
- Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| |
Collapse
|
33
|
Miyoshi Y, Tsujikawa A, Manabe S, Nakano Y, Fujita T, Shiragami C, Hirooka K, Uji A, Muraoka Y. Prevalence, characteristics, and pathogenesis of paravascular inner retinal defects associated with epiretinal membranes. Graefes Arch Clin Exp Ophthalmol 2016; 254:1941-1949. [DOI: 10.1007/s00417-016-3343-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 03/27/2016] [Accepted: 04/04/2016] [Indexed: 11/24/2022] Open
|
34
|
Ng DSC, Cheung CYL, Luk FO, Mohamed S, Brelen ME, Yam JCS, Tsang CW, Lai TYY. Advances of optical coherence tomography in myopia and pathologic myopia. Eye (Lond) 2016; 30:901-16. [PMID: 27055674 DOI: 10.1038/eye.2016.47] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/29/2016] [Indexed: 01/20/2023] Open
Abstract
The natural course of high-axial myopia is variable and the development of pathologic myopia is not fully understood. Advancements in optical coherence tomography (OCT) technology have revealed peculiar intraocular structures in highly myopic eyes and unprecedented pathologies that cause visual impairment. New OCT findings include posterior precortical vitreous pocket and precursor stages of posterior vitreous detachment; peripapillary intrachoroidal cavitation; morphological patterns of scleral inner curvature and dome-shaped macula. Swept source OCT is capable of imaging deeper layers in the posterior pole for investigation of optic nerve pits, stretched and thinned lamina cribrosa, elongated dural attachment at posterior scleral canal, and enlargement of retrobulbar subarachnoid spaces. This has therefore enabled further evaluation of various visual field defects in high myopia and the pathogenesis of glaucomatous optic neuropathy. OCT has many potential clinical uses in managing visual impairing conditions in pathologic myopia. Understanding how retinal nerve fibers are redistributed in axial elongation will allow the development of auto-segmentation software for diagnosis and monitoring progression of glaucoma. OCT is indispensable in the diagnosis of various conditions associated with myopic traction maculopathy and monitoring of post-surgical outcomes. In addition, OCT is commonly used in the multimodal imaging assessment of myopic choroidal neovascularization. Biometry and topography of the retinal layers and choroid will soon be validated for the classification of myopic maculopathy for utilization in epidemiological studies as well as clinical trials.
Collapse
Affiliation(s)
- D S C Ng
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - C Y L Cheung
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - F O Luk
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - S Mohamed
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - M E Brelen
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - J C S Yam
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - C W Tsang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| | - T Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, China
| |
Collapse
|
35
|
Paravascular abnormalities in eyes with idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2016; 254:1723-9. [PMID: 26803488 DOI: 10.1007/s00417-016-3276-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/06/2016] [Accepted: 01/12/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE The purpose was to investigate the paravascular abnormalities (PVA) around the retinal vascular arcades and their post-operative evolution in eyes with epiretinal membranes (ERM). METHODS This is an observational case series. Fifty-seven eyes of 55 patients with concurrent PVA and ERM were studied (study group). Forty-one eyes in 41 patients with ERM but no PVA served as controls. Multiple optical coherence tomography (OCT) scans were made along the upper and lower arcades and across the fovea in each patient. Serial fundus photography and OCT scans were performed in eyes receiving an operation. All surgeries were performed by one surgeon. The incidence and location of paravascular retinal cysts, deep cystic spaces underneath the vessels, and paravascular retinal defects, as well as vitreoretinal interface changes, were determined and correlated with macular thickness. RESULTS In the study group, paravascular retinal cysts were detected in 57 eyes (100 %), deep cystic spaces in nine eyes (15.8 %), and paravascular lamellar holes in 31 eyes (54.4 %). No case had a full-thickness hole. ERM adhesion to the PVA was noted in 16 eyes (28.1 %) and internal limiting membrane (ILM) changes over the PVA in 22 eyes (38.6 %). Compared with the control, the study group had significantly increased macular thickness. PVA, except lamellar holes, disappeared or decrease in severity after ERM and ILM removal surgery. CONCLUSION Different types of PVA are relatively common in eyes with ERM. Our findings suggest that PVA may develop secondary to ERM-induced macular thickening. Except for lamellar holes, most lesions decrease following an operation.
