Fundus changes in high myopic Kashmiri population

Background: High myopia (defined as myopia of -6D or more) is one of the main causes of visual impairment worldwide. High myopia is always accompanied by pathological structural changes such as axial elongation, posterior staphyloma, lacquer crack formation, thinning of the retina and choroid, and choroidal neovascularization. Aims and Objectives: The purpose of this study was to examine the fundus changes in eyes with high myopia. Materials and Methods: All study participants underwent dilated fundus examination and fundus photography. Myopia-related macular (posterior staphyloma, lacquer cracks, Fuchs spot, myopic chorioretinal atrophy, and myopic choroidal neovascularization)and optic disc (optic nerve head tilt,optic disc dimensions, and peripapillary atrophy) changes were evaluated. Results: Statistical analysis was performed to evaluate fundus changes in eyes with high myopia. Data analysis included 107 eyes of 57 patients.Mean ± SE was 12.07 ± 3.184D in eyes with high myopia. Mean ± AL was 26.68± 1.577mm in eyes with high myopia. The mean age was 28.54 ± 9.44 years(14-50 years). Fundus changes were: Temporal crescent in 56 (52.33%) eyes, tessellated fundus appearance in 52(48.59%) eyes, lacquer cracks in 40 (37.38%) eyes, tilted disc in 30 (28%) eyes, lattice degeneration in 20(18.69%) eyes, posterior staphyloma in 20(18.69%) eyes, focal chorioretinal atrophy in 3 (2.8%) eyes. CNV in 2 (1.86%)eyes and retinal hole in 1(1%) eye. Conclusions: Tessellated fundus and temporal crescent were the most common fundus findings among Kashmiri population with high myopia. In this population, lacquer cracks and tilted disc were also common, while CNV and retinal holes were rare.

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Ultra-Widefield Retinal Imaging for Analyzing the Association Between Types of Pathological Myopia and Posterior Staphyloma

Journal of Clinical Medicine ◽

10.3390/jcm8101505 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1505

Author(s):

Mimura ◽

Mori ◽

Torii ◽

Nagai ◽

Suzuki ◽

...

Keyword(s):

Retinal Detachment ◽

Choroidal Neovascularization ◽

Optic Neuropathy ◽

Axial Length ◽

High Myopia ◽

Retinal Imaging ◽

Fundus Photography ◽

Pathological Myopia ◽

Posterior Staphyloma ◽

Myopic Choroidal Neovascularization

High myopia may develop to pathologic myopia, which brings severe visual impairment; however, the etiology is not fully understood. We, therefore, investigated the relationship between the presence of posterior staphyloma and posterior ocular disorders by assessing the patients with high myopia. A retrospective study was performed for the patients, who have more than 26 mm of the axial length and of whom fundus photography was taken with an ultra-widefield retinal imaging system. The objectives were 138 cases encompassing 229 eyes. In 138 cases, 91 were bilateral and 47 were unilateral. The averages ± SD of axial length of bilateral and unilateral were 28.8 ± 2.2 mm, 27.3 ± 1.2 mm, respectively, showing statistically significant difference. The number of eyes with and without posterior staphyloma were 107 (46.7%) and 122 (53.3%), respectively. Retinal detachment and retinal breaks are more observed in cases without posterior staphyloma (p = 0.017). Myopic choroidal neovascularization (mCNV) (p = 0.002), chorioretinal atrophy (p < 0.001), retinoschisis (p < 0.001), and optic neuropathy (p = 0.038) are more often seen in cases with posterior staphyloma. In conclusion, the prevalence rates of myopic choroidal neovascularization, retinal choroidal atrophy, and optic neuropathy were significantly higher with posterior staphyloma. The rate of periocular disorders such as retinal detachment was significantly higher without posterior staphyloma. These results indicate associations between types of pathological myopia and presence or absence of posterior staphyloma analyzed by ultra-widefield retinal imaging.

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Progression of diffuse chorioretinal atrophy among patients with high myopia: a 4-year follow-up study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-316691 ◽

2020 ◽

pp. bjophthalmol-2020-316691

Author(s):

Zhixi Li ◽

Ran Liu ◽

Ou Xiao ◽

Xinxing Guo ◽

Jian Zhang ◽

...

Keyword(s):

