Posterior staphyloma is associated with the microvasculature and microstructure of myopic eyes

Abstract

Objective To investigate the microvasculature and structural characteristics of the eyes of myopic patients and their association with posterior staphyloma (PS). Methods This was a retrospective, case-control study comprising of 106 eyes from 72 individuals. Using 1:1 matching of axial length (AL) of their eyes, patients were allocated into a PS group or no posterior staphyloma (NPS) group. All patients were examined using ultra-widefield fundus imaging, optical coherence tomography angiography, and ocular biometry to acquire microvasculature and microstructure parameters. Results The anterior chamber depth (ACD) of the PS group was significantly different from that of the NPS group (3.56 mm vs 3.76 mm, P < 0.001), as was 1ens thickness (3.72 mm vs 3.57 mm, P = 0.005) and spherical equivalent (SE)(-10.11D vs -8.80D, P = 0.014). The PS group had reduced choriocapillaris flow, subfoveal choroidal thickness (SFCT), and a thinner retinal layer compared with the NPS group. No difference in retinal blood flow between the two groups was observed. The PS group exhibited a smaller disc area (15082.89 vs 17,043.32, P = 0.003) and angle α between temporal retinal arterial vascular arcades (113.29°vs 128.39°, P = 0.003), a larger disc tilt ratio (1.41 vs 1.24, P < 0.001) and parapapillary atrophy (PPA) area (13840.98 vs 8753.86, P = 0.020), compared with the NPS group. Multivariate regression analysis indicated that disc tilt ratio (P = 0.031) and SFCT (P = 0.015) were significant predictors of PS. In addition, PS (P = 0.049), AL (P = 0.003), corneal refractive power (P < 0.001), ACD (P = 0.022), relative lens position (P = 0.045), and disc area (P = 0.011) were significant predictors of SE. Conclusions PS was found to be closely linked to a reduction in choriocapillaris perfusion and anatomical abnormalities including posterior and anterior segments. Furthermore, PS exacerbated the progression of myopia.

Investigation of Macular Structural and Microcirculatory Characteristics of Posterior Staphyloma in High Myopic Eyes by Swept Source Optical Coherence Tomography Angiography

“…The RT, CT, and SFST in the macular area of the PS group were lower than those in the NPS group, and GEE indicated that SFST and foveal and parafoveal CT were significantly correlated with PS. This result was consistent with many previous reports ( Hayashi et al, 2013 ; Igarashi-Yokoi et al, 2021 ; Nie et al, 2021 ). Zhou et al also found a significant correlation between PS and choroidal thinning; the higher the relative height of PS, the more serious the choroidal atrophy ( Zhou et al, 2017 ).…”

“…However, we did not find a significant decrease in the SVD of the PS group. This phenomenon has been similarly reported in a previous study ( Nie et al, 2021 ). Another study hypothesized that impaired hemodynamics in myopic eyes is an early sign of a decrease in ocular blood flow in patients with pathological myopia ( Benavente-Pérez et al, 2010 ).…”

“…DVD and CCPA in the macular area of the PS group were lower than NPS group. Nie et al (2021) also indicated that there were significant differences in foveal DVD and macular CCPA between the PS and NPS groups; however, this phenomenon was not observed in the parafoveal DVD. The results of our study showed that the DVD of the parafoveal in the PS group was also lower than that in the NPS group, which may be due to the differences in the samples we included.…”

Morphology and Microcirculation Changes of Optic Nerve Head Between Simple High Myopia and Pathologic Myopia

“…When the rotation angle is greater than 15°, ONH may considered as rotation. The angle α between retinal temporal arterial vascular arcades was measured from the center of ONH with 250 pixels radius [5].…”

Impact of peripapillary staphylomas on the vascular and structural characteristics in myopic eyes: a propensity score matching analysis

“…Studies have confirmed that eyes with PS are significantly associated with the worsening of visual acuity and serious anatomical alterations than the non-staphylomatous eyes [3][4][5]. However, few comprehensive and quantitative studies have reported the specific effects of each type of PS on visual outcome and anatomical structure in highly myopic eyes.…”