Collapse
|
36
|
Optical coherence tomography and pathological myopia: an update of the literature. Int Ophthalmol 2015; 35:897-902. [DOI: 10.1007/s10792-015-0118-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
|
37
|
Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain oct. Int Ophthalmol 2015; 36:247-52. [DOI: 10.1007/s10792-015-0110-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 08/04/2015] [Indexed: 11/27/2022]
|
38
|
Kamal-Salah R, Morillo-Sanchez MJ, Rius-Diaz F, Garcia-Campos JM. Relationship between paravascular abnormalities and foveoschisis in highly myopic patients. Eye (Lond) 2014; 29:280-5. [PMID: 25359287 DOI: 10.1038/eye.2014.255] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/23/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To describe the prevalence of paravascular abnormalities in highly myopic patients and its relationship with myopic foveoschisis (MF). METHODS Cross-sectional study of 250 highly myopic eyes. All of the patients underwent a complete ophthalmologic examination that included optical coherence tomography . RESULTS Optical coherence tomography images showed 170 eyes (68%) with paravascular microfolds (PM), 121 eyes (48.4%) presented paravascular retinal cysts (PC), and 35 eyes (14%) with paravascular lamellar holes . All the eyes with PCs had PMs. Out of the 250 eyes, 48 (19.2%) had paravascular retinoschisis (PR). All the eyes (100%) with PR had paravascular cysts and PMs. Sixteen eyes (6.4%) had foveoschis. The spherical equivalent (P<0.00), PR (P=0.01), and the presence of tractional structures (P<0.00) were associated with increased risk for foveoschsis in the multivariate study. CONCLUSIONS PMs were the lesions most often observed in the paravascular area in highly myopic eyes. MF would be a result of the action of different forces (intra- and extra-ocular forces), specially tractional structures, on precursor lesions (paravascular cyst and paravascular restinoschisis). Further studies are needed to confirm these results.
Collapse
Affiliation(s)
- R Kamal-Salah
- Department of ophthalmology, Centro de Investigaciones Médico-Sanitarias, Málaga, Spain
| | - M J Morillo-Sanchez
- Department of ophthalmology, Hospital Virgen de la Victoria de Málaga, Málaga, Spain
| | - F Rius-Diaz
- Department of Biostatistics, University of Malaga, Málaga, Spain
| | - J M Garcia-Campos
- 1] Department of ophthalmology, Centro de Investigaciones Médico-Sanitarias, Málaga, Spain [2] Department of ophthalmology, Hospital Virgen de la Victoria de Málaga, Málaga, Spain
| |
Collapse
|
39
|
[Peripapillary changes detected by SD OCT in eyes in high myopia]. J Fr Ophtalmol 2014; 37:635-9. [PMID: 25199484 DOI: 10.1016/j.jfo.2014.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 07/21/2014] [Accepted: 07/28/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE To study the morphologic alterations around the optic disc by spectral optical coherence tomography (SD OCT) in eyes with high myopia. PATIENTS AND METHODS Two hundred eyes (113 patients) with high myopia were included. The participants had complete ophthalmologic examinations and OCT examinations. OCT scans were obtained around the optic in each patient. RESULTS We detected by OCT, a peripapillary detachment in 14 eyes (11.0%), a retinischisis peripapillary in 10 eyes (5%) and paravascular abnormalities as microfolds and paravascular cysts in 80 eyes (40%). A statistically significant difference was found between patients with microfolds paravascular and the rest of the patients concerning age (P=0.0034) and axial length (P=0.001). The patients with paravascular cysts were older (P=0.0022), had a greater axial length (P=0.0044) and a high rate of posterior staphyloma compared to other patients. CONCLUSION Perpapillary changes detected by SD OCT in eyes in high myopia are relatively frequent and don't always present a clinical or ophthalmoscopic changes.
