Department of Ophthalmology, Tokyo Medical and Dental University, Tokyo, Japan.
Ophthalmology. 2014 Sep;121(9):1798-809. doi: 10.1016/j.ophtha.2014.03.035. Epub 2014 May 9.
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).
Observational, case series.
A total of 105 patients with pathologic myopia (spherical equivalent <-8.0 diopters or axial length ≥26.5 mm) were examined by 3D MRI and Optos (Optos, PLC, Dunfermline, Scotland).
Staphyloma was defined as an outpouching of the wall of the eye that had a radius of curvature less than the surrounding curvature of the wall of the eye. The presence and types of staphylomas were determined by the entire eye shape in 3D MRI scans. Fundus abnormalities suggesting the staphyloma border were analyzed in the fundus images, fundus autofluorescence images, and infrared images by Optos.
Incidence and types of posterior staphylomas, and the correlation between the type of staphyloma by MRI and the Optos images.
A total of 198 eyes (105 patients) met the inclusion criteria of pathologic myopia (mean age, 64.3±11.5 years; mean axial length, 30.0±2.3 mm). Among 198 eyes, 98 (49.5%) had no staphylomas in 3D MRI scans and showed a barrel-shaped globe. The other 100 eyes (50.5%) had posterior staphyloma by 3D MRI. The most predominant type was wide, macular staphyloma (74% of eyes with staphyloma), followed by narrow, macular staphyloma (14% of eyes with staphyloma). In eyes with peripapillary and nasal staphylomas, the change of the curvature was slight and the eye had a nasally distorted shape. Optos images showed pigmentary abnormalities or abnormal reflectance along the staphyloma border. The patients with staphylomas were significantly older and had significantly worse visual function and more frequent chorioretinal changes than patients without staphyloma.
Three-dimensional MRI was useful in analyzing the shape of eyes with and without staphyloma. Even in elderly individuals with severe myopia, approximately one half of the patients did not show clear outpouching suggesting staphyloma. Correlating the MRI data to Optos images provided useful information on the relationship between the eye shape and the fundus appearances in the Optos images.
通过分析三维（3D）磁共振成像（MRI）下的整个眼球形状，确定病理性近视眼中后葡萄肿的发生率和类型。
观察性、病例系列研究。
共 105 例病理性近视患者（等效球镜<-8.0 屈光度或眼轴长度≥26.5mm）接受了 3D MRI 和 Optos（苏格兰邓弗姆林 Optos PLC）检查。
葡萄肿定义为眼球壁的向外膨出，其曲率半径小于眼球壁的周围曲率。通过 3D MRI 扫描确定整个眼球形状的葡萄肿的存在和类型。在 Optos 的眼底图像、眼底自发荧光图像和红外图像中分析提示葡萄肿边界的眼底异常。
后葡萄肿的发生率和类型，以及 MRI 与 Optos 图像之间葡萄肿类型的相关性。
共 198 只眼（105 例患者）符合病理性近视的纳入标准（平均年龄 64.3±11.5 岁；平均眼轴长度 30.0±2.3mm）。在 198 只眼中，98 只眼（49.5%）在 3D MRI 扫描中无葡萄肿，表现为桶状眼球。其余 100 只眼（50.5%）有后葡萄肿。最主要的类型是宽型、黄斑葡萄肿（74%有葡萄肿的眼），其次是窄型、黄斑葡萄肿（14%有葡萄肿的眼）。在视盘周围和鼻侧葡萄肿中，曲率的变化较小，眼球呈鼻侧扭曲形状。Optos 图像显示葡萄肿边界处的色素异常或异常反射。有葡萄肿的患者明显比无葡萄肿的患者年龄更大，视力功能更差，脉络膜视网膜病变更频繁。
3D MRI 有助于分析有葡萄肿和无葡萄肿的眼球形状。即使在患有严重近视的老年患者中，也有约一半的患者没有明显的膨出提示葡萄肿。将 MRI 数据与 Optos 图像相关联，提供了有关眼球形状与 Optos 图像中眼底表现之间关系的有用信息。
