Clinical Features of Patchy Chorioretinal Atrophy in Pathologic Myopia

Du, Ran; Fang, Yuxin; Jonas, Jost B.; Yokoi, Tae; Takahashi, Hiroyuki; Uramoto, Kengo; Kamoi, Koju; Yoshida, Takeshi; Ohno‐Matsui, Kyoko

doi:10.1097/iae.0000000000002575

Cited by 27 publications

(35 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 118 Patchy atrophy was found in 10.5% of patients in a clinic-based Japanese highly myopic cohort. 117 The percentage of patchy atrophy increases linearly with age and reaches 32.5% after age 60 years. 115 The prevalence of patchy atrophy is 3.3% in eyes with an axial length from 27.0 to 27.9 mm, and exceeds 25% and 50% if the axial length is longer than 31 mm and 32 mm, respectively.…”

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 97%

“…109 Owing to an absence of RPE and most of the choroid, the sclera can be observed through transparent retinal tissue. The median size of patchy atrophy was 1.73 mm 2 , varying from 0.03 to 101.3 mm 2 , 117 with the diameter of less than one or more lobules of the choriocapillaris. Pigment clumping is observed within the area of patchy atrophy, especially along the margin of the atrophy or along the large choroidal vessels.…”

Section: Features Of Each Lesion Of Myopic Maculopathymentioning

confidence: 98%

“…Swept source OCT also showed that discontinuities of Bruch's membrane in the area of patchy atrophy. 117 , 120 The RPE terminates outside of the margin of the macular Bruch membrane defect. Patchy atrophy could be regarded as a Bruch's membrane rupture, not solely an atrophy.…”

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

“…In addition, swept source OCT revealed that patchy atrophy and myopic MNV-related macular atrophy were not simply an atrophy, but were a macular Bruch's membrane defect. 117 , 120 , 287 Furthermore, OCT enables to detect new macular lesions which were not identified by fundus photographs, such as myopic traction maculopathy and dome-shaped macula.…”

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

See 3 more Smart Citations

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

Self Cite

192

172

View full text Add to dashboard Cite

Pathologic myopia is a major cause of visual impairment worldwide. Pathologic myopia is distinctly different from high myopia. High myopia is a high degree of myopic refractive error, whereas pathologic myopia is defined by a presence of typical complications in the fundus (posterior staphyloma or myopic maculopathy equal to or more serious than diffuse choroidal atrophy). Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without high myopia. Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. The effectiveness of new therapies for complications have been shown, such as anti-VEGF therapies for myopic macular neovascularization and vitreoretinal surgery for myopic traction maculopathy. Myopia, especially childhood myopia, has been increasing rapidly in the world. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In addition, it has remained unclear whether genes responsible for pathologic myopia are the same as those for myopia in general, or whether pathologic myopia is genetically different from other myopia.

show abstract

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 97%

Section: Features Of Each Lesion Of Myopic Maculopathymentioning

confidence: 98%

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

See 2 more Smart Citations

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

Self Cite

192

172

View full text Add to dashboard Cite

show abstract

“…8 According to a recent clinical study, the region with an RPE loss was larger than the region of the BM defect. 33…”

Section: Bruch Membranementioning

confidence: 99%

Myopia: Anatomic Changes and Consequences for Its Etiology

Jonas

Ohno‐Matsui

2019

Asia-Pacific Journal of Ophthalmology

Self Cite

View full text Add to dashboard Cite

The process of emmetropization is the adjustment of the length of the optical axis to the given optical properties of the cornea and lens after the end of the second year of life. Up to the end of the second year of life, the eye grows spherically. Axial elongation in the process of emmetropization after the second year of life is associated with a thinning of the retina and a reduced density of retinal pigment epithelium (RPE) cells in the equatorial and retroequatorial region, and a thinning of the choroid and sclera, starting at the equator and being most marked at the posterior pole. In contrast, retinal thickness and RPE density in the macular region and thickness of Bruch membrane (BM) in any region are independent of axial length. It led to the hypothesis that axial elongation occurs by the production of additional BM in the equatorial and retroequatorial region leading to a decreased RPE density and retinal thinning in that region and a more tube-like than spherical enlargement of the globe, without compromise in the density of the macular RPE cells and in macular retinal thickness. The increased disc-fovea distance in axially myopic eyes is caused by the development and enlargement of parapapillary, BM-free, gamma zone, whereas the length of macular BM, and indirectly macular RPE cell density, and macular retinal thickness, remain constant.

show abstract

Continued Increase of Axial Length and Its Risk Factors in Adults With High Myopia

Xie

Igarashi-Yokoi

et al. 2021

JAMA Ophthalmol

Self Cite

View full text Add to dashboard Cite

IMPORTANCEPathologic myopia due to an excessive increase of axial length is associated with severe visual impairments. Systematic analyses to determine the rate of and the risk factors associated with the axial elongation in adults with high myopia based on long-term follow-up of a large population are needed.OBJECTIVE To determine the risk factors associated with axial elongation in adults with high myopia.DESIGN, SETTING, AND PARTICIPANTS This cohort study used the medical records of 43 201 patient visits in a single-hospital database that were collected from January 3, 2011, to December 28, 2018. A total of 15 745 medical records with the patients' sex, best-corrected visual acuity (BCVA), axial length, type of myopic maculopathy, and the presence or absence of choroidal neovascularization (CNV) were reviewed. Data were analyzed from April 3, 2019, to August 5, 2020.MAIN OUTCOMES AND MEASURES Changes in the axial length at each examination were calculated. The significance of the associations between the annual increase of the axial length and age, sex, baseline axial length, types of myopic maculopathy, and a history of CNV was determined. Generalized linear mixed models were used to evaluate the strength of the risk factors associated with an increase of the axial length in high myopia.RESULTS Among 1877 patients with 9161 visits included in the analysis, the mean (SD) age was 62.10 (12.92) years, and 1357 (72.30%) were women. The mean (SD) axial length was 29.66 (2.20) mm with a mean (SD) growth rate of 0.05 (0.24) mm/y. Among the 9161 visits, 7096 eyes (77.46%) had myopic maculopathy and 2477 eyes (27.04%) had CNV. The odds ratio for inducing a severe elongation of the axial length was 1.46 (95% CI, 1.38-1.55) for female sex, 0.44 (95% CI, 0.35-0.56) to 0.63 (95% CI, 13 0.50-0.78) for older than 40 years, 1.33 (95% CI, 1.15-1.54) for BCVA of less than 20/400, 1.67 (95% CI, 1.54-1.81) to 2.67 (95% CI, 2.46-2.88) for baseline axial length of 28.15 mm or greater, 1.06 (95% CI, 0.96-1.17) to 1.39 (95% CI, 1.24-1.55) for the presence of maculopathy, and 1.37 (95% CI, 1.29-1.47) for prior CNV.CONCLUSIONS AND RELEVANCE This cohort study found continuing axial elongation in adults with high myopia. The risk factors for elongation do not appear to be modifiable, so prevention of myopia may be the best approach to reduce the incidence of pathologic myopia and its complications in the future.

show abstract

Clinical Features of Patchy Chorioretinal Atrophy in Pathologic Myopia

Cited by 27 publications

References 23 publications

IMI Pathologic Myopia

IMI Pathologic Myopia

Myopia: Anatomic Changes and Consequences for Its Etiology

Continued Increase of Axial Length and Its Risk Factors in Adults With High Myopia

Contact Info

Product

Resources

About