Abstract
A tessellated fundus is a common characteristic of myopic eyes and is an important clinical marker for the development of retinochoroidal changes. However, the exact cause and significance of tessellated fundi have not been definitively determined. We determined the degree of tessellation in fundi objectively in normal, non-pathological myopic eyes, and correlated the degree of tessellation and the choroidal thickness (CT) and axial length (AL). This was a prospective observational cross sectional study. The eyes were classified subjectively into three groups based on the degree of tessellation observed ophthalmoscopically. Digital color fundus photographs were assessed for the degree of tessellation by ImageJ, an image processing program. Three tessellated fundus indices (TFIs) were calculated and were compared to the three subjectively-determined groups. The subfoveal and nasal CTs were measured in the optical coherence tomographic images. The correlations between the TFIs and the CT were calculated. Additionally, the correlation between the TFIs and the AL was calculated. One hundred right eyes of 100 healthy volunteers (mean age 25.8±3.9 years) were studied. Ophthalmoscopically, 57 eyes were placed in the non-tessellated group, 27 eyes into the weakly tessellated group, and 16 eyes into the strongly tessellated group. There was a significant correlation between the subjective classifications and the TFI values (P<0.05, Kruskal-Wallis test). All of the TFIs were significantly associated with the subfoveal and nasal CT (R = −0.20 to −0.24, P<0.05). The TFIs were not significantly correlated with the ALs. In conclusion, the significant correlation between the subjective and objective classifications of the degree of tessellation indicates that TFIs can be used to classify the degree of tessellation. The results indicate that the differences in the CT account for the degree of tessellation.
Highlights
High myopia is a common cause of blindness in the Western countries [1], and it is a more serious problem in Asian countries because it is much more prevalent and the degree of myopia is higher [2]
High myopia is usually defined as those eyes with a refractive error of $26.0 diopter, myopic retinochoroidal atrophies do not occur in all eyes with these higher refractive errors
Our results showed that the repeatability of the subjective and objective classifications of the degree of tessellation was high, and that the objective classification with the tessellated fundus indices (TFIs) was significantly correlated with the subjective classification of the degree of tessellation
Summary
High myopia is a common cause of blindness in the Western countries [1], and it is a more serious problem in Asian countries because it is much more prevalent and the degree of myopia is higher [2]. High myopia is usually defined as those eyes with a refractive error of $26.0 diopter, myopic retinochoroidal atrophies do not occur in all eyes with these higher refractive errors. A tessellated fundus is a common characteristic of myopic eyes, and has been found to be an important clinical marker for the development of retinochoroidal changes [6,7]. This important clinical finding is not easy to be assessed because there is no objective method to grade the degree of tessellation. An objective and quantitative method for assessing a tessellated fundus is needed so that it can be used for clinical and experimental studies
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