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Pamela Sherwood, Jamie Leong, Stanley Chang, Gemmy Cheung, Quan Hoang; Posterior Eye Wall Radius of Curvature as a Measure of Staphyloma Progression in Myopic Foveoschisis Patients as Gauged by Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5843.
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Myopic progression occurs in up to 50% of myopic patients. In such eyes, the development of posterior staphyloma may be associated with vision-threatening myopic maculopathy such as foveoschisis, atrophy or choroidal neovascularization. We evaluate the utility of optical coherence tomography (OCT) in assessing the posterior eye wall in patients with myopic posterior staphyloma and determine if a change in staphyloma radius of curvature immediately precedes progression of myopic foveoschisis.
Spectral Domain OCT images (Cirrus, macular cube) obtained from 8 eyes of 8 myopic foveoschisis patients before and during progression were retrospectively reviewed. Central horizontal and vertical images through the fovea were exported and manually segmented to focus on the retinal pigment epithelial (RPE) layer. RPE radius of curvature and root mean square deviation were calculated by curve-fitting in MatLab, and horizontal and vertical values were averaged.
Among pathologic myopia patients who experienced progression of myopic foveoschisis, the results show that a change in radius (within a patient) is not associated with progression. On average, patients experienced a decrease in RPE radius of curvature of 0.06 mm, which is associated with a 2.6 % point increase in the likelihood of experiencing myopic foveoschisis progression. Specifically, our linear regression yielded a coefficient of -0.42 and standard error of 0.97. Given the average decrease in RPE radius of curvature of -0.06 mm (+0.7 to -0.8, n = 8), this translates to an increased likelihood of foveoschisis progression of 2.6 % points, which is a large effect, but not statistically significant (p = 0.68).
RPE radius of curvature is a valid and readily available tool for assessing and tracking myopic staphyloma. Initial studies do not suggest that a change in RPE radius of curvature immediately precedes foveoschisis progression.
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