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      Characteristics and Prevalence of Staphyloma Edges at Different Ages in Highly Myopic Eyes

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          Abstract

          Purpose

          The purpose of this study was to determine the characteristics of staphyloma edges in highly myopic eyes and how they progress.

          Methods

          We conducted a cross-sectional analysis using baseline data and a longitudinal study with follow-up data from 256 patients (447 eyes) with high myopia, with a mean (SD) follow-up of 3.79 (0.78) years. Participants were divided into four age groups: children (<13), youth (13-24), mature (25-59), and elderly (>60). Ultrawide-field swept-source optical coherence tomography was used to analyze staphyloma edges, which were divided into four areas: nasal to the optic disc (OD), superior to the macula, inferior to the macula, and temporal to the macula.

          Results

          Staphylomas were significantly more prevalent in the mature (42.49%) and the elderly (51.35%) groups than in the children (13%) and youth (9%) groups. Staphyloma edges were predominantly superior to the macula in the mature and elderly groups. In contrast, staphylomas were rare in children and youth, with their edges mainly located nasal to the OD. The edges of staphylomas located superior and temporal to the macula were more likely to be associated with myopic traction maculopathy. During the follow-up period, 11 new staphyloma edges developed primarily in the mature group (64%). Additionally, 12 edges had an increased degree of protrusion over time, with most cases occurring in the mature (75%) group.

          Conclusions

          The prevalence and location of staphyloma edges show significant variations depending on age. As time progresses, staphyloma edges manifest at distinct sites and increase their protrusion, potentially playing a role in the emergence of fundus complications.

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          Most cited references26

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          Updates of pathologic myopia.

          Complications from pathologic myopia are a major cause of visual impairment and blindness, especially in east Asia. The eyes with pathologic myopia may develop loss of the best-corrected vision due to various pathologies in the macula, peripheral retina and the optic nerve. Despite its importance, the definition of pathologic myopia has been inconsistent. The refractive error or axial length alone often does not adequately reflect the 'pathologic myopia'. Posterior staphyloma, which is a hallmark lesion of pathologic myopia, can occur also in non-highly myopic eyes. Recently a revised classification system for myopic maculopathy has been proposed to standardize the definition among epidemiological studies. In this META-PM (meta analyses of pathologic myopia) study classification, pathologic myopia was defined as the eyes having chorioretinal atrophy equal to or more severe than diffuse atrophy. In addition, the advent of new imaging technologies such as optical coherence tomography (OCT) and three dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to pathologic myopia. New therapeutic approaches including intravitreal injections of anti-vascular endothelial growth factor agents and the advance of vitreoretinal surgeries have greatly improved the prognosis of patients with pathologic myopia. The purpose of this review article is to provide an update on topics related to the field of pathologic myopia, and to outline the remaining issues which need to be solved in the future.
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            Proposed classification of posterior staphylomas based on analyses of eye shape by three-dimensional magnetic resonance imaging and wide-field fundus imaging.

            To determine the incidence and types of posterior staphylomas in eyes with pathologic myopia by analyzing the entire eye shape by 3-dimensional (3D) magnetic resonance imaging (MRI).
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              Progression of Myopic Maculopathy during 18-Year Follow-up

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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest Ophthalmol Vis Sci
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                18 January 2024
                January 2024
                : 65
                : 1
                : 32
                Affiliations
                [1 ]Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
                [2 ]Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
                Author notes
                [* ]Correspondence: Kyoko Ohno-Matsui, Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 2 Tokyo 1138510, Japan; k.ohno.oph@ 123456tmd.ac.jp .
                Article
                IOVS-23-38923
                10.1167/iovs.65.1.32
                10807494
                38236188
                391294ba-5801-4dd1-9307-f20dcd741831
                Copyright 2024 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 03 January 2024
                : 02 November 2023
                Page count
                Pages: 12
                Categories
                Retina
                Retina

                high myopia,pathologic myopia,posterior staphyloma,ultra-widefield optical coherence tomography (uwf-oct)

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