Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (3): 83-87.doi: 10.6040/j.issn.1673-3770.0.2022.528

• 论著 • Previous Articles    

Association of macular retinoschisis severity with choroidal parameters in patients with high myopia

YOU Ran, GUO Xiaoxiao, WANG Wei, CHEN Xi, WANG Yanling   

  1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
  • Published:2023-05-24

Abstract: Objective This study aimed to evaluate the characteristics and clinical significance of macular choroidal parameters according to the different severity classifications of retinoschisis in patients with high myopia. Methods This cross-sectional study included 74 patients(74 eyes)diagnosed with high myopia of grades T0~T3, according to the atrophy-traction-neovascularization(ATN)classification, from January 2019 to March 2022 at the Ophthalmology Department of the Beijing Friendship Hospital, which is affiliated with the Capital Medical University. Of these patients, there were 20 male(20 eyes)and 54 female(54 eyes)patients with a mean age of(64.3±11.2)years and axial length(AL)of 29.2±2.78 mm. All patients underwent enhanced depth imaging optical coherence tomography. They were then classified as having T0, T1, T2, or T3 grades(n=20, 23, 18, and 13 eyes, respectively)according to the severity of their lesions based on the ATN classification. The choroidal thickness of multiple parts of the fovea was measured, and the macular choroidal volume(MCV)was calculated using the MATLAB software. Correlation analysis of the different parameters was performed. Differences between the groups were compared using univariate and multivariate analyses. Results The mean MCV of the patients in the T0, T1, T2, and T3 groups was(4.6±2.3)mm3,(3.1±1.2)mm3,(2.9±1.3)mm3, and(2.1±1.1)mm3, respectively, and the differences between these groups were statistically significant(P=0.006). The best corrected visual acuity of patients in the T1-T3 groups was significantly lower than that of patients in the T0 group. The AL and absolute value of the spherical equivalent were significantly higher(P<0.05), while the subfoveal choroidal thickness(SFCT)was significantly lower(P<0.05)than those in the T0 group. Differences in the value of the spherical equivalent between the T1 and T3 groups and between the T2 and T3 groups and in SFCT and MCV between the T1 and T2 groups and between the T1 and T3 groups were AL- and age-dependent. Meanwhile, differences in SFCT and MCV between the T2 and T3 groups were independent of AL and age. Conclusion The study revealed a gradual decrease in MCV associated with the increasing severity of retinoschisis in patients with high myopia. The change in MCV was affected by AL, age, and other factors.

Key words: High myopia, Retinoschisis, Macular choroidal volume, Atrophy-traction-neovascularization classification, Optical coherence tomography

CLC Number: 

