The noninvasive retro-mode imaging of confocal scanning laser ophthalmoscopy in myopic maculopathy: a prospective observational study

Abstract

Purpose To investigate the morphological features of myopic maculopathy with a new and noninvasive retro-mode imaging (RMI) technique using a confocal scanning laser ophthalmoscope. Methods A total of 42 patients (69 eyes) with myopic maculopathy were included. RMI combined with fundus photography, fundus fluorescein angiography, and optical coherence tomography together were used to observe and evaluate the morphological features of disease. Results Four in 4 eyes (100%) with macular retinoschisis were found with a characteristic pattern by RMI (firework pattern centrally with surrounding fingerprint pattern). Twenty-four in 24 eyes (100%) with pigment proliferation were found by RMI as dark plain patches, and 23 in 24 eyes with hemorrhage (95.8%) were found by RMI as gray bump. Atrophy of different degrees (12 in 14 eyes, 85.7%) was found by RMI as an area of pseudo-3D choroidal vessels or a fuzzy shadow but both without a clear boundary. Choroidal neovascularization (12 in 16 eyes, 75%) was identified laboriously by RMI as a vague raised region. Lacquer cracks were difficult to figure out in RMI. Conclusions Retinoschisis, pigment proliferation, hemorrhage, and atrophy secondary to myopic maculopathy have characteristic morphologic features in RMI; however, choroidal neovascularization and lacquer crack are not easily distinguishable in RMI.

Diagnostic accuracy of OCTA and OCT for myopic choroidal neovascularisation: a systematic review and meta-analysis

“…Amongst the five studies identified as being on-topic, two evaluated OCTA [ 25 , 28 ], two evaluated spectral domain (SD) OCT [ 24 , 27 ], and one conducted evaluations of OCTA and SD-OCT [ 26 ]. The three studies assessing test accuracy of OCTA reported complete data on a total of 95 participants (101 eyes) [ 25 , 26 , 28 ], whilst the three studies evaluating SD-OCT reported complete data on 130 participants (161 eyes) [ 24 , 26 , 27 ]. Mean (standard deviation) age was 55.90 (7.71) years in the OCTA studies and 53.91 (11.10) years in the SD-OCT studies.…”

“…Negative control group: Excluded patients with co-existing retinal conditions, or previous ocular treatments in the study eye. 36 eyes of 28 patients (23 female, 5 male) Included in analysis: 21 eyes of 17 patients (14 female, 3 male) Mean age 57.8 ± 14.5 years Negative control group: 32 eyes of 32 patients (27 female, 5 male) Mean age 56.2 ± 14.4 years, range 26–84 OCTA vs FA a : Sensitivity 19/21, specificity 30/32 Su et al 2014 [ 27 ] Prospective study of patients who presented to a macular service centre in China with high myopia (<−6D and AL > 26.5 mm) and myopic maculopathy. Excluded patients with other retinal or choroidal diseases, or dense cataracts.…”

“…One study was assessed as high risk of bias in four out of seven bias scoring domains [ 28 ]. One study was assessed as high risk of bias in two out of seven bias scoring domains [ 27 ], whilst the remaining study was rated high risk of bias in one of the seven bias scoring domains [ 25 ]. See Fig.…”

Understanding Pathologic Myopia

“…9.12). Applying retro-mode imaging, a characteristic fingerprint and firework pattern at the corresponding area of a macular retinoschisis have been detected in the region of a macula retinoschisis [44,45]. Shimada et al have classified myopic traction maculopathy according to its location and extent from S0 through S4: S0: no retinoschisis; S1: extrafoveal; S2: foveal; S3: both foveal and extrafoveal but not the entire macula; and S4: entire macula [46].…”

Retromode Imaging Modality of Epiretinal Membranes

“…This enables the formation of pseudo-3D images, through the creation of a shadow to one side of the abnormal feature that is being investigated, which eventually enhances the contrast of the lesion. Knowing the ability of infrared lasers to penetrate deeper retinal layers, retromode imaging with infrared laser-technology has been used to evaluate retinal pathological changes in several retinal and choroidal diseases [ 5 ].…”