Venkatesh Ramesh, Jain Kushagra, Aseem Aditya, Kumar Sabitabh, Yadav Naresh Kumar
Department of Retina and Vitreous, Narayana Nethralaya, #121/C, Chord Road, 1st R Block Rajaji Nagar, Bangalore, 560080, India.
Int Ophthalmol. 2020 Jan;40(1):31-41. doi: 10.1007/s10792-019-01146-0. Epub 2019 Jul 12.
To determine the incidence and characteristics of intrachoroidal cavitation (ICC) in the eyes with high myopia.
In this retrospective, non-interventional, comparative study, we analysed the case records of 108 eyes with and without pathological myopia (PM). PM was defined as having a refractive error (spherical equivalent) of ≥ - 6.0 D or axial length ≥ 26 mm. The presence of other features like posterior vitreous detachment, myopic traction maculopathy, posterior staphyloma, focal/patchy chorioretinal atrophy (CRA), choroidal neovascularisation and retinoschisis was looked for on OCT. The association of these features with ICC was analysed using statistical tests.
In this study, 38 out of 68 eyes with PM and 4 out of 40 eyes with non-PM showed the bowing of the posterior sclera and the presence of ICC. On statistical analysis with Chi-square test and multiple variable linear regression analysis tests, it was identified that the presence of focal/patchy CRA (p = 0.005) and intrascleral vessels (p = 0.018) in and around the cavitation was important features noted in eyes with ICC. The OCT features of macular and peripapillary ICC were similar. The transudation of fluid from the dilated intrascleral vessels in and around the ICC could be one other mechanism responsible for the development of ICC.
ICC is seen in 55.8% of highly myopic eyes with the presence of focal CRA or myopic conus and/or presence of intrascleral vessels near the cavitation. These findings suggest that patchy atrophy affects the scleral contour within posterior staphyloma beyond the funduscopically identified patchy atrophy by ICC. The presence of intrascleral vessels could also contribute to the ICC development. Eyes with patchy CRA or myopic conus needs to be checked on further follow-up visits for the development of macular or peripapillary ICC.
确定高度近视眼中脉络膜内空洞（ICC）的发生率及特征。
在这项回顾性、非干预性、对比研究中，我们分析了108只患有和未患有病理性近视（PM）眼睛的病例记录。病理性近视定义为屈光不正（等效球镜）≥ -6.0 D或眼轴长度≥26 mm。通过光学相干断层扫描（OCT）检查是否存在其他特征，如玻璃体后脱离、近视性牵拉性黄斑病变、后巩膜葡萄肿、局限性/片状脉络膜视网膜萎缩（CRA）、脉络膜新生血管和视网膜劈裂。使用统计检验分析这些特征与ICC的相关性。
在本研究中，68只病理性近视眼中有38只，40只非病理性近视眼中有4只出现后巩膜弯曲和ICC。经卡方检验和多元变量线性回归分析检验，发现局限性/片状CRA（p = 0.005）以及空洞内和周围的巩膜内血管（p = 0.018）是ICC眼中的重要特征。黄斑和视乳头周围ICC的OCT特征相似。ICC内和周围扩张的巩膜内血管渗漏液体可能是ICC形成的另一种机制。
在55.8%的高度近视眼中可见ICC，伴有局限性CRA或近视性圆锥以及/或者空洞附近存在巩膜内血管。这些发现表明，片状萎缩影响后巩膜葡萄肿内的巩膜轮廓，超出了眼底镜检查所确定的ICC片状萎缩范围。巩膜内血管的存在也可能促使ICC形成。对于患有片状CRA或近视性圆锥的眼睛，在进一步随访时需要检查是否出现黄斑或视乳头周围ICC。