  • R774.5
[1] Takahashi H, Tanaka N, Shinohara K, et al. Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J]. Ophthalmology, 2021, 128(2): 256-265. doi:10.1016/j.ophtha.2020.06.063
[2] Shinohara K, Tanaka N, Jonas JB, et al. Ultrawide-field OCT to investigate relationships between myopic macular retinoschisis and posterior staphyloma[J]. Ophthalmology, 2018, 125(10): 1575-1586. doi:10.1016/j.ophtha.2018.03.053
[3] Li Y, Foo LL, Wong CW, et al. Pathologic myopia: advances in imaging and the potential role of artificial intelligence[J]. Br J Ophthalmol, 2022: bjophthalmol-2021. doi:10.1136/bjophthalmol-2021-320926
[4] Cheong KX, Xu LQ, Ohno-Matsui K, et al. An evidence-based review of the epidemiology of myopic traction maculopathy[J]. Surv Ophthalmol, 2022, 67(6): 1603-1630. doi:10.1016/j.survophthal.2022.03.007
[5] Zheng FH, Wong CW, Sabanayagam C, et al. Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide-field optical coherence tomography in Singapore adults with high myopia[J]. Acta Ophthalmol, 2021, 99(2): e144-e153. doi:10.1111/aos.14527
[6] Sun CB, You YS, Liu Z, et al. Myopic macular retinoschisis in teenagers: clinical characteristics and spectral domain optical coherence tomography findings[J]. Sci Rep, 2016, 6: 27952. doi:10.1038/srep27952
[7] Xiao W, Zhu ZT, Odouard C, et al. Wide-field en face swept-source optical coherence tomography features of extrafoveal retinoschisis in highly myopic eyes[J]. Invest Ophthalmol Vis Sci, 2017, 58(2): 1037. doi:10.1167/iovs.16-20607
[8] Ruiz-Medrano J, Montero JA, Flores-Moreno I, et al. Myopic maculopathy: current status and proposal for a new classification and grading system(ATN)[J]. Prog Retin Eye Res, 2019, 69: 80-115. doi:10.1016/j.preteyeres.2018.10.005
[9] Ohno-Matsui K, Kawasaki R, Jonas JB, et al. International photographic classification and grading system for myopic maculopathy[J]. Am J Ophthalmol, 2015, 159(5): 877-883.e7. doi:10.1016/j.ajo.2015.01.022
[10] Whitmore SS, Sohn EH, Chirco KR, et al. Complement activation and choriocapillaris loss in early AMD: implications for pathophysiology and therapy[J]. Prog Retin Eye Res, 2015, 45: 1-29. doi:10.1016/j.preteyeres.2014.11.005
[11] Laíns I, Figueira J, Santos AR, et al. Choroidal thickness in diabetic retinopathy: the influence of antiangiogenic therapy[J]. Retina, 2014, 34(6): 1199-1207. doi:10.1097/IAE.0000000000000053
[12] Vujosevic S, Martini F, Cavarzeran F, et al. Macular and peripapillary choroidal thickness in diabetic patients[J]. Retina, 2012, 32(9): 1781-1790. doi:10.1097/iae.0b013e31825db73d
[13] Li ZX, Wang W, Liu R, et al. Choroidal thickness predicts progression of myopic maculopathy in high myopes: a 2-year longitudinal study[J]. Br J Ophthalmol, 2021, 105(12): 1744-1750. doi:10.1136/bjophthalmol-2020-316866
[14] Jonas JB, Xu L. Histological changes of high axial myopia[J]. Eye(Lond), 2014, 28(2): 113-117. doi:10.1038/eye.2013.223
[15] Zhou LX, Shao L, Xu L, et al. The relationship between scleral staphyloma and choroidal thinning in highly myopic eyes: the Beijing Eye Study[J]. Sci Rep, 2017, 7(1): 9825. doi:10.1038/s41598-017-10660-z
[16] Hsia Y, Wang SW, Huang CJ, et al. Clinical characteristics of highly myopic patients with asymmetric myopic atrophic maculopathy-analysis using multimodal imaging[J]. Invest Ophthalmol Vis Sci, 2021, 62(3): 21. doi:10.1167/iovs.62.3.21
[17] Du R, Xie SQ, Igarashi-Yokoi T, et al. Continued increase of axial length and its risk factors in adults with high Myopia[J]. JAMA Ophthalmol, 2021, 139(10): 1096-1103. doi:10.1001/jamaophthalmol.2021.3303
[18] Ueda E, Yasuda M, Fujiwara K, et al. Five-year incidence of myopic maculopathy in a general Japanese population: the hisayama study[J]. JAMA Ophthalmol, 2020, 138(8): 887-893. doi:10.1001/jamaophthalmol.2020.2211
[19] Igarashi-Yokoi T, Shinohara K, Fang YX, et al. Prognostic factors for axial length elongation and posterior staphyloma in adults with high Myopia: a Japanese observational study[J]. Am J Ophthalmol, 2021, 225: 76-85. doi:10.1016/j.ajo.2020.11.023
[20] 尤冉, 郭笑霄, 陈曦, 等. 高度近视患者视网膜和脉络膜形态结构研究[J]. 临床和实验医学杂志, 2018, 17(22): 2396-2400. doi:10.3969/j.issn.1671-4695.2018.22.013 YOU Ran, GUO Xiaoxiao, CHEN Xi, et al. Retinal and choroidal morphology in 32 patients with high myopia[J]. Journal of Clinical and Experimental Medicine, 2018, 17(22): 2396-2400. doi:10.3969/j.issn.1671-4695.2018.22.013
[21] Ohno-Matsui K, Jonas JB. Posterior staphyloma in pathologic myopia[J]. Prog Retin Eye Res, 2019, 70: 99-109. doi:10.1016/j.preteyeres.2018.12.001
[22] Ohno-Matsui K, Fang Y, Shinohara K, et al. Imaging of pathologic myopia[J]. Asia Pac J Ophthalmol(Phila), 2019, 8:172-177. doi: 10.22608/APO.2018494
[23] Yan YN, Wang YX, Yang Y, et al. Ten-year progression of myopic maculopathy: the Beijing eye study 2001-2011[J]. Ophthalmology, 2018, 125(8): 1253-1263. doi:10.1016/j.ophtha.2018.01.035
[24] Hirata A, Negi A. Morphological changes of choriocapillaris in experimentally induced chick myopia[J]. Graefe's Arch Clin Exp Ophthalmol, 1998, 236(2): 132-137. doi:10.1007/s004170050053
[25] Ohno-Matsui K, Takahashi H, Mao ZX, et al. Determining posterior vitreous structure by analysis of images obtained by AI-based 3D segmentation and ultrawidefield optical coherence tomography[J]. Br J Ophthalmol, 2023, 107(5):732-737. doi:10.1136/bjophthalmol-2021-320131
[26] Fang YX, Du R, Nagaoka N, et al. OCT-based diagnostic criteria for different stages of myopic maculopathy[J]. Ophthalmology, 2019, 126(7): 1018-1032. doi:10.1016/j.ophtha.2019.01.012
