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Fenghua Wang, Xiaohan Wang; Posterior Vitreous Detachment in High Myopia Eyes with Macular Disorders. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5484. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Posterior vitreous detachment plays a critical role in traction maculopathy, ie. EMT, laminar hole, and epiretinal membrane. In this study, enhanced high-definition optical coherence tomography scans were performed to observe the prevalence of different types of myopic traction maculopathy and their correlation with posterior vitreous status.
In this cross-sectional study, myopic eyes were examined using the enhanced vitreous imaging (EVI) mode and enhanced depth imaging (EDI) mode. According to the findings of vitreous, the eyes were divided into four groups: PPVP group (posterior precortical vitreous pockets), VA group (vitreous adhesion), ERM group (epiretinal membrane), and NA group (no adhesion). The types and location of myopic traction maculopathy were recorded and the correlation of epiretinal traction and posterior viterous adhesion were analyzed.
224 highly myopic eyes of 138 patients were included in this study. Among the 224 highly myopic eyes , the vitreous status of 47 eyes (20.9%) was classified as PPVP status ; that of 55 eyes (24.6%) as VA status; that of 45 eyes (20.0%) as ERM status; that of 77 eyes (34.3%) as NA status . Retinoschisis that included extrafoveal retinoschisis and retinoschisis involved the fovea detected in VA group (40 eyes of 55 eyes, 72.7%)and ERM group(30 eyes of 45 eyes, 66.7%) were more than that in the NA group(25 eyes of 77 eyes, 32.5%, P<0.00001). Highly myopic eyes from PPVP group were younger, less myopia, and had shorter axial length than highly myopic eyes of the other three groups. Hyperreflective lines and dots that may be related to vitreous degeneration can be observed on the vitreoretinal interface and no any types of myopic traction maculopathy were found in PPVP group. There were multiple abnormalities of MTM found in VA and ERM groups, also, the prevalence of most types of abnormalities were higher than NA group.
Vitreoschisis occurred before the formation of traction maculopathy in most in highly myopic eyes. Residual vitreous and epiretinal membrane adhesion can facilitate the formation of myopic traction maculopathy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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