Posterior staphylomas and scleral curvature in highly myopic children and adolescents investigated by ultra-widefield optical coherence tomography

Tanaka, Noriko; Shinohara, Kosei; Yokoi, Tae; Uramoto, Kengo; Takahashi, Hiroyuki; Onishi, Yuka; Horie, Shintaro; Yoshida, Takeshi; Ohno‐Matsui, Kyoko

doi:10.1371/journal.pone.0218107

Cited by 36 publications

(39 citation statements)

References 14 publications

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“…The staphyloma edges in retinitis pigmentosa exhibit gradual choroidal thinning from the fundus periphery toward the edge of the staphyloma with a gradual re-thickening of the choroid towards the posterior pole, and a slight inward protrusion of the sclera at the border of the staphyloma. A similar characteristic of choroidal thickness has been observed previously in PM with PS [10,20]. This observation implies that eyes with PS exhibit a unique attribute, independent of myopia.…”

Section: Discussionsupporting

confidence: 87%

“…However, Ohno-Matsui et al [6,7] have proposed that the choroid or other tissues are potentially primarily involved in PS formation, based on previous studies. A number of investigations have shown significant differences in morphological features and vision between eyes with and without PS [8][9][10]. However, where axial length (AL) differs between two eyes, it is difficult to determine whether the anatomical abnormalities are due to AL itself or PS.…”

Section: Introductionmentioning

confidence: 99%

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

Nie

Ouyang

Tang

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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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.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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

Nie

Ouyang

Tang

et al. 2021

Graefes Arch Clin Exp Ophthalmol

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“…In a study by Tanaka et al, 105 55 eyes of 30 patients with a mean age of 12.3 years and a mean axial length of 27.9 mm were studied. Seven of the 55 eyes (12.7%) had a posterior displacement of the sclera and were diagnosed as having a staphyloma.…”

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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212

159

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Pathologic myopia is a major cause of visual impairment worldwide. Pathologic myopia is distinctly different from high myopia. High myopia is a high degree of myopic refractive error, whereas pathologic myopia is defined by a presence of typical complications in the fundus (posterior staphyloma or myopic maculopathy equal to or more serious than diffuse choroidal atrophy). Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without high myopia. Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. The effectiveness of new therapies for complications have been shown, such as anti-VEGF therapies for myopic macular neovascularization and vitreoretinal surgery for myopic traction maculopathy. Myopia, especially childhood myopia, has been increasing rapidly in the world. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In addition, it has remained unclear whether genes responsible for pathologic myopia are the same as those for myopia in general, or whether pathologic myopia is genetically different from other myopia.

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“… 23 , 24 Although high myopia–related ocular complications are recognized to increase with age, particularly after age 50 years, these complications are now also being recognized in highly myopic children. 25 The continual refinement of optical coherence tomography (OCT) will undoubtedly contribute to improving the understanding of pathologic myopia, and one specific OCT-based definition—myopic traction maculopathy (MTM), which is becoming more widely used. The clinical characteristics of MTM are becoming well defined, 26 and a staging system has now been proposed.…”

Section: Imi Digest 2021—defining and Classifying Myopiamentioning

confidence: 99%

IMI 2021 Yearly Digest

Jong

Jonas

Wolffsohn

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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Purpose The International Myopia Institute (IMI) Yearly Digest highlights new research considered to be of importance since the publication of the first series of IMI white papers. Methods A literature search was conducted for articles on myopia between 2019 and mid-2020 to inform definitions and classifications, experimental models, genetics, interventions, clinical trials, and clinical management. Conference abstracts from key meetings in the same period were also considered. Results One thousand articles on myopia have been published between 2019 and mid-2020. Key advances include the use of the definition of premyopia in studies currently under way to test interventions in myopia, new definitions in the field of pathologic myopia, the role of new pharmacologic treatments in experimental models such as intraocular pressure–lowering latanoprost, a large meta-analysis of refractive error identifying 336 new genetic loci, new clinical interventions such as the defocus incorporated multisegment spectacles and combination therapy with low-dose atropine and orthokeratology (OK), normative standards in refractive error, the ethical dilemma of a placebo control group when myopia control treatments are established, reporting the physical metric of myopia reduction versus a percentage reduction, comparison of the risk of pediatric OK wear with risk of vision impairment in myopia, the justification of preventing myopic and axial length increase versus quality of life, and future vision loss. Conclusions Large amounts of research in myopia have been published since the IMI 2019 white papers were released. The yearly digest serves to highlight the latest research and advances in myopia.

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Posterior staphylomas and scleral curvature in highly myopic children and adolescents investigated by ultra-widefield optical coherence tomography

Cited by 36 publications

References 14 publications

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

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

IMI Pathologic Myopia

IMI 2021 Yearly Digest

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