June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Macular Bruchs Membrane Defects and Axial Length: Association with Gamma Zone and Delta Zone in Peripapillary Region
Author Affiliations & Notes
  • Jost Jonas
    Ophthalmology, Medical Faculty Mannheim-Heidelberg, Mannheim, Germany
  • Kyoko Ohno-Matsui
    Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
  • Richard Spaide
    Vitreous-Retina-Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY
  • Leonard Holbach
    Department of Ophthalmology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
  • Songhomitra Panda-Jonas
    Ophthalmology, Medical Faculty Mannheim-Heidelberg, Mannheim, Germany
  • Footnotes
    Commercial Relationships Jost Jonas, Allergan (C), MSD (C), Alimera (C), CellMed AG (P); Kyoko Ohno-Matsui, None; Richard Spaide, Topcon (P), Thrombogenics (C), Bausch and Lomb (C); Leonard Holbach, None; Songhomitra Panda-Jonas, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4513. doi:https://doi.org/
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      Jost Jonas, Kyoko Ohno-Matsui, Richard Spaide, Leonard Holbach, Songhomitra Panda-Jonas; Macular Bruchs Membrane Defects and Axial Length: Association with Gamma Zone and Delta Zone in Peripapillary Region. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4513. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: To examine histomorphometrically the macular region of highly myopic eyes

Methods: On horizontal anterior-posterior histological sections, we examined the region of the macula and optic nerve head of 138 human globes (axial length:20-35mm). In the parapapillary region, we differentiated between beta zone (Bruchs membrane without retinal pigment epithelium (RPE)), gamma zone (parapapillary region without Bruchs membrane), and delta zone (elongated and thinned gamma zone).

Results: In 12 (8.7%) eyes, a macular Bruchs membrane defect (MBMD) was detected. The MBMD showed a complete lack of RPE and choriocapillaris, and an almost complete lack of photoreceptors. Presence of MBMD was associated with longer axial length (P<0.001), longer gamma zone (P=0.04) and delta zone (P<0.001), thinner peripapillary scleral flange, and lower thickness of the sclera just outside of the optic nerve meninges (P<0.001) and at the posterior pole (P<0.001). A MBMD was found only in eyes with an axial length of ≥27 mm. Presence of a MBMD was not significantly related to length of beta zone of parapapillary atrophy (P=0.09). In multivariate binary regression analysis, MBMD presence was significantly (P<0.001) associated only with axial length.

Conclusions: Highly myopic eyes (axial length ≥27mm) can show a MBMD associated with complete loss of RPE and choriocapillaris, and marked reduction of photoreceptors and large choroidal vessels. MBMD presence was strongly associated with axial length and indirectly with parapapillary gamma zone and delta zone. The myopia associated secondary MBMDs may occur parallel to the myopia associated widening of Bruchs membrane opening around the optic nerve head.

Keywords: 605 myopia • 688 retina • 585 macula/fovea  

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