Ultrawide-Field OCT to Investigate Relationships between Myopic Macular Retinoschisis and Posterior Staphyloma
Ultrawide-Field OCT to Investigate Relationships between Myopic Macular Retinoschisis and Posterior Staphyloma
复制标题
DOI：
10.1016/j.ophtha.2018.03.053
复制
发表时间：
2018-10-01
期刊：
影响因子：
13.7
通讯作者：
Ohno-Matsui, Kyoko
中科院分区：
文献类型：
--
作者：
Shinohara, Kosei;Tanaka, Noriko;Ohno-Matsui, Kyoko
目的：探讨近视黄斑视网膜劈裂（MRS）与后葡萄肿之间的关系，并揭示与 MRS 相关的其他视网膜病变的特征。设计：回顾性、观察性病例系列。研究对象：420 名高度近视患者的 729 只眼，高度近视的定义为近视屈光不正超过 -8.0 屈光度或眼轴长度超过 -8.0 屈光度。 26.5 mm。方法：采用超宽视场（UWF）扫频（SS）OCT检查高度近视眼，扫描宽度可达23 mm，扫描深度为5 mm。在 UWF SS OCT 图像中检查 MRS 和后葡萄肿的 OCT 特征及其空间关系。主要结果指标：MRS 与葡萄肿之间的关联。结果：在平均眼轴长度为 30.2 +/- 2.1 mm 的 729 只眼中，482 只眼（66.1%）检测到后葡萄肿，136 只眼（18.7%）检测到 MRS。所有 136 只眼睛进行 MRS 均显示外层视网膜劈裂，40 只眼睛 (29.4%) 还显示内层视网膜劈裂。与没有 MRS 的眼睛（365/593 [61.6%]；P < 0.001）相比，接受 MRS 的眼睛（117/136 [86.0%]）发现后葡萄肿的频率明显更高。在所有同时患有葡萄肿和外视网膜劈裂的眼睛中，外视网膜劈裂的区域仅限于葡萄肿内的区域。 19只患有外层视网膜劈裂但无葡萄肿的眼睛中，有1只眼睛的外层视网膜劈裂超出了扫描眼底区域的范围。 40只眼存在内层视网膜劈裂，其中内层视网膜劈裂位于外层视网膜劈裂区域内的有39只眼（97.5%）。在所有患有内视网膜劈裂的眼睛中，在内视网膜劈裂区域内都发现了引起向内牵引力的视网膜病变。结论：在高度近视眼中，MRS和葡萄肿的位置在空间上彼此相关。与葡萄肿相关的后向力以及由视网膜前膜或玻璃体视网膜附着物产生的向内力可能是 MRS 的致病因素。然而，与 MRS 发展相关的确切机制可能是多种多样且复杂的。 (C) 2018 年美国眼科学会
Purpose: To investigate the relationships between myopic macular retinoschisis (MRS) and posterior staphylomas and to reveal the characteristics of other retinal lesions associated with MRS.Design: Retrospective, observational case series.Participants: Seven hundred twenty-nine eyes of 420 patients with high myopia, which was defined as myopic refractive error of more than -8.0 diopters or an axial length longer than 26.5 mm.Methods: Highly myopic eyes were examined by ultrawide-field (UWF) swept-source (SS) OCT with scan width of up to 23 mm and scan depth of 5 mm. The OCT features of MRS and posterior staphylomas and their spatial relationship were examined in UWF SS OCT images.Main Outcome Measures: Associations between MRS and staphylomas.Results: In 729 eyes with mean axial length of 30.2 +/- 2.1 mm, posterior staphyloma was detected in 482 eyes (66.1%) and MRS was detected in 136 eyes (18.7%). All 136 eyes with an MRS showed outer retinoschisis, and 40 eyes (29.4%) also showed inner retinoschisis. Posterior staphyloma was detected significantly more frequently in eyes with MRS (117/136 [86.0%]) than in eyes without MRS (365/593 [61.6%]; P < 0.001). In all eyes with both staphyloma and outer retinoschisis, the area of the outer retinoschisis was restricted to the area within the staphyloma. In 1 of the 19 eyes with outer retinoschisis but without staphyloma, the outer retinoschisis extended beyond the range of the scanned fundus area. Among the 40 eyes with inner retinoschisis, the inner retinoschisis was located within the region of the outer retinoschisis in 39 eyes (97.5%). In all eyes with inner retinoschisis, retinal lesions causing an inward-directed tractional force were found within the area of the inner retinoschisis.Conclusions: In highly myopic eyes, the sites of the MRS and staphylomas were spatially related to each other. Posterior-directed force in association with staphylomas, and an inward-directed force resulting from epiretinal membranes or vitreoretinal attachments, may act as causative factors for MRS. However, the exact mechanisms related to the development of an MRS are probably diverse and complex. (C) 2018 by the American Academy of Ophthalmology