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      Posterior staphylomas and scleral curvature in highly myopic children and adolescents investigated by ultra-widefield optical coherence tomography

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          Abstract

          Purpose

          To determine the early signs of posterior staphylomas in highly myopic eyes of younger subjects by swept-source ultra-widefield optical coherence tomography (WF-OCT).

          Methods

          This was an observational case series study. Highly myopic subjects younger than 20 years old who were examined consecutively by prototype WF-OCT were studied. High myopia was defined according to the Ministry of Health and Welfare, Japan classification. A posterior displacement of the sclera and two OCT features indicating the staphyloma edges were used as markers of a staphyloma.

          Results

          Fifty-five eyes of 30 patients with the mean age of 12.3 years, and the mean axial length of 27.9 mm were studied. Seven of the 55 eyes (12.7%) had a posterior displacement of the sclera and were diagnosed as having a staphyloma. Among the two OCT features of the staphyloma edges, a gradual thinning of the choroid toward the staphyloma edge and gradual re-thickening of choroid from the staphyloma edge toward the posterior pole were found in these 7 eyes. However, the other feature of an inward protrusion of the sclera at the staphyloma edge, was obvious in only 2 eyes. The subfoveal choroid and choroid nasal to the optic disc were significantly thinner in eyes with a staphyloma than those without it.

          Conclusions

          The changes of the choroidal thickness toward the staphyloma edge with the posterior displacement of the sclera were considered an early sign which precedes an inward protrusion of sclera at the staphyloma edge.

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          Most cited references13

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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.

          Kyoko Ohno-Matsui (2014)
          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).
          Article 0 comments Cited 78 times – based on 0 reviews     Review now
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            Clinical characteristics of posterior staphyloma in eyes with pathologic myopia.

            Huang Hsiang, Kyoko Ohno-Matsui, Noriaki Shimada … (2008)
            To determine the morphologic features (grade and type) of posterior staphylomas and to analyze the relationship between the morphologic features and the incidence of myopic macular lesions. Observational case series. Two hundred and nine eyes of 108 consecutive patients with high myopia were studied. The grade of staphylomas was determined from B-scan ultrasonographic images across the optic disk. The type of staphyloma was determined by binocular funduscopy and was classified according to the criteria of Curtin. The participants were divided into two groups: younger than 50 years and 50 years and older. The long-term morphologic progression of staphylomas was analyzed in nine patients who were followed up for more than 20 years. Ninety percent of 209 eyes had a staphyloma. The prevalence of staphylomas and more advanced grades of staphylomas (> grade 2) were significantly higher in the older than in the younger patients. The higher grades of staphylomas were associated with more severe myopic retinal degeneration. Type II staphyloma was the most prominent overall; however, in older subjects, the incidence of type II was decreased significantly, and that of type IX was increased significantly. The eyes with type IX staphyloma tended to have more severe myopic retinal degeneration than eyes with type II staphylomas. The long-term follow-up study demonstrated a progression from type II to type IX with increasing age. These results suggest that the morphologic features of staphylomas worsens as the patient ages. The progression from type II to type IX probably increases the mechanical tension on the macular area of highly myopic eyes, which then leads to myopic fundus lesions.
            Article 0 comments Cited 52 times – based on 0 reviews     Review now
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              The posterior staphyloma of pathologic myopia.

              R B Curtin (1976)
              A total of 250 myopic patients with posterior staphyloma affecting one or both eyes received a complete ocular examination including binocular indirect ophthalmoscopy, refraction, and axial length measurement. Ten types of staphyloma were noted; five primary and five compound. The primary staphyloma involved the posterior pole (Type I), macular area (Type II), peripapillary area (Type III), the fundus nasal to the disc (Type IV) and the area below the disc (Type V). Compound staphylomas consisted of combined primary staphylomas or distinctive and complex variations of a primary staphyloma, usually Type I. This type also was found to have the greatest prevalence of all ten types. Patients in this group had a 19% incidence of legal blindness with 34.5% of staphylomatous eyes having a vision of 20/200 or less. A remarkably wide range of refractions and axial lengths were found for each staphyloma type. These results indicate the importance of the staphyloma in the diagnosis and prognosis of pathologic myopia. It also offers an improved basis for genetic studies of this disease.
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                Author and article information

                Contributors
                Noriko Tanaka: Role: Formal analysisRole: InvestigationRole: ResourcesRole: VisualizationRole: Writing – original draft
                Kosei Shinohara: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Tae Yokoi: Role: Formal analysisRole: Resources
                Kengo Uramoto: Role: Resources
                Hiroyuki Takahashi: Role: Resources
                Yuka Onishi: Role: Resources
                Shintaro Horie: Role: Resources
                Takeshi Yoshida: Role: Resources
                Kyoko Ohno-Matsui: Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Gemmy Cheung: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 10 June 2019
                Publication date Collection: 2019
                Volume: 14
                Issue: 6
                Electronic Location Identifier: e0218107
                Affiliations
                [1 ] Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
                [2 ] Tokyo Metropolitan Hiroo Hospital, Shibuya-ku, Tokyo, Japan
                [3 ] Musashino Red Cross Hospital, Musashino-shi, Tokyo, Japan
                Singapore National Eye Centre, SINGAPORE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Article
                Publisher ID: PONE-D-19-06616
                DOI: 10.1371/journal.pone.0218107
                PMC ID: 6557512
                PubMed ID: 31181108
                SO-VID: 5f02da04-69e1-4493-b2c1-d97ea80f5dcf
                Copyright © © 2019 Tanaka et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 6 March 2019
                Date accepted : 27 May 2019
                Page count
                Figures: 5, Tables: 2, Pages: 11
                Funding
                Funded by: The Japanese Society for Promotion of Science
                Award ID: 15H04993, 15K15629
                Award Recipient :
                This study was funded by the Japanese Society for Promotion of Science, grants 15H04993 and 15K15629 to KOM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Head
                Subject: Eyes
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Head
                Subject: Eyes
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Eyes
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Eyes
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Choroid
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Choroid
                Subject: Medicine and Health Sciences
                Subject: Diagnostic Medicine
                Subject: Signs and Symptoms
                Subject: Atrophy
                Subject: Medicine and Health Sciences
                Subject: Pathology and Laboratory Medicine
                Subject: Signs and Symptoms
                Subject: Atrophy
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Fovea Centralis
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Fovea Centralis
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Optic Disc
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Optic Disc
                Subject: Medicine and Health Sciences
                Subject: Ophthalmology
                Subject: Visual Impairments
                Subject: Myopia
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Optic Nerve
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Optic Nerve
                Subject: Biology and Life Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Subject: Medicine and Health Sciences
                Subject: Anatomy
                Subject: Ocular System
                Subject: Ocular Anatomy
                Custom metadata
                Data Availability All relevant data are within the manuscript. We do not have any Supporting Information Files.

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