Nan-Kai Wang1, Yi-Ming Wu2, Jung-Pan Wang3, Laura Liu4, Ling Yeung5, Yen-Po Chen4, Yi-Hsing Chen4, Lung-Kun Yeh4, Wei-Chi Wu4, Lan-Hsin Chuang5, Chi-Chun Lai4. 1. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address: wang.nankai@gmail.com. 2. Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan. 3. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Orthopaedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan. 4. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan. 5. Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan.
Abstract
PURPOSE: To describe the features of posterior staphylomas in myopic eyes with an axial length shorter than 26.5 mm causing visual loss in old age. DESIGN: Retrospective, observational case series. METHODS: After reviewing cases of staphyloma, we isolated 16 eyes from 10 patients with an axial length <26.5 mm for further analysis. These patients had all undergone fundus photography and spectral-domain optical coherence tomography (SDOCT) and some had undergone 3-dimensional magnetic resonance imaging (3D-MRI). RESULTS: The mean age of the patients was 70.0 ± 6.3 years (mean ± standard deviation; range 59-81). The mean axial length of the eyes with a posterior staphyloma was 25.14 ± 0.77 mm and the mean refractive error of the affected eyes was -4.28 ± 2.65 diopters. The median visual acuity was 20/60. All eyes presented with diffuse chorioretinal atrophy, which resembles pathologic myopic maculopathy. Fuchs spots previously were detected in 3 eyes (19%) and lacquer cracks in 2 (12%). SDOCT imaging of the macula showed decreased choroidal thickness in all eyes. A macular retinoschisis was detected in 5 eyes (31%), decreased ellipsoid zone reflectivity in 4 (25%), foveal retinal detachment in 2 (12%), a dome-shaped macula in 1 (6%), a choroidal neovascularization-related subretinal scar in 3 (19%), and loss of ellipsoid zone and outer nuclear layer in 3 (19%). The 3D-MRI scans from 8 eyes showed posterior staphylomas, lateral angulation, or protrusion in all eyes. No eye featured a tilted disc syndrome. CONCLUSIONS: Posterior staphylomas in myopic eyes with an axial length shorter than 26.5 mm exhibit features resembling pathologic myopic maculopathy. This type of staphyloma might cause visual impairment in elderly patients and can be considered atypical forms of pathologic myopia in old age.
PURPOSE: To describe the features of posterior staphylomas in myopic eyes with an axial length shorter than 26.5 mm causing visual loss in old age. DESIGN: Retrospective, observational case series. METHODS: After reviewing cases of staphyloma, we isolated 16 eyes from 10 patients with an axial length <26.5 mm for further analysis. These patients had all undergone fundus photography and spectral-domain optical coherence tomography (SDOCT) and some had undergone 3-dimensional magnetic resonance imaging (3D-MRI). RESULTS: The mean age of the patients was 70.0 ± 6.3 years (mean ± standard deviation; range 59-81). The mean axial length of the eyes with a posterior staphyloma was 25.14 ± 0.77 mm and the mean refractive error of the affected eyes was -4.28 ± 2.65 diopters. The median visual acuity was 20/60. All eyes presented with diffuse chorioretinal atrophy, which resembles pathologic myopic maculopathy. Fuchs spots previously were detected in 3 eyes (19%) and lacquer cracks in 2 (12%). SDOCT imaging of the macula showed decreased choroidal thickness in all eyes. A macular retinoschisis was detected in 5 eyes (31%), decreased ellipsoid zone reflectivity in 4 (25%), foveal retinal detachment in 2 (12%), a dome-shaped macula in 1 (6%), a choroidal neovascularization-related subretinal scar in 3 (19%), and loss of ellipsoid zone and outer nuclear layer in 3 (19%). The 3D-MRI scans from 8 eyes showed posterior staphylomas, lateral angulation, or protrusion in all eyes. No eye featured a tilted disc syndrome. CONCLUSIONS: Posterior staphylomas in myopic eyes with an axial length shorter than 26.5 mm exhibit features resembling pathologic myopic maculopathy. This type of staphyloma might cause visual impairment in elderly patients and can be considered atypical forms of pathologic myopia in old age.