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Quan V Hoang, Chee Wai Wong, Ian Yeo, Gavin S Tan, Shu Yen Lee, Gemmy Cheung; Characterization of the Shorter Eye in Highly Myopic Patients with more than 3 mm of Axial Anisometropia. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4739.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence of anisometropia of > 3 mm and associated factors among highly myopic (HM) patients.
We retrospectively analyzed a consecutive series of staphylomatous high myopia patients (≤ -6.00 D and/or > 25 mm axial length (AL) in at least 1 eye) who were seen a High Myopia Clinic between 1/2017-11/2017. All patients underwent dilated retinal exam, AL measurement, fundus photography/autofluorescence, and widefield swept source optical coherence tomography.
126 patients (89 female, 62 ± 13 years old, range 19-88) were included. Overall, when excluding unilateral eyes < 25 mm, AL was 29.6 ± 2.3 mm (25-36.7 mm). Severity of myopic macular degeneration (MMD) according to the Meta-PM classification was MMD Category (MMDCat) 1 in 48 eyes (20%), MMDCat2 in 83 (34%), MMDCat3 in 78 (32%) and MMDCat4 in 37 (15%). Among the 251 HM eyes, 44 had (18%) foveoschisis, 34 (14%) CNV, 10 (4%) macular/lamellar hole, 17 (7%) vitreomacular adhesion and 26 (10%) dome-shaped macula. Twenty of 126 patients (16%) had high anisometropia of ≥ 3 mm AL (range 3-11.2 mm). Of these 20 patients, among the shorter eye: AL was 26.0 ± 2.1 mm (23.3-30.24 mm), 2 eyes (10%) had peripapillary staphyloma, 1 (5%) had dome-shaped macula, 6 (30%) had wide macular staphyloma and the remaining 11 eyes had no staphyloma, Of the 5 eyes with AL < 24 mm, 3 were MMDCat0/1, however 1 was MMDCat3 with foveoschisis and Fuch’s spot, and 1 was MMDCat4 with dome-shaped macula and myopic choroidal neovascularization.
The shorter eyes in HM patients with anisometropia (based on refraction or AL alone) may have shorter AL attributable to dome-shaped macula or an eccentric, non-foveal location of the staphyloma apex, and therefore are also at risk of MMD changes.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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