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

Zheng, Feihui; Wong, Chee‐Wai; Sabanayagam, Charumathi; Cheung, Yin‐Bun; Matsumura, Saiko; Chua, Jacqueline; Man, Ryan Eyn Kidd; Ohno‐Matsui, Kyoko; Wong, Tien‐Yin; Cheng, Ching‐Yu; Tai, E. Shyong; Lamoureux, Ecosse L.; Schmetterer, Leopold; Kuo, Anthony N.; Hoang, Quan V.; Saw, Seang‐Mei

doi:10.1111/aos.14527

Cited by 30 publications

(26 citation statements)

References 40 publications

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“…[7][8][9][10][11] In contrast, MMD represents a spectrum of degenerative-based PM, including chorioretinal atrophy and myopic choroidal neovascularization (CNV). 4,9 MTM is known to be strongly associated with persistent vitreous adhesion, vitreomacular traction, and posterior staphyloma (PS), 8,[12][13][14][15] whereas for MMD, the pathogenic pathway is less clear, aside from its association with ageing and greater axial length (AL). 4,7,16,17 Interestingly, not all highly myopic eyes develop degenerative PM changes, even in the same individual with comparable AL in both eyes.…”

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confidence: 99%

“…These forces may, over time, contribute to atrophic changes in the retina and choroid resulting in MMD. 15 Additionally, MTM represents the inability of the retina to withstand the various tractional forces, 8 that if left unresolved, may ultimately lead to atrophy of the retinal tissue. Beyond PS and MTM, the vitreous itself could be a factor, as an attached posterior hyaloid normally serves as a mechanism to buffer and equally distribute forces on the posterior segment.…”

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confidence: 99%

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Association of Aberrant Posterior Vitreous Detachment and Pathologic Tractional Forces With Myopic Macular Degeneration

Tey

Wong

Dan

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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The purpose of this study was to assess whether the tractional elements of pathologic myopia (PM; e.g. myopic traction maculopathy [MTM], posterior staphyloma [PS], and aberrant posterior vitreous detachment [PVD]) are associated with myopic macular degeneration (MMD) independent of age and axial length, among highly myopic (HM) eyes. METHODS.One hundred twenty-nine individuals with 239 HM eyes from the Myopic and Pathologic Eyes in Singapore (MyoPES) cohort underwent ocular biometry, fundus photography, swept-source optical coherence tomography, and ocular B-scan ultrasound.Images were analyzed for PVD grade, and presence of MTM, PS, and MMD. The χ 2 test was done to determine the difference in prevalence of MMD between eyes with and without PVD, PS, and MTM. Multivariate probit regression analyses were performed to ascertain the relationship between the potential predictors (PVD, PS, and MTM) and outcome variable (MMD), after accounting for possible confounders (e.g. age and axial length). Marginal effects were reported. RESULTS.Controlling for potential confounders, eyes with MTM have a 29.92 percentage point higher likelihood of having MMD (P = 0.003), and eyes with PS have a 25.72 percentage point higher likelihood of having MMD (P = 0.002). The likelihood of MMD increases by 10.61 percentage points per 1 mm increase in axial length (P < 0.001). Subanalysis revealed that eyes with incomplete PVD have a 22.54 percentage point higher likelihood of having MMD than eyes with early PVD (P = 0.04). CONCLUSIONS.Our study demonstrated an association between tractional (MTM, PS, and persistently incomplete PVD) and degenerative elements of PM independent of age and axial length. These data provide further insights into the pathogenesis of MMD.

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confidence: 99%

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confidence: 99%

Association of Aberrant Posterior Vitreous Detachment and Pathologic Tractional Forces With Myopic Macular Degeneration

Tey

Wong

Dan

et al. 2021

Invest. Ophthalmol. Vis. Sci.

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“…Despite consisting of myopes and emmetropes, the sample lacked highly myopic participants with an axial length of >26 mm, which could have led to more pronounced and significant differences and correlation results. Moreover, the prevalence of staphyloma [39] increases with higher degrees of myopia, leading to more irregular retinal shapes and PRX profiles, as well as an unknown relationship between them. The eye model was adjusted for the individual axial length, but not for other optical components, such as corneal curvature.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Methods for Estimating Retinal Shape: Peripheral Refraction vs. Optical Coherence Tomography

