Posterior Staphyloma as Determining Factor for Myopic Maculopathy

Abstract

The aim of this study was to determine the influence of posterior staphyloma (PS) on the development of myopic maculopathy. Cross-sectional study. 467 highly myopic eyes (axial length (AL) ≥26 mm) of 246 patients were included. Patients underwent a complete ophthalmological exam, including multimodal imaging. Presence of PS was defined as the main variable analysing between groups (PS vs. non-PS): age, AL, best-corrected visual acuity (BCVA), Atrophy/Traction/Neovascularization (ATN) components and presence of severe pathologic myopia (PM). Two different cohorts were studied (age-matched and AL-matched) comparing PS vs. non-PS eyes. Of the total, 325 eyes (69.59%) presented PS. Eyes without PS were younger and had lower AL, ATN-components and prevalence of severe PM than those with PS (p<0.001). Moreover, non-PS eyes had better BCVA (p<0.001). Analysing age-matched cohort (p=0.96); mean AL, A and T components, and severe PM were significantly higher in PS group (p<0.001), as well as N component (p<0.005), showing worse BCVA (p<0.001). Regarding AL-matched cohort (p=0.93); PS group showed worse BCVA (p<0.01), older age (p<0.001), A (p<0.001) and T components (p<0.01), and severe PM (p<0.01). The risk of PS increases by 10% per year-old (odds ratio: 1.109, p<0.001) and by 132% per each mm growth of AL (odds ratio: 2.318, p<0.001). Posterior staphyloma is associated with myopic maculopathy, worse visual acuity, and higher prevalence of severe PM. The AL and age, following this order, constitute the main factors associated with the onset of PS.