Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China.
Retina. 2019 Sep;39(9):1732-1741. doi: 10.1097/IAE.0000000000002226.
To observe features of the posterior vitreous and vitreoretinal interface in highly myopic eyes with retinoschisis using enhanced vitreous imaging optical coherence tomography.
Comprehensive ophthalmologic examination and enhanced vitreous imaging optical coherence tomography were performed in 77 eyes of 63 patients with highly myopic retinoschisis. Two different modes of spectral domain optical coherence tomography were employed to estimate retinoschisis and the posterior vitreous features in optical coherence tomography images, respectively. The types and distribution of vitreoretinal interface abnormalities were also analyzed.
Complete posterior vitreous detachment (PVD) was identified in 55 eyes (71.4%) with a Weiss ring. Residual cortex was found in 39 eyes (70.9%) with complete PVD. Vitreoretinal interface changes, including vitreoretinal adhesion and epiretinal membrane (ERM), most frequently appeared in the macular area (47.3%), followed by the inferior arched vessels region (34.5%). In partial PVD eyes, vitreoretinal traction, vitreoretinal adhesion, and epiretinal membrane tended to be observed in the inferior and superior arched vessels regions (54.5 and 40.9%, respectively). Among all types of vitreoretinal interface abnormalities, epiretinal membrane comprised the largest proportion (46.8%) despite the status of PVD. The presence of inner layers of retinoschisis connoted a relatively high possibility of vitreoretinal interface abnormalities occurring.
Enhanced vitreous imaging optical coherence tomography reveals a high prevalence of vitreoretinal interface abnormalities in highly myopic eyes with retinoschisis. Vitreous cortex tends to remain on the macular area in eyes with complete PVD. Our findings may lead to better guidance for the surgical treatment of highly myopic retinoschisis.
应用增强型玻璃体成像光相干断层扫描观察高度近视性视网膜劈裂患者的后玻璃体和玻璃体视网膜界面特征。
对 63 例（77 只眼）高度近视性视网膜劈裂患者进行全面眼科检查和增强型玻璃体成像光相干断层扫描。分别采用两种不同模式的光谱域光相干断层扫描来评估光相干断层扫描图像中的视网膜劈裂和后玻璃体特征，并分析玻璃体视网膜界面异常的类型和分布。
55 只眼（71.4%）存在完全玻璃体后脱离（PVD）并伴有 Weiss 环，39 只眼（70.9%）存在完全 PVD 时残留皮质。玻璃体视网膜界面改变，包括玻璃体视网膜粘连和视网膜内膜（ERM），最常发生在黄斑区（47.3%），其次是下弓状血管区（34.5%）。在部分 PVD 眼中，玻璃体视网膜牵引、玻璃体视网膜粘连和 ERM 倾向于在下弓状血管区和上弓状血管区观察到（分别为 54.5%和 40.9%）。在所有类型的玻璃体视网膜界面异常中，视网膜内膜的比例最大（46.8%），尽管存在 PVD。内层视网膜劈裂的存在提示玻璃体视网膜界面异常发生的可能性相对较高。
增强型玻璃体成像光相干断层扫描显示高度近视性视网膜劈裂患者中玻璃体视网膜界面异常的发生率较高。完全 PVD 眼的黄斑区倾向于保留玻璃体皮质。我们的发现可能为高度近视性视网膜劈裂的手术治疗提供更好的指导。