Breher

Calabuig

Kühlewein

et al. 2021

JCM

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Retinal shape presents a clinical parameter of interest for myopia, and has commonly been inferred indirectly from peripheral refraction (PRX) profiles. Distortion-corrected optical coherence tomography (OCT) scans offer a new and direct possibility for retinal shape estimation. The current study compared retinal curvatures derived from OCT scans vs. PRX measurements in three refractive profiles (0° and 90° meridians, plus spherical equivalent) for 25 participants via Bland–Altman analysis. The radial differences between both procedures were correlated to axial length using Pearson correlation. In general, PRX- and OCT-based retinal radii showed low correlation (all intraclass correlation coefficients < 0.21). PRX found flatter retinal curvatures compared to OCT, with the highest absolute agreement found with the 90° meridian (mean difference +0.08 mm) and lowest in the 0° meridian (mean difference +0.89 mm). Moreover, a negative relation between axial length and the agreement of both methods was detected especially in the 90° meridian (R = −0.38, p = 0.06). PRX measurements tend to underestimate the retinal radius with increasing myopia when compared to OCT measurements. Therefore, future conclusions from PRX on retinal shape should be made cautiously. Rather, faster and more clinically feasible OCT imaging should be performed for this purpose.

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“…These degenerative changes can occur in any area of the retina and collectively, they are named "pathologic myopia" [12,13]. Older age, higher myopic spherical equivalent, longer axial length [13] are associated with a higher prevalence of myopic maculopathy [14] and posterior staphyloma [15]. In addition, retinal lattice degeneration has also been frequently observed in moderate myopic eyes and it has been postulated that this type of retinal degeneration may contribute to the high prevalence of retinal detachment among moderate myopia patients [16].…”

Section: Introductionmentioning

confidence: 99%

RNA-Seq Analysis Reveals an Essential Role of the Tyrosine Metabolic Pathway and Inflammation in Myopia-Induced Retinal Degeneration in Guinea Pigs

Zeng

Liu³

et al. 2021

IJMS

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Myopia is the second leading cause of visual impairment globally. Myopia can induce sight-threatening retinal degeneration and the underlying mechanism remains poorly defined. We generated a model of myopia-induced early-stage retinal degeneration in guinea pigs and investigated the mechanism of action. Methods: The form-deprivation-induced myopia (FDM) was induced in the right eyes of 2~3-week-old guinea pigs using a translucent balloon for 15 weeks. The left eye remained untreated and served as a self-control. Another group of untreated age-matched animals was used as naïve controls. The refractive error and ocular biometrics were measured at 3, 7, 9, 12 and 15 weeks post-FDM induction. Visual function was evaluated by electroretinography. Retinal neurons and synaptic structures were examined by confocal microscopy of immunolabelled retinal sections. The total RNAs were extracted from the retinas and processed for RNA sequencing analysis. Results: The FDM eyes presented a progressive axial length elongation and refractive error development. After 15 weeks of intervention, the average refractive power was −3.40 ± 1.85 D in the FDM eyes, +2.94 ± 0.59 D and +2.69 ± 0.56 D in the self-control and naïve control eyes, respectively. The a-wave amplitude was significantly lower in FDM eyes and these eyes had a significantly lower number of rods, secretagogin+ bipolar cells, and GABAergic amacrine cells in selected retinal areas. RNA-seq analysis showed that 288 genes were upregulated and 119 genes were downregulated in FDM retinas compared to naïve control retinas. In addition, 152 genes were upregulated and 12 were downregulated in FDM retinas compared to self-control retinas. The KEGG enrichment analysis showed that tyrosine metabolism, ABC transporters and inflammatory pathways were upregulated, whereas tight junction, lipid and glycosaminoglycan biosynthesis were downregulated in FDM eyes. Conclusions: The long-term (15-week) FDM in the guinea pig models induced an early-stage retinal degeneration. The dysregulation of the tyrosine metabolism and inflammatory pathways may contribute to the pathogenesis of myopia-induced retinal degeneration.

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

Cited by 30 publications

References 40 publications

Association of Aberrant Posterior Vitreous Detachment and Pathologic Tractional Forces With Myopic Macular Degeneration

Association of Aberrant Posterior Vitreous Detachment and Pathologic Tractional Forces With Myopic Macular Degeneration

Comparison of Methods for Estimating Retinal Shape: Peripheral Refraction vs. Optical Coherence Tomography

RNA-Seq Analysis Reveals an Essential Role of the Tyrosine Metabolic Pathway and Inflammation in Myopia-Induced Retinal Degeneration in Guinea Pigs

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