Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Ophthalmology. 2012 Aug;119(8):1685-92. doi: 10.1016/j.ophtha.2012.01.047. Epub 2012 Apr 10.
To examine the incidence and characteristics of pit-like structures around the optic disc and myopic conus in eyes with high myopia.
Prospective, observational case series.
We evaluated 198 eyes of 119 patients with pathologic myopia (spherical equivalent >-8 diopters [D]). We also evaluated 32 eyes of 32 subjects with emmetropia (refractive error ≤±3 D) as controls.
The papillary and peripapillary areas were examined with a prototype swept-source optical coherence tomography (OCT) system with a center wavelength of 1050 nm. We studied the structural characteristics of pit-like changes.
The incidence and characteristics of the optic nerve (ON) pits in eyes with high myopia.
Pit-like clefts were found at the outer border of the ON or within the adjacent scleral crescent in 32 of 198 highly myopic eyes (16.2%) but in none of the emmetropic eyes. The eyes with these pits were more myopic, had significantly longer axial lengths, and had significantly larger optic discs than the highly myopic eyes without pits. The pits were located in the optic disc area (optic disc pits) in 11 of 32 eyes and in the area of the conus outside the optic disc (conus pits) in 22 of 32 eyes. One eye had both optic disc pits and conus pits. The optic disc pits existed in the superior or inferior border of the optic disc. All but 1 eye with conus pits had a type IX staphyloma, and the location of the conus pits were present nasal to the scleral ridge or outside the ridge temporal to the nerve. The optic disc pits were associated with discontinuities of the lamina cribrosa, whereas the conus pits appeared to develop from a scleral stretch-associated schisis or to emissary openings for the short posterior ciliary arteries in the sclera. The nerve fiber tissue overlying the pits was discontinuous at the site of the pits.
Optic nerve pits are common in highly myopic eyes. The ON pits are barely visible ophthalmoscopically but can be demonstrated by using swept-source OCT.
观察高度近视患者视盘周围和近视圆锥部的 pit-like 结构的发生率和特征。
前瞻性、观察性病例系列。
我们评估了 198 只患有病理性近视（等效球镜>-8 屈光度[D]）的 119 名患者的眼睛，还评估了 32 只正视眼（屈光不正≤±3 D）的 32 名受试者作为对照组。
使用中心波长为 1050nm 的原型扫频源光学相干断层扫描（OCT）系统检查视盘和视盘周围区域。我们研究了 pit-like 改变的结构特征。
高度近视患者视神经（ON） pit 的发生率和特征。
在 198 只高度近视眼中，有 32 只（16.2%）在外层视神经或相邻巩膜新月形处发现 pit-like 裂隙，但在正视眼中无一例发现。这些有裂隙的眼睛更近视，眼轴明显更长，视盘明显更大。裂隙位于视盘区（视盘 pit）的有 11 只眼，位于视盘外圆锥区（圆锥 pit）的有 22 只眼。1 只眼既有视盘 pit 又有圆锥 pit。视盘 pit 存在于视盘的上或下边界。所有 22 只具有圆锥 pit 的眼中均存在Ⅸ型 staphyloma，圆锥 pit 的位置位于巩膜嵴的鼻侧或神经颞侧的嵴外。视盘 pit 与筛板的不连续性有关，而圆锥 pit 似乎是由巩膜伸展相关的劈裂或巩膜中短睫状后动脉的穿通支引起的。裂隙上方的神经纤维组织在裂隙处不连续。
视神经 pit 在高度近视眼中很常见。ON pit 眼底镜下几乎不可见，但可通过扫频 OCT 显示。
