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Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Nagahisa Yoshimura, Kyoko Ohno-Matsui; Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2017;58(9):3750-3758. doi: 10.1167/iovs.17-22319.
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© ARVO (1962-2015); The Authors (2016-present)
To examine posterior staphylomas by widefield optical coherence tomography (WF-OCT) and three-dimensional magnetic resonance imaging (3D-MRI).
Highly myopic patients (myopic refractive error >8.0 diopters or axial length >26.5 mm) who had previously undergone orbital 3D-MRI were examined by WF-OCT.
The study included 100 eyes of 57 patients with a mean age of 67.9 ± 10.7 years (range, 44–85 years) and mean axial length of 30.0 ± 2.3 mm (range, 25.1–36.5 mm). All staphylomas detected on the 3D-MRI, except for two very large staphylomas, were visualized on the WF-OCT images. Morphologic hallmarks of the staphylomas were smoothly configured staphyloma border with a gradual thinning of the choroid and an inward protrusion of the sclera at the staphyloma edge. Comparing the detectability of the staphylomas on the WF-OCT images versus 3D-MRI revealed no significant difference between both techniques (P = 0.12; χ2 test). Comparing the staphyloma classification between both techniques showed a good concordance with a concordance index kappa of 0.61 (95% confidence interval: 0.50–0.72). A spatial relationship between the staphylomatous areas and the macula and optic nerve head was observed by WF-OCT.
WF-OCT can provide tomographic images of posterior staphylomas in a resolution and size unachievable so far, and may replace 3D-MRI in assessing posterior staphylomas. Future studies using WF-OCT may explore the detailed morphologic characteristics of posterior staphylomas and give clues to the etiology of staphylomas.
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