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Wei Liu, Gezhi Xu, Chunhui Jiang; Observation of Posterior Paravascular Lamellar holes by Spectral-Domain Optical Coherence Tomography in Highly Myopic Eyes. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2711.
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To characterize posterior paravascular lamellar holes in patients with highly myopia and to further understanding of lamellar hole pathogenesis by spectral-domain optical coherence tomography (SD-OCT)
A cross-sectional retrospective study of 160 eyes of 88 highly myopic patients was performed. All patients had a complete ophthalmologic examination, including stereoscopic fudus observations and SD-OCT examination. Multiple five-line raster scans by SD-OCT were made along the entire extend of the posterior vascular arcade and across the fovea in each eye. The morphologic alterations and the incidence of pathologies such as vitreoretinal traction, retinoshisis/foveoschisis, internal limiting membrane (ILM) abnormalities including ILM detachment, interruption and fragment, vitreoschisis and foveoschisis were evaluated.
Of the 160 highly myopic eyes, 33 eyes (20.6%) had posterior paravascular lamellar holes on OCT examination. Compared to the group without paravascular lamellar holes, the group with paravascular lamellar holes has elder age(56±9years vs. 40±15years, p=0.001 Mann-Whitney U test), higher spherical equivalent (-13D±3.6D vs.-10±3.7D, P=0.013), longer axial length (29.1±1.4mm vs. 27.8±1.8mm, p=0.003),higher incidence of posterior staphyloma (91% vs. 42%) and foveoschisis (73% vs. 7.1%).In the multivariate analysis, age (p=0.003) and posterior staphyloma (p=0.026) were independently associated with paravascular lamellar holes in highly myopia. At the sites of lamellar holes, OCT examinations showed inner retinocysts in 31eyes (94%), retinoschisis in 23eyes (70%), ILM abnormalities in 16 eyes (48.5%,), vitreoretinal traction in 11 eyes (33.3%), vitreoschisis in 4 eyes (12%).
Posterior paravascular lamellar holes were not uncommon in highly myopia, especially in older patients with posterior staphyloma. Multiple factors including vitroretinal traction, ILM abnormalities, adherent vitreous plaques contraction, and retinoschisis, were associated with the formation of posterior paravascular lamellar holes in highly myopia. Furthermore, paravascular lamellar holes might contribute to the development of myopic foveoschisis. SD-OCT provides detailed information about this abnormality and allowed a further understanding for this pathological condition.
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