| Background and objectiveWith the increasing incidence of myopia,the incidence of pathologic myopia(PM)is increasing yearly.PM is usually binocular,and patients tend to be relatively young.Generally,the vision loss impairment of PM is mainly caused by the pathological changes of the anatomical structure of the eye.Posterior Staphyloma(PS)is the most destructive pathological feature of PM and the main cause of myopic maculopathy.Also,myopic retinoschisis(MRS)is considered the critical step of PM.This research used 3D-MRI to find out on the association between PS and MRS,as well as the relationship between best corrected visual acuity(BCVA)and the risk factors(age,axial length [AL] spherical equivalent [SE],eye shapes,and the PS types)Material and methodsThis retrospective,cross-sectional study included 125 eyes of 65 patients with PM from the Henan Eye Institute,China,whose SE were lower than-8.0D or ALs were longer than 26.5mm.We also collected and analyzed the data of pathological myopic patients’ general demographics,AL,SE,BCVA,3D-MRI image,OCT image,and B-Mode Ultrasound image.According to the changes of eye shape,we divided the eyes into spherical shape,nasal shape,temporal shape,conical shape and cylindrical shape.According to Curtin’s classification,we divided PS into simple staphyloma and complex staphyloma.According to Ohno-Matsui’s classification,we divided PS into wide macular staphyloma,narrow macular staphyloma,peripapillary staphyloma,nasal staphyloma,inferior staphyloma and others.According to the shape of MRS,we divided MRS into inner retinoschisis,outer retinoschisis and mixed retinoschisis.ResultsMost of the patients with bilateral PM had the same eye shape(82.14%)and PS type(80.77%)in both eyes.Nasal eye shape is common among PM patients(41.67%).The complexity of PSs was related to patient’s age(P < 0.01).The complexity and the types of PS were related to patient’s age(P < 0.01).Complex PS was more common in elderly patients than in younger patients(P < 0.01).Eyes with wide macular PS had a longer AL(P = 0.010),high SE(P < 0.05),and worse BCVA(P < 0.01).Moreover,PS with wide macular has longer AL(P = 0.012),worse BCVA(P = 0.049).Most of MRS combined with PS(94.00%),in which the macular types(wide macular and narrow macular)were the majority(88.57%).MRS with the narrow macular type was more likely to involve fovea(P = 0.045).ConclusionsThe eye shapes and PS types of PM patients are related to age.The patients with complex PS are older,and have longer AL,poor vision and lower SE.The occurrence of MRS is associated with PS,which is related to the change of vitreoretinal interface.3D-MRI can more directly observe the morphological changes of the eyeball,and OCT can observe the microscopic changes of the retina.These morphological changes are related to the visual prognosis of PM.Early fundus imaging monitoring is very important for PM patients. |
