Imaging etiology of pathological myopia results in visual impairment

Objective

To analyze the imaging etiology of patients having vision loss with pathological myopia.

Methods

A cross-sectional study was conducted.The clinical data of 110 cases (138 eyes) who had vision loss with pathological myopia diagnosed in Xiamen Eye Center of Xiamen University from June 1st, 2016 to May 31st, 2017 was collected and analyzed.Fundus photography was used to observe lacquer cracks; spectral domain optical coherence tomography (SD-OCT), fundus fluorescein angiography, indocyanine green angiography and optical coherence tomography angiography (OCTA) were employed to evaluate the choroidal neovascularization (CNV) and punctate inner choroidopathy (PIC). The macular retinoschisis (MRS), macular atrophy, macular hole and epiretinal membranes were assessed by SD-OCT.The proportion and age distribution of different fundus lesions of pathological myopia complicated with vision loss were analyzed.The study protocol was approved by an Ethics Committee of Xiamen Eye Center of Xiamen University (No.XMYKZX-2016-KY-010). Written informed consent was obtained from each patient before study.

Results

Among the imaging causes of visual impairment caused by pathological myopia, there were 87 (63.0%) eyes of myopic CNV (MCNV) with the highest proportion, followed by 53 (38.4%) eyes of lacquer cracks, 48 (34.8%) eyes of MRS, 44 (31.9%) eyes of macular atrophy, 42 (30.4%) eyes of epiretinal membranes, 14 (10.1%) eyes of macular lamellar hole, 19 (13.8%) eyes of full-thickness macular hole (FTMH), and 3 (2.2%) eyes of PIC.The average age was (53.00±1.51) years of MCNV, (53.00±1.77) years of lacquer cracks, (58.00±1.64) years of MRS, (57.00±1.76) years of macular atrophy, (59.00±1.48) years of epiretinal membranes, (61.00±3.90) years of macular lamellar hole, (59.00±3.39) years of FTMH with retinal detachment (RD), and (67.00±0.50) years of FTMH without RD.The average age of PIC patients was (31.00±8.50) years, which was significantly smaller than that of the other groups (all at P<0.05).

Conclusions

The main cause of visual impairment resulted from pathological myopia is the obvious abnormality of macular structure, and MCNV is the most common type.

Choroidal neovascularization; Pathological myopia; Etiology; Imagiug