High Myopia ◽

Fundus Photography ◽

Interventional Study ◽

Follow Up Study ◽

Chorioretinal Atrophy ◽

Corrected Visual Acuity ◽

Study Participants ◽

Myopic Maculopathy ◽

Best Corrected Visual Acuity

AimsTo investigate the progression pattern of diffuse chorioretinal atrophy (DCA) among Chinese participants with high myopia.MethodsThis is a longitudinal, non-interventional study. Participants with high myopia, defined as ≤−6 diopters spherical power, were included and followed up for 4 years, and underwent cycloplegic autorefraction, best-corrected visual acuity (BCVA) and fundus photography examinations. Newly established DCA, enlargement of existing DCA and development of other lesions of myopic maculopathy were regarded as DCA progression.ResultsOf the 484 participants with a mean age of 21.5±12.7 years (range, 6.8–69.7 years), 68 eyes (14.0%) showed DCA progression, with 88 lesion changes. The first appearance of DCA was identified in 21 eyes (23.9%). Of 88 eyes with DCA at baseline, 47 eyes (53.4%) showed progression, with 67 lesion changes, including 45 eyes (67.2%) with enlargement of DCA, 17 (25.3%) with a first appearance of lacquer cracks, 4 (6.0%) with development of patchy chorioretinal atrophy and 1 (1.5%) with increased numbers of lacquer cracks. Longer axial length (p<0.001), baseline DCA (p=0.005) and baseline DCA closer to the fovea (p=0.013) predicted DCA progression. Eyes had poorer BCVA at the follow-up if DCA was enlarging (p<0.001) or DCA was closer to the fovea at baseline (p=0.028) after adjusting for age,gender and cataract.ConclusionApproximately half of the participants with DCA had progression over a 4-year follow-up. Enlargement and newly developed DCA were common progression patterns. Larger areas of DCA and foveal involvement with DCA could be indicators of a worse BCVA later.

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Optic Coherence Tomography Angiography Findings of Bilateral Choroidal Neovascularization Associated with Optic Disc Drusen Treated with Intravitreal Aflibercept Injection

Case Reports in Ophthalmological Medicine ◽

10.1155/2020/8398054 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Melih Akıdan ◽

Mehmet Bulut ◽

Lütfiye Yaprak ◽

Muhammet Kazım Erol ◽

Elcin Suren

Keyword(s):

Optic Disc ◽

Choroidal Neovascularization ◽

Fundus Photography ◽

Vascular Density ◽

Optic Coherence Tomography ◽

Main Trunk ◽

Optic Disc Drusen ◽

Intravitreal Aflibercept ◽

The Right ◽

Sd Oct

Purpose. The purpose of this case report is to present the findings of optical coherence tomography angiography (OCTA) of a patient with bilateral choroidal neovascularization (CNV) associated with optic disc drusen (ODD), who was treated with intravitreal aflibercept injection. Case presentation. A 14-year-old girl presented with a complaint of visual loss and metamorphopsia in her both eyes. Best-corrected visual acuity (BCVA) was 20/32 and 20/25, respectively, in the right and left eyes. Intraocular pressure and anterior segment examination were normal. Dilated fundus examination revealed elevated optic discs with blurred margins in both eyes. In addition, slightly elevated yellow lesion extending from optic nerve head to the macula was observed bilaterally. The patient underwent imaging with colour fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), spectral-domain optic coherence tomography (SD-OCT), OCTA, orbital ultrasonography (USG), and computed tomography (CT). In particular, OCTA demonstrated clearly the large circular CNV complex in the right eye and the CNV structure in the left eye containing slightly activated main trunk and minimal vessel loops in the papillomacular region. CNV secondary to bilateral ODD was suspected. Intravitreal aflibercept injections were performed in 3 doses to the right eye and a single dose to the left eye. After the injections, BCVA reached its complete level in both eyes. SD-OCT revealed irregularity of RPE in the temporal region of the optic disc and complete regression of the subretinal fluid. Interestingly, the entire CNV complex including the main trunk completely disappeared in OCTA. CNV complex was not observed in OCTA during 1-year follow-up, and peripapillary and macular vascular density measurements did not show any significant change. BCVA was preserved, and no additional injections were needed. Conclusion. It is possible that OCTA can be used for detailed evaluation of CNV associated with ODD, response to anti-VEGF treatment, and peripapillary and macular vascular density. There is a need for further studies to confirm the changes such as disappearance of CNV in OCTA after injection as we observed in our patient.

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Electrophysiological and Structural Changes in Chinese Patients with LHON

Journal of Ophthalmology ◽

10.1155/2020/4734276 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Min Wang ◽

Hong Guo ◽

Shiying Li ◽

Gang Wang ◽

Yanling Long ◽

...

Keyword(s):

