Abstract
Background/objectivesMyopic traction maculopathy of the retinoschisis type is a unique entity that has been frequently overlooked in refraction correction in daily practice in myopic eyes. The objective of this study was to describe the imaging characteristics of myopic traction maculopathy (MTM) seen on optical coherence tomography angiography (OCTA) and to detect biomarkers of the associated functional changes.Subjects/methodsWe performed OCTA on eyes with MTM and retinoschisis (RS group; n = 27) and highly myopic eyes without MTM (control group; n = 27). The RS group was further divided into a dome-shaped macula (DSM) group and a non-DSM group. The groups were compared for morphologic and perfusion characteristics.ResultsThe RS and control groups had comparable spherical equivalence (p = 0.65), but the RS group had worse best-corrected visual acuity (p < 0.01), larger retinal volumes (p < 0.01), and greater subfoveal choroid capillary vessel density values (p = 0.04). Compared to the non-DSM group, the DSM group had significantly smaller inner retinal volumes (p = 0.05) and significantly larger choroid capillary vessel density values in both the whole macula (p = 0.005) and the fovea (p = 0.03).ConclusionsOur high-resolution OCTA morphologic and vascular perfusion data correlated well with functional abnormalities encountered in myopic eyes. Changes in vessel density may elucidate the pathogenesis of MTM and characterize the mechanical stretch forces acting in eyes with MTM.
Highlights
Myopic traction maculopathy of the retinoschisis type is a unique entity that has no obvious anatomical abnormalities, except for foveoschisis of the sensory retina
In 2004, Panozzo et al proposed the term “myopic traction maculopathy” (MTM) to describe the macular damage caused by traction forces from the epiretinal membrane or residual focal vitreoretinal adhesion combined with posterior staphyloma and progressive scleral stretching in myopic eyes [2]
This study is the first to systematically evaluate MTM using optical coherence tomography angiography (OCTA) to describe the severity of retinoschisis using threedimensional analysis and to identify biomarkers on OCTA that are pathognomonic of MTM
Summary
Myopic traction maculopathy of the retinoschisis type is a unique entity that has no obvious anatomical abnormalities, except for foveoschisis of the sensory retina. The condition is frequently overlooked in the refraction correction of visual acuity in daily practice in myopic eyes. The term “myopic foveoschisis” was coined by Takano and Kishi to describe retinal splitting at the macula observed on optical coherence tomography (OCT) in patients with high myopia and posterior staphyloma [1]. In 2004, Panozzo et al proposed the term “myopic traction maculopathy” (MTM) to describe the macular damage caused by traction forces from the epiretinal membrane or residual focal vitreoretinal adhesion combined with posterior staphyloma and progressive scleral stretching in myopic eyes [2]. OCT is essential when evaluating highly myopic eyes, in which MTM is suspected because it can provide detailed images of macular damage and may elucidate the poorly understood pathogenesis of MTM. The incidence of myopia has increased in recent decades in many countries,
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