Collapse
|
40
|
VITRECTOMY FOR MYOPIC FOVEOSCHISIS WITH INTERNAL LIMITING MEMBRANE PEELING AND NO GAS TAMPONADE. Retina 2014; 34:455-60. [DOI: 10.1097/iae.0b013e3182a0e477] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
41
|
|
42
|
|
43
|
Lamellar Hole Along the Papillomacular Bundle of Unknown Cause. Retina 2013; 33:1477-8. [DOI: 10.1097/iae.0b013e318287d9d7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
44
|
Henaine-Berra A, Zand-Hadas IM, Fromow-Guerra J, García-Aguirre G. Prevalence of Macular Anatomic Abnormalities in High Myopia. Ophthalmic Surg Lasers Imaging Retina 2013; 44:140-4. [DOI: 10.3928/23258160-20130219-01] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 12/18/2012] [Indexed: 11/20/2022]
|
45
|
Three-dimensional tomographic features of dome-shaped macula by swept-source optical coherence tomography. Am J Ophthalmol 2013; 155:320-328.e2. [PMID: 23127750 DOI: 10.1016/j.ajo.2012.08.007] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 08/17/2012] [Accepted: 08/21/2012] [Indexed: 12/21/2022]
Abstract
PURPOSE To study the tomographic and pathomorphologic features of dome-shaped maculas with swept-source optical coherence tomography (OCT). DESIGN Prospective, cross-sectional study. METHODS The macular area of 51 highly myopic eyes (35 patients) with dome-shaped maculas was studied with swept-source OCT at 1050 nm. Three-dimensional (3-D) data sets were obtained with raster scanning covering a 12 × 8-mm(2) area; 3-D images of the posterior pole were constructed by autosegmentation of the retinal pigment epithelium (RPE). RESULTS In all reconstructed 3-D images of the RPE, 2 outward concavities were seen within the posterior staphyloma and a horizontal ridge was formed between these 2 concavities. In 42 of these eyes, this horizontal ridge was band shaped. The vertical OCT section through the fovea showed a convex configuration of RPE, but the horizontal section showed an almost flat RPE line. In 9 eyes, 3-D images showed a typical dome-shaped convexity within the staphyloma. OCT scans showed no outward protrusions in the external scleral surface, but marked scleral thinning was seen consistent with the 2 outward concavities of the RPE. The sclera of the fovea (518.6 ± 97.6 μm) was significantly thicker than that in all 4 quadrants of the parafoveal area (range, 277.2 to 360.3 μm; P < .001). CONCLUSIONS In highly myopic eyes with a dome-shaped macula, a horizontal ridge is formed within the posterior staphyloma by uneven thinning of the sclera.
Collapse
|
46
|
Ikuno Y, Ohji M. High Myopia and the Vitreoretinal Complications. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
47
|
|
48
|
MACULAR VITREORETINAL INTERFACE ABNORMALITIES IN HIGHLY MYOPIC EYES WITH POSTERIOR STAPHYLOMA. Retina 2012; 32:1531-8. [DOI: 10.1097/iae.0b013e318255062c] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
49
|
Fischer MD, Inhoffen W, Ziemssen F. [Spectral domain optical coherence tomography in the treatment of myopic choroidal neovascularization]. Ophthalmologe 2012; 109:758-65. [PMID: 22911353 DOI: 10.1007/s00347-011-2499-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Spectral domain optical coherence tomography (SD-OCT) investigations provide additional information about the morphological characteristics of myopic choroidal neovascularization (mCNV). Reproducible measurements of intraretinal and subretinal fluid are of growing importance for an evaluation of progression. The non-invasive technique reduces the need for frequent fluorescence angiography after individual assessment. Appropriate correction of the reference arm is mandatory. Automatic adjustment of transversal measured values due to alterations in the paraxial field (depending on the axial length) has been implemented in a new device. Mirror artefacts and excess curvature can be avoided by reducing the length of the OCT cross-section (15°). New possibilities to record the choriocapillaris and choroid have expanded the knowledge of potential pathomechanisms and risk factors.
Collapse
Affiliation(s)
- M D Fischer
- Department für Augenheilkunde, Universitäts-Augenklinik, Schleichstrasse 12-16, Tübingen, Germany.
| | | | | |
Collapse
|
50
|
Xirou T, Kidess A, Kourentis C, Xirou V, Feretis E, Kabanarou SA. Lamellar macular hole formation following vitrectomy for rhegmatogenous retinal detachment repair. Clin Ophthalmol 2012; 6:571-4. [PMID: 22553416 PMCID: PMC3340123 DOI: 10.2147/opth.s30107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate lamellar macular hole formation in six patients after rhegmatogenous retinal detachment repair. METHODS A retrospective review of medical records of patients who underwent primary pars plana vitrectomy for rhegmatogenous retinal detachment repair was performed. Optical coherence tomography characteristics and best-corrected visual acuity were evaluated. Patients who developed lamellar macular hole after pars plana vitrectomy for rhegmatogenous retinal detachment repair were identified. RESULTS A total of 1185 eyes underwent pars plana vitrectomy for retinal detachment between 2004 and 2009. Optical coherence tomography evaluation was available in 450 cases. Six of these cases demonstrated lamellar macular hole formation, which was diagnosed by OCT-3. The mean time from retinal detachment surgery to lamellar hole diagnosis was 4.1 months. The presence of an epiretinal membrane on the surface of the juxtafoveal retina was a common finding in all six patients. Visual acuity was improved after successful retinal reattachment and remained unchanged after lamellar hole formation. CONCLUSION Lamellar macular holes developing after pars plana vitrectomy is a rare complication. Stability of optical coherence tomography findings and best-corrected visual acuity after lamellar macular hole formation may be observed for at least two years.
Collapse
Affiliation(s)
- Tina Xirou
- Retina Department, Hellenic Red Cross General Hospital, Athens, Greece
| | | | | | | | | | | |
Collapse
|