Clinical characteristics and risk factors of myopic retinoschisis in an elderly high myopia population

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.

Multimodal imaging of optic nerve head abnormalities in high myopia

“…However, PPRS has been primarily discussed in the context of glaucoma rather than high myopia in previous studies. Based on research by Sherman et al and Li et al, the incidence of PPRS in highly myopic eyes increases from 3% (19/600) to 27.5% (123/448) with age ( 69 , 70 ).…”

Comparative Proteomic Analysis of Aqueous Humor Reveals Biochemical Disparities in the Eyes of High Myopic Patients

“…Low myopia is very easy to detect by the patient and there is an easy cure to wear glasses. However, for high myopia (diopter less than −6.0 D or axial length greater than 26 mm), not only does it affect visual quality, but as the degree of myopia deepens (especially axial length >28 mm), it can lead to blindness such as glaucoma, macular retinoschisis, myopic atrophic maculopathy, and myopic choroidal neovascularization. − According to an epidemiological study, the number of people suffering from high myopia worldwide is 163 million, accounting for 2.7% of the world’s total population. It is expected that this proportion will increase to 9.8% by 2050 .…”

CORRESPONDENCE Regarding the article: Mylonas et al. The impact of the vitreomacular interface on functional and anatomical outcomes in diabetic macular edema treated with three different anti-VEGF agents: post hoc analysis of the Protocol T study. Retina 2022;42:2066-2074.

“…[4][5][6][7][8][9][10][11][12][13] Unless combined with vitreofoveal traction, one may detect that the posterior hyaloid was either completely separated from the fovea or not detected at all in each of these extrafoveal traction B-scan images. [4][5][6][7][8][9][10][11][12][13] However, the latter images were detectable using diverse OCT scanning characteristics: 1) in case that the 6 • 6-mm scan center was foveal, and the scanning has covered each retinal point (without raster lines, such as by SD-OCT, Topcon 1,000); these were classically apparent by video clips; 2) when the scan center was extrafoveal, such as at the papillary site; or 3) by cross-sectional wide-field OCT. [3][4][5][6][9][10][11][12] A more advanced option in detecting extrafoveal traction was by 4) evaluating the vitreomacular or vitreopapillary interfaces in 3dimension (3D) SD-OCT (Figure 1), the real-life status that would be also detected intraoperatively by triamcinolone acetonide staining, or 5) by wide-field 3D sweptsource OCT that has required an enhanced visualization method of the posterior vitreous and vitreoretinal interface (traction was termed here 7 as "adhesions/pegs"). 4,[6][7][8]13 The 3D OCT images and video clips used in detecting extrafoveal traction in its association would be preferable to the B-scans because the posterior hyaloid adjacent to the traction site is detached and would therefore regularly appear in different OCT meridians than that of the traction site (Fig.…”

“…These included diffuse DME, macular edema secondary to branch retinal vein occlusion or other causes, high myopia, and age-related macular degeneration. 4–13…”

“…These included diffuse DME, macular edema secondary to branch retinal vein occlusion or other causes, high myopia, and age-related macular degeneration. [4][5][6][7][8][9][10][11][12][13] Unless combined with vitreofoveal traction, one may detect that the posterior hyaloid was either completely separated from the fovea or not detected at all in each of these extrafoveal traction B-scan images. [4][5][6][7][8][9][10][11][12][13] However, the latter images were detectable using diverse OCT scanning characteristics: 1) in case that the 6 • 6-mm scan center was foveal, and the scanning has covered each retinal point (without raster lines, such as by SD-OCT, Topcon 1,000); these were classically apparent by video clips; 2) when the scan center was extrafoveal, such as at the papillary site; or 3) by cross-sectional wide-field OCT. [3][4][5][6][9][10][11][12] A more advanced option in detecting extrafoveal traction was by 4) evaluating the vitreomacular or vitreopapillary interfaces in 3dimension (3D) SD-OCT (Figure 1), the real-life status that would be also detected intraoperatively by triamcinolone acetonide staining, or 5) by wide-field 3D sweptsource OCT that has required an enhanced visualization method of the posterior vitreous and vitreoretinal interface (traction was termed here 7 as "adhesions/pegs").…”