Investigation Of The Classification And Characteristic Of Myopic Maculopathy And Its Correlation With Retinoschisis In High Myopic Eyes

Objective:To study the correlation between retinoschisis and different types of fundus disease in high myopia and evaluate the different types of morphologic characteristics in highly myopic eyes.Methods: In this cross-sectional study,116 participants(174 eyes)were enrolled.We collected their information including best corrected visual acuity(BCVA),eye axial length,diopter,fundus photograph and optical coherence tomography(OCT)graph.The characteristics and types of macular degeneration were judged by two doctors through consultation,according to the fundus color photography.The types of retinoschisis were determined and recorded according to OCT.Independent sample t test or one-way ANOVA were used to compare the numeric data such as BCVA,eye axial length and age,while Chi square test(Fisher ’s exact probability method)was used to compare the numerical data,linear regression analysis was used for correlation test.Results: There were 37 males(53 eyes)and 79 females(121 eyes),their mean age was 54.0 ± 14.1 years,mean axial length was 28.68 ±1.81 mm,and the diopter range from-6.0D to-26.0D.The distribution of fundus disease was: Type1,no macular lesions(C0)in 10 eyes(8%),Type2,tessellated fundus(C1)in 74 eyes(60%),Type 3,diffuse chorioretinal atrophy(C2)in 36 eyes(29%),Type 4,patchy chorioretinal atrophy(C3)in25 eyes(20%)and Type 5,macular atrophy(C4)in 29 eyes(23%).Particularly,C1 was the most common type of those fundus diseases,accompany with better visual acuity,lower diopter,and smaller axial length.Retinoschisis was detected in 70 eyes(40.2%)among the Type 1,2,3,and 4,and it occurred most frequently in type C4 fundus lesions(65.52%).It can be divided into S0: no macular retinoschisis 104 eyes(60%),S1:extrafoveal retinoschisis 38 eyes(22%),S2: foveal retinoschisis 6 eyes(3%),S3: both fovea and extrafovea but not the entire macula retinoschisis 8 eyes(5%),S4: entire macula retinoschisis 18 eyes(10%).Obviously,S1 is the most common type.Both axial length and age were highly correlated to macular degeneration or retinoschisis.Besides,we found 37 cases(52.9%)suffered retinoschisis accompany with incomplete posterior vitreous detachment,which appeared in the prophase of myopic maculopathy more often,while 43 eyes(61.4%)suffered retinoschisis accompany with epiretinal membrane,appeared in the later period,and the epiretinal membrane was highly correlated to macular degeneration and retinoschisis.Conclusions:1.Type C1 tessellated fundus lesions are the most common in high myopia with better vision,relatively small diopter and axial length.2.Both axial length and age are strong risk factors of macular degeneration or retinoschisis in high myopia patients.From C0 to C4 showing progressive degeneration of high myopia.3.Based on fundus color photography combined with OCT shows the highest prevalence of retinoschisis in highly myopia patients with macular atrophy,which S1 occurred most frequently,but retinoschisis does not directly reflect the degree of fundus degeneration.4.Epiretinal membrane is an important degenerative pathological changes in the eyes of high myopia,which is correlated with macular degeneration or retinoschisis.It often occurs in the late stage of degenerative high myopia.