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Fundus changes in high myopia cataract with posterior scleral staphyloma
- YUSUFU·Maierhaba, ABULA·Kelimujiang, DING Lin, QIN Yanli, CHEN Xueyi
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Journal of Otolaryngology and Ophthalmology of Shandong University. 2023, 37(5):
107-114.
doi:10.6040/j.issn.1673-3770.0.2022.354
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Objective To investigate the fundus changes in high myopia cataract with posterior scleral staphyloma. Methods This was a retrospective case-control study, the data of 103 eyes of 68 patients with cataract between August and December 2021 were analyzed. All cases were divided into two groups based on axial length: the high myopia group, with an axial length ≥ 26.5 mm, and the control group, with an axial length of 22.0-24.0 mm. The high myopia group was divided into two subgroups: those with staphyloma and those without staphyloma. Cirrus HD-OCT 5000 was used to measure the retinal thickness(RT), choroidal thickness(CT), retinal nerve fiber layer(RNFL)and optical coherence tomography angiography(OCTA)at the fovea and at 1 000 μm and 3 000 μm from the fovea. Moreover, the optical coherence tomography(OCT)and optical coherence tomography angiography of the macular and optical nerve were measured. All patients were graded according to the ATN classification of high myopia fundus lesions. Results The control group had the best postoperative vision acuity, followed by the high myopia group without staphyloma, while the high myopia group with staphyloma had the worst. The ATN grade of patients with staphyloma was significantly higher than that of patients without staphyloma(P=0.007,0.015,0.001). The high myopia group had thinner RT, CT, and retinal nerve fiber layer(RNFL)compared with those in the control group(P=0.004,0.004,0.001,0.001,0.018,0.001). Moreover, the area of the foveal avascular zone(FAZ)in high myopia group was smaller(P=0.001,0.001)and the optical nerve OCTA blood flow signal was lower(P=0.025,0.001,0.001,0.001,0.026,0.001,0.001,0.001). However, there was no significant difference in OCTA between patients with and without staphyloma(P=0.871,0.964,0.888,0.911,0.765,0.999,0.999,0.806). Conclusion The fundus lesions of high myopia patients with posterior scleral staphyloma are more serious, and this may affect visual recovery after cataract surgery. This may also be related to the RT, CT, RNFL, macular and optic nerve blood flow, and FAZ dysplasia difference.