Prevalence of posterior staphyloma and factors associated with its shape in the Japanese population

Abstract

Myopia is increasing rapidly worldwide. We performed a cross-sectional study to investigate the prevalence of posterior staphyloma, a complication of myopia, and its shape characteristics in relation to age, sex, and axial length (AL) in a Japanese community-based cohort. The right eyes of 3748 participants who underwent fundus photography and optical coherence tomography (OCT) examination were evaluated. Posterior staphyloma prevalence was evaluated using fundus photographs and OCT images. Furthermore, fundus shapes were analyzed by measuring local fundus curvatures on 6 mm cross-line OCT images at intervals of 1 µm. The mean and variance of the curvatures were calculated to represent the fundus shape of each eye for investigation of the relationship between fundus curvature and age, sex, and AL. Seventy-seven eyes (2.05%) had posterior staphyloma. The mean and variance of the fundus curvatures were significantly greater in women than in men and became greater with age, suggesting that the shape of the staphyloma was steeper and less smooth in women and elderly subjects. AL and mean curvature showed a significant correlation (P = 2 × 10−16, R = 0.480), which was significantly affected by age (P < 2 × 10−16). Quantitative analysis of fundus shapes was useful for statistical analysis of posterior staphyloma in relation to age, sex, and AL.

Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide‐field optical coherence tomography in Singapore adults with high myopia

“…They reported in two hospital‐based studies that, in high myopic eyes with SE < −8 D or AL > 26.5 mm, posterior staphyloma was detected in 75 of 100 eyes (75%) (mean SE = −12.2 ± 4.1 D, mean AL = 30.0 ± 2.3 mm, mean age = 67.9 ± 10.7 year) using a 14 × 16 mm WF‐OCT (Shinohara et al 2017) and 482 of 729 eyes (66.1%) (mean SE = –13.7 ± 4.8 D, mean AL = 30.2 ± 2.1 mm, mean age = 63.2 ± 12.5 year) using a 23 × 20 mm ultra‐WF‐OCT (Shinohara et al 2018). Their reported presences of posterior staphyloma were much higher than that of our study (20.9%), while the previously reported prevalence of posterior staphyloma in high myopic eyes varied from 19% to 90% with different diagnostic methods (Numa et al 2018). The reasons for this wide variation in the prevalence rates may due to the use of different OCTs or other methods, differences in the recruitment of the study populations (referred patients visiting the high myopia clinic versus general population), as well as differences in age, SE and AL.…”

“…As demonstrated in our population‐based study (Fig. 3) and a Japanese community‐based study, which used a conventional 6 mm cross‐line OCT and detected 10.9% of high myopic eyes (AL ≥ 26 mm) with posterior staphyloma(Numa et al 2018), the prevalence of posterior staphyloma increased significantly at older age, longer AL and more myopic SE levels. The recent WF‐OCT enables the visualization of the choroid and sclera over a wide area of the posterior pole.…”

Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide‐field optical coherence tomography in Singapore adults with high myopia

“…They reported in two hospital‐based studies that, in high myopic eyes with SE < −8 D or AL > 26.5 mm, posterior staphyloma was detected in 75 of 100 eyes (75%) (mean SE = −12.2 ± 4.1 D, mean AL = 30.0 ± 2.3 mm, mean age = 67.9 ± 10.7 year) using a 14 × 16 mm WF‐OCT (Shinohara et al 2017) and 482 of 729 eyes (66.1%) (mean SE = –13.7 ± 4.8 D, mean AL = 30.2 ± 2.1 mm, mean age = 63.2 ± 12.5 year) using a 23 × 20 mm ultra‐WF‐OCT (Shinohara et al 2018). Their reported presences of posterior staphyloma were much higher than that of our study (20.9%), while the previously reported prevalence of posterior staphyloma in high myopic eyes varied from 19% to 90% with different diagnostic methods (Numa et al 2018). The reasons for this wide variation in the prevalence rates may due to the use of different OCTs or other methods, differences in the recruitment of the study populations (referred patients visiting the high myopia clinic versus general population), as well as differences in age, SE and AL.…”

“…As demonstrated in our population‐based study (Fig. 3) and a Japanese community‐based study, which used a conventional 6 mm cross‐line OCT and detected 10.9% of high myopic eyes (AL ≥ 26 mm) with posterior staphyloma(Numa et al 2018), the prevalence of posterior staphyloma increased significantly at older age, longer AL and more myopic SE levels. The recent WF‐OCT enables the visualization of the choroid and sclera over a wide area of the posterior pole.…”

Exploration of Choroidal Thinning Located Temporal to the Fovea: A Pilot Study

“…Despite the importance of PS as a hallmark of pathologic myopia [37], many unknowns remain; current pathogenetic hypotheses [17,19] do not explain all its characteristics, nor its specific locations on the eye wall which underpin its classification. While we observed ChT in 70% of eyes, PS is described in 0.7% to 2.5% of eyes in population studies [38,39]. Furthermore, PS does not occur in all eyes with high myopia [40].…”

