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T.-C. Ho, Y.-F. Shih, S.-Y. Lin, L. Lin, M.-S. Chen; Development of Peripapillary Break in Pathologic Myopia - A Newly Recognized Retinal Lesion Detected by Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5738.
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Optical coherence tomography (OCT) was used to detect peripapillary break (PPB) over the disc crescent in pathologic myopia. The development of retinal neural tissue loss located inside the disc crescent in pathologic myopia is a newly recognized fundus lesion.
Review of thirteen eyes of thirteen patients with peripapillary yellowish-white retinal lesions who underwent OCT for evaluation of the nature of PPNTL in pathologic myopia. OCT, fluorescein angiography, automated visual fields, axial length measurement with ultrasound A scan.
Thirteen eyes of thirteen patients were identified during a 16-year period to have findings characteristic of PPNTL. The mean age of the patients was 46 years. They were followed up for an average of 10 years. The mean spherical equivalent correction was -10.25 diopters (D) (range -6.0--16.0 D). The mean axial length was 28.9 mm (range 26.30-31.50mm). In each case, OCT showed a complete retinal discontinuity in the PPNTL lesion. Automated visual field examination showed corresponding arcuate scotoma. During the follow-up period, the inner retina layer of the retinal defect margin was elevated by posterior hyaloid and partial retinal detachment developed in one eye. Extreme atrophic change of neural retina and intrachoroidal cavitation formation were found in another eye.
PPB in pathologic myopia is a relatively asymptomatic, yellowish-white peripapillary retinal discontinuity. Recognition of this lesion is important because the visual field defect may mimic glaucomatous changes owing to the loss of nerve fiber layer. Progressive partial retinal detachment may ensue as one of the complications of the peripapillary lesion, which may result from extreme atrophic changes of junctional thinning or tractional avulsion of neural retina.
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