ABSTRACT
AIM:To observe the changes of macular morphology and microcirculation in myopic maculopathy(MM), and investigate theirs correlation and effects on vision.METHODS: Case-control study. A total of 165 patients(189 eyes)with high myopia and 154 healthy volunteers(154 eyes)from October 2016 to December 2018 were selected. According to the classification of Meta-analysis for pathologic myopia(META-PM), participants were divided into M0 group(category 0, 41 eyes), M1 group(category 1, 53 eyes), M2 group(category 2 and 3, 52 eyes), and myopic choroidal neovascularization(mCNV)group(43 eyes). All participants underwent optical coherence tomography angiography(OCTA)examination. Morphological and microcirculation parameters of retina at different layers were compared between groups. Pearson correlation was used to assess the correlation between morphological and microcirculation parameters. Correlations between vision and other parameters were analyzed using multiple linear regression analysis.RESULTS:Foveal full retinal thickness(FRT)and outer retinal thickness(ORT)were all lower in M0, M1 and M2 groups than those of control group(all P<0.01). Foveal superficial capillary plexus vessel density(SVD)and deep capillary plexus vessel density(DVD)were all lower in M2 and mCNV groups than those of the control group(all P<0.01). Parafoveal FRT and ORT were all lower in M0, M1, M2 and mCNV groups than those of the control group(all P<0.01). Parafoveal inner retinal thickness(IRT), SVD and DVD were all lower in M2 and mCNV groups than those of the control group(all P<0.01). Subfoveal choroidal thickness(SFCT)and choroid capillaries vessel density(CVD)were all lower in M0, M1, M2 and mCNV groups than those of the control group(all P<0.01). Foveal vessel density of retina and choroid were positively correlated with its thickness in patients with MM without CNV(all P<0.05). Multivariate analysis showed that axial length(AL), diffuse or patchy chorioretinal atrophy were influencing foctors of best corrected visual acuity(BCVA; all P<0.01).CONCLUSION:Retinal morphological changes precede microcirculation changes in MM. Most of all, ORT changes precede IRT changes. Foveal vessel density of retina and choroid were positively correlated with its thickness. The main influencing factors of BCVA were AL and types of MM.
ABSTRACT
A patient, being a moderate myope with an axial length of 24.71 mm, presented to us with a fresh rhegmatogenous retinal detachment and marked peripheral chorioretinal degeneration. Difficulty in maneuvering with the standard 23 gauge vitrectomy cutter, inability to identify the break due to poor peripheral contrast, inadequate laser uptake, and an unusual large silicon oil fill (7.3 ml) were a few findings raising suspicion. Postoperative ocular ultrasonography showed an oblate eyeball with a relatively longer oblique axis (26.1 mm) as compared to the axial length confirming our suspicion. Oblateness should be suspected when the chorioretinal degenerations are more marked in the periphery as compared to the posterior pole. Intraoperative difficulties should be kept in mind while operating such cases.
ABSTRACT
@#AIM:To evaluate changes in peripapillary atrophy(PPA)and retinal in young adults with high myopia(HM)for three years.<p>METHODS:A total of 22 HM patients(<i>n</i>=32 eyes, >-9 D), 35-45y, were enrolled in this self-controlled retrospective review. The following parameters were measured at baseline and 3-year follow-up visits: area of optic nerve head(ONH); area of peripapillary atrophy(PPA); area of peripapillary chorioretinal atrophy(PCA); type of PPA; average retinal thickness(ART); and total central retinal volume(TCRV). <p>RESULTS: There were no changes in the area of ONH(<i>t</i>=0.95, <i>P</i>=0.35)between baseline and 3-year follow-up visits. In contrast, the areas of PPA and PCA were significantly greater(0.69±0.71 and 0.57±0.97mm<sup>2</sup>,respectively)at the 3-year follow-up versus baseline(<i>t</i>=-3.99, <i>P</i>=0.001 and <i>t</i>=-2.33, <i>P</i>=0.03, respectively)visits. There were no changes in the type of the PPA. ART and TCRV did not differ significantly at the 3-year follow-up versus baseline visits(<i>P</i>>0.05).<p>CONCLUSION:Increased areas of PCA and PPA are the main fundus features of HM(>-9 D)in young adults. PPA and PCA should be important morphological parameters during follow-up for HM in clinic.
ABSTRACT
PURPOSE: To report a case of chorioretinal atrophy after photodynamic therapy to subfoveal choroidal neovascular membrane. METHODS: We followed up the photodynamic treatment to a 57-year-old woman who complained of the falling of vision in her right eye for 2 months and was diagnosed with subfoveal choroidal neovascular membrane at our institution. Since the size of neovascular membrane increased 3 month after the first photodynamic treatment, the patient underwent retreatment. Concentric chorioretinal atrophy developed around the laser applied site 3 months after retreatment, and enlargement of the atrophy area occurred 2 years later. In multifocal electroretinography, the retinal function of the chorioretinal atrophic eye was not decreased compared with the other eye. RESULTS: The choroids collateral circulation damage or direct drug photochemical effect was thought to be the cause of the chorioretinal atrophy after photodynamic treatment at the laser applied site but there is no functional decline of the atrophic retina.