Pathologic Findings in Pathologic Myopia

Grossniklaus, H. E.; Wr, Green

doi:10.1097/00006982-199212020-00009

Cited by 458 publications

(285 citation statements)

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“…The evidence of transitional changes as the SD-OCT scan moved from the lacquer cracks to the patchy atrophy indicates that patchy chorioretinal atrophy involves an area with greater thinning of the choroid than that which occurs in the area associated with lacquer cracks, and that NIR images show brighter reflectance in areas of patchy chorioretinal atrophy than in lacquer cracks. As indicated by other studies, 3,4,11 patchy chorioretinal atrophy is probably a more advanced phase of myopic maculopathy than lacquer cracks. Similar NIR hyperreflectance correlated to a lack of choroid was observed in eyes from the patients with choroideremia (Figure 4a).…”

Section: Nir Of Lacquer Cracks and Correlation With Sd-octsupporting

confidence: 53%

“…6,10 Its prevalence ranges from 4.3-9.2% in highly myopic eyes. 4,10,11 Several studies have reported that lacquer cracks represent linear breaks in Bruch's membrane and are associated with retinal hemorrhage and subretinal neovascularization. [11][12][13] The histopathology of patients affected by lacquer cracks that can enable correlation with clinical presentation has rarely been reported.…”

Section: Introductionmentioning

confidence: 99%

“…4,10,11 Several studies have reported that lacquer cracks represent linear breaks in Bruch's membrane and are associated with retinal hemorrhage and subretinal neovascularization. [11][12][13] The histopathology of patients affected by lacquer cracks that can enable correlation with clinical presentation has rarely been reported. Grossniklaus and Green analyzed 308 eyes with pathological myopia and found breaks in Bruch's membrane in two eyes (0.6%) with both lacquer cracks and subretinal neovascularization.…”

Section: Introductionmentioning

confidence: 99%

“…Grossniklaus and Green analyzed 308 eyes with pathological myopia and found breaks in Bruch's membrane in two eyes (0.6%) with both lacquer cracks and subretinal neovascularization. 11 However, there have been till now no histopathological studies on lacquer cracks without retinal hemorrhage or subretinal neovascularization.…”

Section: Introductionmentioning

confidence: 99%

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Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes

Liu

Lai

et al. 2014

Eye

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Purpose To compare multimodal imaging in detecting lacquer cracks in highly myopic eyes, and to correlate these findings with those of spectral-domain optical coherence tomography (SD-OCT). Methods An observational case series study. Patients with a refractive error worse than À 8 diopters and lacquer cracks were recruited. The rates of detection of the lacquer cracks using multimodal imaging including near-infrared reflectance (NIR) imaging, fundus autofluorescence (FAF) imaging, and fluorescence angiography (FA) were compared. The characteristic findings of multimodal imaging were correlated with those of SD-OCT. Results NIR imaging was more sensitive (92.9%) in detecting lacquer cracks than either FAF (12.5%) or FA (67.9%). Lacquer cracks showed hyperreflectance on NIR, and they were consistently associated with a continuous retinal pigment epitheliumBruch's membrane complex, thinner choroid, and acoustic shadows on SD-OCT. Conclusions NIR imaging is superior to blue laser light (FAF and FA) imaging in detecting lacquer cracks. SD-OCT in combination with NIR located primary pathological lacquer cracks in the intact retinal pigment epithelium-Bruch's membrane complex as well as thinner choroid. These findings indicate that multimodal cSLO and SD-OCT imaging allow for detecting of lacquer cracks in highly myopic eyes.

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Section: Nir Of Lacquer Cracks and Correlation With Sd-octsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes

Liu

Lai

et al. 2014

Eye

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“…In addition, chorioretinal atrophy within the staphyloma might weaken the adherence between the sensory retina and retinal pigment epithelium (RPE). 12 Within the foveal detachment, subretinal fluid is poorly pumped out due to RPE atrophy within the area of chorioretinal atrophy.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with foveoschisis and foveal detachment without macular hole in high myopia

Chen

et al. 2007

Eye

126

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Purpose To investigate the associated factors of foveoschisis and foveal detachment without macular hole in highly myopic eyes. Methods A cross-sectional study of 124 eyes of 68 highly myopic patients was performed. The patients underwent complete ocular examination, fundus photography, and optical coherence tomography (OCT). Results Of the 124 eyes, 10 (8%, 10/124) had foveoschisis or foveal detachment without a macular hole on OCT examination. On the basis of univariate analysis, six variables were associated with the pathologic changes, including age over 40 years (P ¼ 0.018), spherical equivalent over 10 D (P ¼ 0.042), axial length over 31 mm (P ¼ 0.001), macular chorioretinal atrophy (P ¼ 0.00003), posterior staphyloma (P ¼ 0.0003), and vitreoretinal interface factors, including epiretinal membrane, posterior vitreoschisis, and vitreomacular traction (P ¼ 0.00002). In the multivariate analysis, three factors were independently associated with foveoschisis and foveal detachment without macular hole in high myopia: axial length, macular chorioretinal atrophy, and vitreoretinal interface factors. Conclusions Foveoschisis and foveal detachment without macular hole are sight-threatening disorders in highly myopic eyes. Axial length, macular chorioretinal atrophy, and vitreoretinal interface factors were independently associated with these pathological conditions. Thus, both intraocular and outer ocular wall factors play important roles and merit further study.

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Subretinal Surgery for Choroidal Neovascularization in Patients With High Myopia

Uemura

Thomas²

2000

Arch Ophthalmol

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To analyze the visual outcome in patients undergoing surgical removal of subfoveal choroidal neovascularization (CNV) in eyes with high myopia. Methods: We retrospectively reviewed the medical records of 48 consecutive patients with high myopia (Ն6 diopters [D]) who underwent vitrectomy with surgical removal of subfoveal CNV. The patient population consisted of 2 groups. Group 1 included 23 patients with findings only of myopic degeneration, and group 2 included 25 patients with presumed ocular histoplasmosis syndrome and myopia of 6 D or more. Results: In group 1, the visual acuity improved by 2 or more Snellen lines in 9 eyes (39%), decreased in 8 eyes (35%), and remained unchanged in 6 (26%), with a mean follow-up of 24 months (range, 8-60 months). The preoperative visual acuity was 20/40 or better in only 1 eye (4%), but 8 (35%) achieved a final visual acuity of 20/40 or better. In group 2, the visual acuity improved in 16 eyes (64%), was stable in 4 (16%), and deteriorated in 5 (20%), with a mean follow-up of 18 months (range, 6-44 months). Only 3 eyes (12%) had a preoperative visual acuity of 20/40 or better, but 11 (44%) achieved a final visual acuity of 20/40 or better. Recurrence occurred in 13 (57%) of the 23 eyes in group 1 and in 9 (36%) of the 25 eyes in group 2. Univariate analysis demonstrated a significant relation between younger patient age (group 1) and absence of postoperative CNV recurrence (group 2) and an improvement of visual acuity (PϽ.01). Conclusions: Surgical removal of CNV may provide visual benefit in selected cases of subfoveal CNV associated with high myopia. The determination of whether surgical intervention is appropriate in these cases requires a prospective, randomized, clinical trial.

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Pathologic Findings in Pathologic Myopia

Cited by 458 publications

References 0 publications

Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes

Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes

Factors associated with foveoschisis and foveal detachment without macular hole in high myopia

Subretinal Surgery for Choroidal Neovascularization in Patients With High Myopia

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