Patchy Scotoma Observed in Chorioretinal Patchy Atrophy of Myopic Macular Degeneration

Lo, Jung; Poon, Yi-Chieh; Chen, Yi-Hao; Kuo, Hsi-Kung; Chen, Yung-Jen; Chiang, Wen-Son; Wu, Pei-Chang

doi:10.1167/iovs.61.2.15

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…However, it is uncommon for extrafoveal patchy atrophy to later involve the central fovea. This means that it is rare for patchy atrophy to cause the central vision loss although this lesion leads to a paracentral absolute scotoma 123 owing to a loss of photoreceptors within the atrophic area ( Table 3 ).…”

Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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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.

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Section: Clinical Aspects Of Pathologic Myopiamentioning

confidence: 99%

IMI Pathologic Myopia

Ohno‐Matsui

Yamashiro

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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192

159

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“…This finding was in concordance with Lo et al's study, in which they reported reduced retinal sensitivity in regions beyond the atrophic lesions. 23 Another key finding was that MS decreased significantly with reduced deep retinal PD (b = 0.15, P = 0.004) but not with superficial PD (b = 0.03, P = 0.62), suggesting that sparser DCP may be related to functional impairment in MMD. This finding is in line with Tsui et al's observation that DCP was associated with MS in the temporal and nasal sectors in HM but not SVP.…”

Section: Discussionmentioning

confidence: 92%

“…This finding was in concordance with Lo et al's study, in which they reported reduced retinal sensitivity in regions beyond the atrophic lesions. 23…”

Section: Discussionmentioning

confidence: 99%

Macular Sensitivity and Capillary Perfusion in Highly Myopic Eyes With Myopic Macular Degeneration

Zheng

Chua

Sim

et al. 2022

Retina

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Purpose: To evaluate the interrelationship between macular sensitivity and retinal perfusion density (PD) in eyes with myopic macular degeneration (MMD).Methods: One hundred and thirty-eight highly myopic eyes from 82 adult participants were recruited. Macular sensitivity was evaluated using the Microperimeter MP-3. Retinal PD was measured using the PLEX Elite 9000 swept source optical coherence tomography angiography. Macular sensitivity values between different categories of MMD and its relationship with optical coherence tomography angiography measurements were evaluated using multivariable linear mixed models, adjusting for age and axial length.Results: Macular sensitivity reduced with increasing severity of MMD (b # 20.95, P , 0.001), whereas the best-corrected visual acuity was not associated with MMD severity (P . 0.04). Persons who were older (b = 20.08, P , 0.001), with longer axial length (b = 20.32, P = 0.005), presence of macular diffuse choroidal atrophy (b = 22.16, P , 0.001) or worse MMD (b = 25.70, P , 0.001), and presence of macular posterior staphyloma (b # 22.98, P , 0.001) or Fuchs spot (b = 21.58, P = 0.04) were associated with reduced macular sensitivity. Macular sensitivity was significantly associated with deep retinal PD in MMD (b = 0.15, P = 0.004) but not with superficial retinal PD (P = 0.62).Conclusion: There was a strong correlation between reduced macular sensitivity and increasing MMD severity, even in mild MMD independent of the best-corrected visual acuity. Furthermore, macular sensitivity was correlated with deep retinal PD, suggesting a vasculature-function relationship in MMD.

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“…In eyes with PA lesions (namely, category 3 myopic maculopathy), the mean retinal sensitivity was lowest at zone 1 testing points, which were within or at the border of the PA lesion, followed by the adjacent points of zone 2 and distant points of zone 3, suggesting a gradual change in retinal sensitivity across the junctional zone of the PA lesion. These results imply that microperimetry is a useful functional assay to assess altered retinal function in patients with myopic maculopathy, particularly to detect scotoma and subtle functional decline around the atrophic lesion in patients with PA. 17 The completeness of hyperreflective lines of the RPE and photoreceptors in OCT also decreased gradually across the margin of PA lesions, reflecting the differences in retinal sensitivity among the zones. Thus, it could be concluded that anatomical and functional alterations also involve the adjacent region of the PA lesion, which significantly influences retinal sensitivity.…”

Section: Discussionmentioning

confidence: 97%

Association of Retinal Sensitivity With Optical Coherence Tomography Microstructure in Highly Myopic Patients

Park

Yoon

Bae

et al. 2022

Invest. Ophthalmol. Vis. Sci.

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Purpose To investigate the association of retinal sensitivity with microstructural features in optical coherence tomography (OCT) of high myopic eyes. Methods This cross-sectional study included 78 eyes (78 patients). Microstructural features on spectral-domain OCT, such as the integrity of the retinal pigment epithelium (RPE), ellipsoid zone (EZ), and external limiting membrane (ELM) and outer retinoschisis, were evaluated at each retinal location corresponding to microperimetric testing points. Results For all testing points, retinal sensitivity was significantly associated with the integrity of the RPE, EZ, and ELM (all P < 0.001) based on OCT but not with outer retinoschisis ( P = 0.183). A higher category of myopic maculopathy according to the Meta-Analysis of Pathologic Myopia classification was associated with lower mean retinal sensitivity ( P < 0.001). In eyes with patchy atrophy (PA), mean retinal sensitivity of testing points adjacent to the PA lesion (15.7 ± 6.8 dB) was greater than points within or at the PA border (2.6 ± 5.2 dB; P < 0.001) but lower than distant points (19.6 ± 4.3 dB; P < 0.001). Microstructural features in OCT were well correlated with the differences in retinal sensitivity according to myopic maculopathy severity and proximity to the PA lesion. Conclusions In highly myopic eyes, retinal sensitivity on microperimetry was strongly associated with microstructural features in OCT. Both retinal sensitivity and microstructure were affected by the severity of myopic degeneration and proximity to the PA lesion.

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Patchy Scotoma Observed in Chorioretinal Patchy Atrophy of Myopic Macular Degeneration

Cited by 8 publications

References 30 publications

IMI Pathologic Myopia

IMI Pathologic Myopia

Macular Sensitivity and Capillary Perfusion in Highly Myopic Eyes With Myopic Macular Degeneration

Association of Retinal Sensitivity With Optical Coherence Tomography Microstructure in Highly Myopic Patients

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