[1] ZHAO Lu, TIAN Huiwen, MENG Bo, WANG Wei, WANG Yanling. Analysis of macular retinal-choroidal thickness changes in patients with internal carotid artery occlusion [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 72-76.
[2] XIONG Pianpian, WANG Jialin, SUN Jiao, ZHOU Zhuohua, WANG Yanling. Analysis of retinal choroidal blood flow changes and correlation with tessellated fundus in highly myopic eyes [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 114-121.
[3] ZHAO Hongxiao, ZHANG Han. Effect of optical amplification on measurement of ganglion cell complex [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 105-109.
[4] LI Pengwei, SU Guangming, LIU Jiangchuan, MU Yalin. Application of optical coherence tomography angiography in macular telangiectasia type 2 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 140-144.
[5] TANG Feiran, KONG XiangyunOverview,SHEN JiaquanGuidance. Research progress in the role of OCTA in measuring superficial peripapillary vessel density in the diagnosis and treatment of glaucoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 77-82.
[6] YANG Ru, ZHANG Yuguang, XU Xianghui, WU Xuelian, TAO Yuan, TAN Yue. A clinical study on the effect of phacoemulsification on the retinal structure in the macular region of senile cataract [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 97-102.
[7] ZHANG Min,LI Yan. Research progress of optical coherence tomography and angiography in the diagnosis of Alzheimer's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 157-162.
[8] LI Yingying, FENG Jie,LI Wei, DING Tianjiao. Effects of ischemic stroke and other neurodegenerative diseases on RNFL thickness [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 163-168.
[9] ZHANG Xinyu,,LEI Chunyan, ZHANG Meixia. Retinochoriodal changes associated with silicone oil tamponade detected by optical coherence tomography and optical coherence tomography angiography [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 132-136.
[10] Ocular ischemic syndrome(OIS)is usually undiagnosed or misdiagnosed due to its asymptomatic onset, complicated ocular manifestations, and the lack of awareness, and patients with OIS have a higher mortality. Improving the understanding, diagnosis, and treatment of OIS through multidisciplinary collaboration is key to investigating and preventing systemic vascular events as well as decreasing blindness and mortality. This review summarizes the recent advances in the epidemiology, clinical diagnosis, and management of OIS.. Recent ocular ischemic syndrome advancesWANG Luping Overview HUANG Yingxiang, WANG Yanling Guidance Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 23-27.
[11] Spectral-domain optical coherence tomography(SD-OCT)was used to measure and observe the characteristics of the subfoveal choroidal thickness(SFCT)in patients with ocular ischemic syndrome(OIS)as well as explore the indicators for early evaluation of OIS. MethodsThis was a retrospective case-control study. Forty-eight patients(48 eyes)were included between January 2017 and January 2020. The patients were divided into two groups: the OIS and the control groups, with each consisting of 24 patients(24 eyes). Their basic information, including age, gender, body mass index(BMI), and the history of diabetes, hypertension, and hyperlipidemia, was collected. SFCT was measured using SD-OCT in EDI mode. The basic data and SFCTs of the two groups were compared. ResultsThere were no significant differences between the ages, gender, BMIs, and the prevalence of diabetes, hypertension, and hyperlipidemia of the two groups(all P>0.05). The mean SFCT of the OIS group was 204.83±27.34 μm, and that of the control group was 226.58±33.49 μm. The differences between the two groups were statistically significant(t=2.464, P=0.018). ConclusionsSFCT was thinner in patients with OIS. SFCT can be used as an indicator for early assessment of OIS.. Analysis of choroidal thickness in patients with ocular ischemic syndromeFU Qiang, WANG Hongxing Department of Ophthalmology, Beijing Chuiyangliu Hospital, Beijing 100022, ChinaAbstract: Objective〓 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 60-63.
[12] ObjectiveTo analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). MethodsThis was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. ResultsThere were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). ConclusionsAmong the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.. Association between the classification of blood pressure and retinal vessel diameter measured by SD-OCTFENG Xue1, WANG Haiwei2, LI Wensi1, YANG Xintong1, SUN Cun1, ZHAO Yuan1, ZHAO Pengbo1, ZHANG Jianqiang1 1. Department of Ophthalmology, Beijing Moslem People's Hospital, Beijing 100054, China; 2. Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing 100038, ChinaAbstract: [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(4): 64-68.
[13] ZHANG Jing, TAO Ye, LI Fusheng, WANG Shen, QU Dongyi, LI Ying, ZHOU Yuehua. Analysis of the advantages of flaps created with an optical coherence tomography-guided femtosecond laser [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 17-21.
[14] LIANG Gang, MA Rong, ZHANG Fengju. Early clinical observations of intraoperative corneal stromal pocket irrigation with dexamethasone in small incision lenticule extraction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 22-31.
[15] WAN Bo, LI Donghui, LUO Yan, LI Ying. Lens vault changes and associated factors after implantation of implantable collamer lenses with central flow [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 36-41.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!