Ganglion Cell ◽

Optic Disc ◽

Retinal Ganglion Cell ◽

Structural Changes ◽

Chinese Patients ◽

Fundus Photography ◽

Inner Plexiform Layer ◽

Retinal Ganglion ◽

Group 2 ◽

Group 1

Objective. To review retrospectively the electrophysiological and structural changes in 13 Chinese patients with Leber hereditary optic neuropathy (LHON). Methods. 26 eyes of 13 patients with a genetically confirmed diagnosis of LHON were categorized into two groups according to the duration of the disease: group 1 (duration less than 3 months) and group 2 (duration between 3 months and 18 years). Clinical history, comprehensive visual electrophysiology, optical coherence tomography (OCT), and color fundus photography were performed. Results. Fundoscopy showed optic disc hyperemia in group 1 and optic atrophy in group 2. OCT measures of retinal nerve fiber layer (RNFL) thickness around the optic disc and surrounding macula were normal in group 1 but reduced in group 2 (10 of 10 eyes). The thickness of the retinal ganglion cell layer (GCL) plus inner plexiform layer (IPL) surrounding the macula reduced significantly in group 1 and group 2 compared with a healthy control group. Pattern ERG (PERG) P50 amplitude was normal, but the N95/P50 ratio reduced in most of group 1 (4 of 5 eyes) and in all of group 2 (11 eyes). PERG P50 peak time was abnormally short in group 2. Multifocal electroretinography (mfERG) showed subnormal responses associated with ring 1 (the central area) and ring 2 in group 1 and reductions in rings 1, 2, and 3 in group 2. Conclusion. The study highlights differences in retinal structure and function between the acute and chronic stages of LHON in a group of Chinese patients. There is PERG evidence of retinal ganglion cell dysfunction and OCT evidence of GCL + IPL thinning in both groups, but there is additional peripapillary RNFL loss in the chronic stage, associated with more severe RGC dysfunction. There is multifocal ERG evidence of localized macular dysfunction in both acute and chronic groups. The study highlights the importance of comprehensive electrophysiological and structural assessments of the retina in LHON and is pertinent to studies that aim to monitor disease progression or the effects of future therapeutic interventions.

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Decreased choroidal and scleral thicknesses in highly myopic eyes with posterior staphyloma

Scientific Reports ◽

10.1038/s41598-021-87065-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Un Chul Park ◽

Eun Kyoung Lee ◽

Bo Hee Kim ◽

Baek-Lok Oh

Keyword(s):

Choroidal Thickness ◽

Structural Changes ◽

Meta Analysis ◽

Cross Sectional Study ◽

Pathologic Myopia ◽

Sectional Study ◽

Cross Sectional ◽

Swept Source ◽

Posterior Staphyloma ◽

Myopic Maculopathy

AbstractIn this cross-sectional study, we investigated choroidal thickness (CT) and scleral thickness (ST) in highly myopic eyes and their associations with ocular factors. Patients underwent widefield swept-source optical coherence tomography (OCT) to measure the CT and ST at the subfovea and 3000 μm superior, inferior, temporal, and nasal to the fovea and macular curvature. A total of 237 eyes (154 patients) were included. At all five measurement points, thinner CTs and STs were associated with longer axial lengths (r = − 0.548 to − 0.357, all P < 0.001) and greater macular curvatures (r = − 0.542 to − 0.305, all P < 0.001). The CT and ST were significantly thinner in eyes with posterior staphyloma than in those without at all measurement points (all P ≤ 0.006) but did not differ between eyes with the wide macular and narrow macular type of staphyloma. Eyes with myopic maculopathy of category ≥ 3 according to the International Meta-Analysis for Pathologic Myopia classification had significantly thinner CTs and STs than those with category ≤ 2 (all P ≤ 0.005). In highly myopic eyes, a decrease in the CT and ST was more pronounced in eyes with more structural changes, such as longer axial length, steeper macular curvature, and the presence of posterior staphyloma.

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Bilateral juxtapapillary choroidal neovascularization secondary to Birdshot chorioretinopathy -- case report

10.22541/au.161483816.62051911/v1 ◽

2021 ◽

Author(s):

Sania Vidas Pauk ◽

Nenad Vukojević ◽

Sonja Jandroković ◽

Miro Kalauz ◽

Martina Tomić ◽

...

Keyword(s):

Case Report ◽

Macular Edema ◽

Choroidal Neovascularization ◽

High Myopia ◽

Vision Loss ◽

Detailed Examination ◽

Central Vision ◽

Birdshot Chorioretinopathy ◽

Central Vision Loss ◽

The Right

Central vision loss, photopsia, floaters and macular edema in a highly myopic patient can easily be misrelated to high myopia complications. However, in atypical cases, detailed examination along with a thorough diagnostic is required to establish the right diagnosis, which is often beyond the limits of the condition originally considered.

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

10.21203/rs.3.rs-1038132/v1 ◽

2021 ◽

Author(s):

Wenquan Tang ◽

Xuanchu Duan ◽

Junyi Ouyang ◽

YuLin Luo ◽

Xilang Wang

Keyword(s):

Optic Nerve ◽

Optic Nerve Head ◽

High Myopia ◽

Structural Changes ◽

Pathologic Myopia ◽

Disease Development ◽

Pathological Changes ◽

Choroidal Perfusion ◽

Morphology Changes

Abstract This study explored morphology and microcirculation changes of optic nerve head (ONH) in simple high myopia(SHM) and pathologic myopia(PM), in order to evaluate and identify ONH changes in the development of PM. We divided 193 right eyes of 193 patients into SHM and PM according to the retinopathy. We found that ONH is one of the earliest pathological changes in myopia, and its morphology changes were also the most obvious. PM is closely linked to the reduction of choroidal perfusion and structural changes of ONH. Microcirculation showed a significant priority changes in myopia. Further research should address whether these fndings are associated with future disease development in highly myopic eyes.

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