Understanding Posterior Staphyloma in Pathologic Myopia: Current Overview, New Input, and Perspectives

“……”

Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide‐field optical coherence tomography in Singapore adults with high myopia

“…They reported in two hospital‐based studies that, in high myopic eyes with SE < −8 D or AL > 26.5 mm, posterior staphyloma was detected in 75 of 100 eyes (75%) (mean SE = −12.2 ± 4.1 D, mean AL = 30.0 ± 2.3 mm, mean age = 67.9 ± 10.7 year) using a 14 × 16 mm WF‐OCT (Shinohara et al 2017) and 482 of 729 eyes (66.1%) (mean SE = –13.7 ± 4.8 D, mean AL = 30.2 ± 2.1 mm, mean age = 63.2 ± 12.5 year) using a 23 × 20 mm ultra‐WF‐OCT (Shinohara et al 2018). Their reported presences of posterior staphyloma were much higher than that of our study (20.9%), while the previously reported prevalence of posterior staphyloma in high myopic eyes varied from 19% to 90% with different diagnostic methods (Numa et al 2018). The reasons for this wide variation in the prevalence rates may due to the use of different OCTs or other methods, differences in the recruitment of the study populations (referred patients visiting the high myopia clinic versus general population), as well as differences in age, SE and AL.…”

“…As demonstrated in our population‐based study (Fig. 3) and a Japanese community‐based study, which used a conventional 6 mm cross‐line OCT and detected 10.9% of high myopic eyes (AL ≥ 26 mm) with posterior staphyloma(Numa et al 2018), the prevalence of posterior staphyloma increased significantly at older age, longer AL and more myopic SE levels. The recent WF‐OCT enables the visualization of the choroid and sclera over a wide area of the posterior pole.…”

Exploration of Choroidal Thinning Located Temporal to the Fovea: A Pilot Study

“…Despite the importance of PS as a hallmark of pathologic myopia [37], many unknowns remain; current pathogenetic hypotheses [17,19] do not explain all its characteristics, nor its specific locations on the eye wall which underpin its classification. While we observed ChT in 70% of eyes, PS is described in 0.7% to 2.5% of eyes in population studies [38,39]. Furthermore, PS does not occur in all eyes with high myopia [40].…”

Understanding Posterior Staphyloma in Pathologic Myopia: Current Overview, New Input, and Perspectives

“……”

Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide‐field optical coherence tomography in Singapore adults with high myopia

“…They reported in two hospital‐based studies that, in high myopic eyes with SE < −8 D or AL > 26.5 mm, posterior staphyloma was detected in 75 of 100 eyes (75%) (mean SE = −12.2 ± 4.1 D, mean AL = 30.0 ± 2.3 mm, mean age = 67.9 ± 10.7 year) using a 14 × 16 mm WF‐OCT (Shinohara et al 2017) and 482 of 729 eyes (66.1%) (mean SE = –13.7 ± 4.8 D, mean AL = 30.2 ± 2.1 mm, mean age = 63.2 ± 12.5 year) using a 23 × 20 mm ultra‐WF‐OCT (Shinohara et al 2018). Their reported presences of posterior staphyloma were much higher than that of our study (20.9%), while the previously reported prevalence of posterior staphyloma in high myopic eyes varied from 19% to 90% with different diagnostic methods (Numa et al 2018). The reasons for this wide variation in the prevalence rates may due to the use of different OCTs or other methods, differences in the recruitment of the study populations (referred patients visiting the high myopia clinic versus general population), as well as differences in age, SE and AL.…”

“…As demonstrated in our population‐based study (Fig. 3) and a Japanese community‐based study, which used a conventional 6 mm cross‐line OCT and detected 10.9% of high myopic eyes (AL ≥ 26 mm) with posterior staphyloma(Numa et al 2018), the prevalence of posterior staphyloma increased significantly at older age, longer AL and more myopic SE levels. The recent WF‐OCT enables the visualization of the choroid and sclera over a wide area of the posterior pole.…”

Exploration of Choroidal Thinning Located Temporal to the Fovea: A Pilot Study

“…Despite the importance of PS as a hallmark of pathologic myopia [37], many unknowns remain; current pathogenetic hypotheses [17,19] do not explain all its characteristics, nor its specific locations on the eye wall which underpin its classification. While we observed ChT in 70% of eyes, PS is described in 0.7% to 2.5% of eyes in population studies [38,39]. Furthermore, PS does not occur in all eyes with high myopia [40].…”

Understanding Posterior Staphyloma in Pathologic Myopia: Current Overview, New Input, and Perspectives

“……”