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Xiaodong Sun, Tong Li, Fenghua Wang; Observation of Paravascular Abnormalities by Optical Coherence Tomography and Relation to Retinoschisis in Highly Myopic Eyes.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5492.
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To investigate the retinal features and distribution of paravascular abnormalities (PVAs) and its relationship with retinoschisis and myopic maculopathy classification in highly myopic eyes.
The cross-sectional study evaluated 152 eyes of 88 patients with high myopia who had undergone complete ophthalmic examinations. Multiple optical coherence tomography (OCT) scans were performed to study the microstructural alterations at retinal vascular arcades and entire macular area. Myopic maculopathy was classified based on the International Classification of Myopic Maculopathy. The presence of various PVAs, retinoschsis, myopic maculopathy and the association between these parameters were analyzed.
Of the 152 highly myopic eyes, PVAs were detected by OCT in 126 eyes (82.9%), including paravascular microfolds in all 126 eyes, paravscular cysts in 108 eyes (71.1%), and paravascular lamellar holes in 40 eyes (26.3%). Patients with PVAs were significantly older, had higher spherical equivalent (SE), longer axial length (AL), higher incidence of retinoschisis at vascular arcades and macular retinoschisis. All the three types of PVAs were observed more frequently along the temporal vascular arcades than the nasal vascular arcades (P < 0.005). All of the 78 eyes (51.3%) with retinoschsis at vascular arcades had PVAs. Retinoschisis at vascular arcades was observed most frequently in eyes with all three types of PVAs ( P < 0.001) and was independently correlated with age, AL, paravascular cysts and lamellar holes. Macular retinoschisis was detected in 26 eyes (17.1%) and was associated with SE, presence of traction structure at macular area and inner limiting membrane (ILM) detachment at vascular arcades. PVAs were most frequently demonstrated in fundus with diffuse chorioretinal atrophy.
Highly myopic eyes were susceptible of PVAs, and the lesions were mainly observed along the temporal vascular arcades. The development of macular retinoschsis could be a result of progression of myopia and intraocular forces, especially the traction of vitreous at macular area, and the splitting of ILM along the vascular arcades which is associated with the formation of paravascular lamellar holes. The incidences of PVAs differed in eyes with various categories of myopic maculopathy. Retinae retaining integrity and thickness were more likely to be affected by PVAs.
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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