Multimodal imaging to differentiate myopic macular pit and localized deep staphyloma in high myopia

Vadivelu, Jaya Prakash; Shah, Amravi; Khetan, Vikas; Gopal, Lingam

doi:10.4103/ijo.ijo_1577_18

Cited by 4 publications

(5 citation statements)

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“…In higher grade of PM, the structure of retina dramatically is altered, and it is possible that the abnormality of tissue structure of the eyes may cover a wide area such as sclera. In HM eyes, some scleral abnormalities were previously reported such as thinning of sclera, posterior staphyloma and myopic scleral pit [33,34], which may in uence aqueous humor out ow, especially in the PM eyes. Taken together, it is reasonable our results that the outcome of trabeculotomy in PM patients was not favorable.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Yoshida

Nomura

Yoshimoto

et al. 2023

Preprint

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Background We retrospectively evaluate the long-term efficacy and safety of trabeculotomy glaucoma surgery in treating open-angle glaucoma (OAG) in eyes with high myopia (HM). Methods This study included 20 eyes with HM (axial length ≥ 26.5 mm) and OAG; age, preoperative IOP (intraocular pressure), and sex-matched 20 non-HM eyes (axial length < 26.5 mm) served as controls. Each eye underwent standalone ab interno trabeculotomy using a Kahook dual blade. A follow-up examination was performed 36 months after surgery. The main outcome measure was the operative success rate (i.e., a ≥ 20% pre- to post-operative reduction in IOP with or without IOP-lowering medication). Kaplan-Meier analysis was employed as a measure of surgical success. The secondary outcome measures were postoperative IOP, the number of glaucoma medications, and postoperative complications. Results IOP and the number of glaucoma medications were statistically significantly reduced at all postoperative follow-up examinations. The Kaplan-Meier analysis demonstrated that the probability of postoperative success at 36 months was 45% and 65% for HM and non-HM eyes, respectively. In the HM group, the presence of pathological myopia (PM) was statistically significant risk factor for surgical failure. No critical postoperative complications were detected. Conclusions In our study, the long-term efficacy of ab interno trabeculotomy in HM eyes with OAG was inferior to that in non-HM eyes with OAG. Our findings suggest that surgical indications for trabeculotomy in HM should be determined based on the presence of PM.

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Section: Discussionmentioning

confidence: 97%

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Yoshida

Nomura

Yoshimoto

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…In higher grade of PM, the structure of retina is dramatically altered, and it is possible that the ocular tissues abnormality extends to the sclera. In HM eyes, several scleral abnormalities such as thinning of sclera, posterior staphyloma and myopic scleral pit, have been described [ 34 , 35 ], and may influence aqueous humor outflow, especially in the PM eyes. Taken together, it is reasonable our results that the outcome of trabeculotomy in PM patients was not favorable.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of standalone ab interno trabeculotomy in the treatment of open-angle glaucoma in eyes with high myopia

et al. 2023

View full text Add to dashboard Cite

Background We retrospectively evaluate the long-term efficacy and safety of trabeculotomy glaucoma surgery in treating open-angle glaucoma (OAG) in eyes with high myopia (HM). Methods This study included 20 eyes with HM (axial length ≥ 26.5 mm) and OAG; age, preoperative IOP (intraocular pressure), and sex-matched 20 non-HM eyes (axial length < 26.5 mm) served as controls. Each eye underwent standalone ab interno trabeculotomy using a Kahook dual blade. A follow-up examination was performed 36 months after surgery. The main outcome measure was the operative success rate (i.e., a ≥ 20% pre- to post-operative reduction in IOP with or without IOP-lowering medication). Kaplan–Meier analysis was employed as a measure of surgical success. The secondary outcome measures were postoperative IOP, the number of glaucoma medications, and postoperative complications. Results IOP and the number of glaucoma medications were statistically significantly reduced at all postoperative follow-up examinations. The Kaplan–Meier analysis demonstrated that the probability of postoperative success at 36 months was 45% and 65% for HM and non-HM eyes, respectively. In the HM group, the presence of pathological myopia was statistically significant risk factor for surgical failure. No critical postoperative complications were detected. Conclusions In our study, the long-term efficacy of ab interno trabeculotomy in HM eyes with OAG was inferior to that in non-HM eyes with OAG. Our findings suggest that surgical indications for trabeculotomy in HM should be determined based on the presence of pathological myopia.

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“…The pit was lower than the fovea with 902 μm in depth and 397 μm in width. Also, episcleral tissue can be imaged in a few areas [ 10 ]. As described in our cases, these pits were located below the macular area and in the chorioretinal atrophy in high myopia.…”

Section: Discussionmentioning

confidence: 99%

“…In the eyes of the localized deep posterior staphyloma, fluorescein and indocyanine green angiography showed cilioretinal artery branching nasally, dipping in and emerging from the temporal margin. OCT showed thinning and outpouching of outer retina, RPE, choroid, and sclera with intact inner retina [ 10 ]. The phenotype of a scleral pit seems a plausible rationale, but its correlation with the pathogenesis and histological morphology of posterior scleral staphyloma is yet to be investigated.…”

Section: Discussionmentioning

confidence: 99%

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A physical sign of pathological myopia: myopic scleral pit

Zhang

et al. 2023

BMC Ophthalmol

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Purpose Myopic scleral pit (MSP) is a rare physical sign of pathological myopia (PM). The aim of this study was to summarize the clinical characteristics of MSP and analyze its correlation with PM. Methods Eight cases with PM and MSP were enrolled in this study. Comprehensive ophthalmic examinations, including subjective refraction, slit-lamp biomicroscope, intraocular pressure, fundus photographs, A- and B-scan ultrasonography and spectral-domain optical coherence tomography, were performed. Results All the patients had a long history of PM with visual impairment, long axial length, and myopia-related fundus degeneration. Mean axial length was 31.48 ± 2.17 mm. Mean size of MSP was 0.69 ± 0.29 optic disc diameter (PD). Mean logMAR BCVA was 1.21 ± 0.88 logMAR. Spearman correlation analysis showed that the logMAR BCVA had no correlation with the size of pits (P = 0.34). Fundus examination revealed a focal pale concave located in the sclera exposed area of retinal choroid atrophy was found in all cases. OCT showed a deep scleral pit where the retinal choroid was thin or absent, without retinal sensory detachment or sensory defect. Conclusions This study identified a rare scleral lesion in all eight individuals with PM, which was termed “myopic scleral pit”. This phenomenon is different from focal choroidal excavation and posterior staphyloma.

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Multimodal imaging to differentiate myopic macular pit and localized deep staphyloma in high myopia

Cited by 4 publications

References 5 publications

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Outcomes of Standalone Ab Interno Trabeculotomy in the Treatment of Open-Angle Glaucoma in Eyes with High Myopia

Outcomes of standalone ab interno trabeculotomy in the treatment of open-angle glaucoma in eyes with high myopia

A physical sign of pathological myopia: myopic scleral pit

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