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      Assessment of Posterior Segment Using Spectral Domain OCT in Highly Myopic Eyes

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          Abstract

          Purpose:

          Spectral Domain Optical Coherence Tomography (SD-OCT) was used to evaluate retinal and vitreo-retinal changes that occur in highly myopic patients.

          Methods:

          This prospective study included 472 eyes of 472 patients suffering from high myopia (> -6.00 D), between May 2012 and December 2015. All patients were examined, using Cirrus HD OCT (Zeiss Cirrus TM HD-OCT model 4000), to detect any retinal or vitreo-retinal interface abnormalities.

          All obtained data was analyzed using Statistical Package for the Social Sciences software version 17 (SPSS Inc, Chicago, IL, USA) and the paired two-sided t-test. Bivariate correlations were performed between different parameters using the Spearman correlation coefficient (r).

          Results:

          Mean spherical equivalent (MSE) was -13.11± 4.35D. Mean axial length (AL) was 28.5±1.62 mm. Posterior vitreous detachment (PVD) was the most frequent OCT finding; representing 33.4% of the cases, 13.7% of them were associated with macular traction. A statistically significant positive correlation was found between AL and MTM, full thickness macular hole, PVD with traction, and dome shaped macula (r = 0.49 and P = 0.001, r = 0.422 and P = 0.0001, r = 0.25 and P = 0.03, r=0.475, P=0.001 respectively)

          Conclusion:

          OCT is a valuable tool in detecting retinal and vitreo-retinal interface abnormalities in highly myopic eyes, and it can be used for follow up of those patients to avoid advanced retinal damage.

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          Most cited references36

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          Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review.

          To summarize the epidemiology of pathologic myopia and myopic choroidal neovascularization (CNV) and their impact on vision.
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            Foveal retinoschisis and retinal detachment in severely myopic eyes with posterior staphyloma.

            To evaluate the tomographic features of the retina in patients with severe myopia and posterior staphyloma. In a prospective study of 32 eyes of 19 consecutive patients with severe myopia and posterior staphyloma, we performed complete ophthalmic examinations and studied cross-sectional images of the macula with optical coherence tomography. Patients' age ranged from 41 to 83 years (average, 62.7 years). Best-corrected visual acuity ranged from 20/500 to 20/40 (average, 20/120). The study included 26 phakic and six pseudophakic eyes. The refractive errors of 26 phakic eyes ranged from -8 to -31 diopters (average, -16.7 diopters). Although refractive errors were within -8 diopters in six pseudophakic eyes, the eyes had apparent posterior staphyloma. The axial lengths measured by A-mode ultrasonography ranged from 25.7 to 32.7 mm (average, 29.2 mm). Slit-lamp examination with contact lens showed that none of the eyes had a macular hole. In nine eyes with shallow retinal elevation on slit-lamp examination, optical coherence tomography disclosed a foveal retinal detachment with retinoschisis in eight eyes and a foveal retinal detachment in one eye. Two of the remaining 23 eyes had retinoschisis. Foveal retinal detachment and retinoschisis are common features in severely myopic eyes with posterior staphyloma. Retinal detachment may precede the formation of a macular hole in severely myopic eyes.
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              Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome.

              To determine the natural evolution and surgical indications of myopic foveoschisis (MF), which are still poorly documented, and the factors that predict poor prognosis. Retrospective observational case series. Twenty-nine operated and nonoperated cases of MF (29 eyes of 23 patients) were studied. All eyes underwent repeated examinations, including optical coherence tomographic (OCT) recordings, during a mean follow-up of 31.2 months. Special attention was paid to the evolution of visual acuity (VA) and to the thickness of foveoschisis. Mean refraction was -14.4 diopters, and mean axial length was 29.1 mm. OCT scans revealed that the foveoschisis was associated with macular anomalies: a premacular structure in 13 (44.8%) of 29 eyes, a foveal detachment in 10 (34.5%) of 29 eyes, and a lamellar macular hole in six (20.7%) of 29 eyes. Isolated foveoschisis was found in four eyes (13.8%). During follow-up, foveoschisis and VA worsened in 20 eyes and remained stable in nine. Ten of the 20 eyes that worsened had a premacular structure. A macular hole occurred in nine eyes, six of which had previously exhibited foveal detachment. Eleven eyes with foveoschisis underwent surgery, which improved VA significantly (P = .04, Wilcoxon test), but three eyes developed a macular hole. MF may remain stable for many years without affecting VA. However, when it is combined with the presence of a premacular structure, the risk of a decrease in VA increases. When it is combined with foveal detachment, a macular hole seems to develop frequently, whether or not surgery is performed.
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                Author and article information

                Journal
                Open Ophthalmol J
                Open Ophthalmol J
                TOOPHTJ
                The Open Ophthalmology Journal
                Bentham Open
                1874-3641
                22 November 2017
                2017
                : 11
                : 334-345
                Affiliations
                Ophthalmology Department, Lecturer of Ophthalmology, Minia University Hospital, Faculty of Medicine, Minia University, Al-Minya, Egypt
                Author notes
                [* ]Address correspondence to this author at the Ophthalmology Department, Lecturer of Ophthalmology, Minia University Hospital, Faculty of Medicine, Minia University, Al-Minia, Postal code: 61111, Egypt; Tel: +20862342505; E-mail: heba.ali@ 123456mu.edu.eg
                Article
                TOOPHTJ-11-334
                10.2174/1874364101711010334
                5725562
                ccd1448e-d109-4dc1-adf6-86520d03c913
                © 2017 AttaAllah et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 July 2017
                : 19 October 2017
                : 30 October 2017
                Categories
                Article

                Ophthalmology & Optometry
                dome shaped macula,foveoschisis,high myopia,myopic traction maculopathy,myopic macular hole,myopic cnv

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