Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain oct

Abstract

The purpose of the study is to determine the incidence and distribution of paravascular lamellar holes (PLH) around retinal vessels in highly myopic eyes and their relationship with macular retinoschisis (MR). We examined 306 eyes of 178 patients with high myopia, performing multiple scans of the posterior pole within the retinal vascular arcades using spectral-domain OCT. Type of staphyloma was determined. PLH were divided into three groups: holes only (group 1), holes extending below vessels (group 2), and holes in an area of paravascular retinoschisis (group 3). OCT showed that 96/306 eyes (31.4 %) had PLH mainly along the infero-temporal arcade (39.9 %). Type V and IX staphylomas had a higher proportion of PLH in the infero-temporal arcade than other staphylomas. Group 3 eyes presented higher rates of myopia and staphyloma. MR was detected in 10/27 eyes (37 %) in Group 3, but only in 2/33 eyes (6.1 %) in Group 1. No MR was found in Group 2. PLH are relatively common in highly myopic eyes and mainly distributed in the inferior temporal arcade. Findings from this descriptive study suggest that distribution of PLH might be related to the type of staphyloma. Further studies are needed to evaluate the relevance of PLH in the pathogenesis of MR.

Paravascular abnormalities observed by spectral domain optical coherence tomography are risk factors for retinoschisis in eyes with high myopia

“…Vela et al. () recently reported a higher incidence of paravascular lamellar holes along the inferior temporal vascular arcades and suggested that this result may relate to the type of staphyloma with evidence indicating an inferior shift of staphyloma apex (Ikuno & Tano ; Ohno‐Matsui ). We considered the difference may result from the much higher prevalence of wide macular staphyloma in our study.…”

“…; Vela et al. ). The pathogenesis of lamellar holes detected adjacent to retinal vessels remains unknown.…”

“…However, a recent study reported a full-thickness hole adjacent to the upper nasal retinal arcade in a highly myopic eye (detailed information not shown) (Vela et al 2016). The incidence of paravascular lamellar holes varied among several studies, ranging from 14% to 31.4%, according to different OCT scan protocols (Shimada et al 2008;Kamal-Salah et al 2015;Vela et al 2016). The pathogenesis of lamellar holes detected adjacent to retinal vessels remains unknown.…”

“…; Vela et al. ). Several studies have shown that PVAs may be associated with foveoschisis secondary to high myopia (Shimada et al.…”

“…Recently, various types of paravascular abnormalities (PVAs), including paravascular microfolds, paravascular cysts, and paravascular lamellar holes, have been demonstrated by optical coherence tomography (OCT) in highly myopic eyes (Forte et al 2008;Shimada et al 2008;Vela et al 2016). Several studies have shown that PVAs may be associated with foveoschisis secondary to high myopia (Shimada et al 2008;Kamal-Salah et al 2015).…”