Clinical and Morphologic Features of Posterior Staphyloma Edges by Ultra-Widefield Imaging in Pathologic Myopia

Abstract

Purpose: To investigate morphologic features along posterior staphyloma edges in eyes with pathologic myopia using ultra-widefield optical coherence tomography imaging.Methods: Highly myopic patients (refractive error , 28 diopters or axial length $26.5 mm) were consecutively examined by prototype ultra-widefield optical coherence tomography with a scan width of 23 mm and depth of 5 mm. Staphyloma edges were assessed for scleral, choroidal, and retinal status, as well as measurements of angle size. Findings were correlated with pigmentary changes observed on Optos fundus photography, and multivariate logistic regression analyses were performed.Results: In 164 eyes diagnosed with posterior staphyloma by ultra-widefield optical coherence tomography, choroidal thinning and scleral protrusion were hallmark features of staphyloma edges, observed simultaneously in more than 95% of staphylomatous eyes. Outer neural retinal thinning was observed in 80 eyes (48.8%), whereas 15 eyes (9.1%) showed retinal pigment epithelium damage. The mean angle at the staphyloma edge was 23°± 12.4°(range 8°to 77°). Larger angles were significant predictors of retinal thinning (adjusted odds ratio: 1.17, confidence interval: 1.09-1.25), and the staphyloma was detected by Optos pseudocolor fundus photography (adjusted odds ratio: 1.08, confidence interval: 1.02-1.15).Conclusion: These morphologic findings may provide a basis for exploring the natural evolution of posterior staphyloma as part of the development of pathologic myopia.

Anomalies of Choroidal Venous Structure in Highly Myopic Eyes

“…As the bending angles were not uniform along the entire circumference of the staphyloma, we measured the steepness of the superior, inferior, nasal, and temporal edges according to a reported method. 25 With each selected radial scanning line of the WF-OCT, two tangent lines were drawn along the surface of the retinal pigment epithelium, and the angle between the two lines was measured as the staphyloma angle. The MNV history was defined as past or existing MNV at the time of the first WF-ICGA examination or MNV development during the follow-up period.…”

Anatomic Peculiarities Associated with Axial Elongation of the Myopic Eye

“…Scleral staphylomas are a feature of highly myopic eyes. They have been described as outpouchings of a circumscribed region of the posterior sclera [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. Scleral staphylomas show a relatively abrupt scleral thinning at the staphyloma edge; a pronounced de-arrangement of scleral collagen fibrils; a marked, segmentally accentuated, choroidal thinning, most marked at the staphyloma border; and spatially correlated BM defects.…”

“…Elevations in the foveal region of highly myopic eyes can be differentiated into dome-shaped maculas and macular ridges [ 37 , 143 , 144 , 145 , 146 , 147 , 148 , 149 ]. A dome-shaped macula is a circular inward protrusion of the macula and is associated with a higher prevalence of macular BM defects and a relative thickening and relative inward protrusion of the central sclera and choroid.…”

Impact of peripapillary staphylomas on the vascular and structural characteristics in myopic eyes: a propensity score matching analysis

“…To the best of our knowledge, this phenomenon has not been previously reported and the mechanisms to explain anterior segments anatomical abnormalities remains unclear. Liu and colleagues [18] reported that eyes with more apparent PS visible on fundus imaging had significantly shorter AL than the eyes without fundus pigmentary changes. As PS angle size (an index of describing the edge of the PS) increased, AL significantly decreased.…”