El Matri Leila, Falfoul Yousra, El Matri Khaled, El Euch Issam, Ghali Hela, Habibi Imen, Hassairi Asma, Chaker Nibrass, Schorderet Daniel, Chebil Ahmed
Oculogenetic Laboratory LR14SP01, Tunis El Manar University, Tunis, Tunisia.
B Department, Hedi Rais Institute of Ophthalmology, Faculty of Medicine of Tunis, Tunis, Tunisia.
Int Ophthalmol. 2020 Sep;40(9):2159-2168. doi: 10.1007/s10792-020-01396-3. Epub 2020 May 2.
Our aim was to highlight the presence and the frequency of posterior staphyloma (PS) in non-highly myopic retinitis pigmentosa (RP) patients and to study the relationship between PS and choroidal thickness (CT).
This was a retrospective case-control study of 77 eyes (39 patients) with RP, axial length inferior to 26 mm and clinically preserved macular area. All patients underwent fundus photography, A- and B-scan ocular ultrasonography, fundus autofluorescence (FAF) and swept source optical coherence tomography (SS-OCT). PS was defined by an outward bowing of the sclera on SS-OCT and B-scans. The relationship between the PS and SS-OCT layers thicknesses was determined.
Over 77 RP eyes of 39 patients studied, a PS was identified in 17 eyes (22%) of nine patients. Fifteen eyes had a narrow macular staphyloma (NMS), and two eyes had a wide macular staphyloma (WMS). Mean age in this group was 34.2 years (range 19-53 years), mean axial length was 23.60 ± 0.61 mm and mean CT was 185.7 ± 71 um versus 259.7 um in eyes without PS. The staphyloma edges corresponded to area of outer retina loss on SS-OCT and were larger than the hyperautofluorescent ring on FAF. We found a significant association between PS and CT in our RP patients (p = 0.003). The mean CT was significantly thinner in PS eyes compared to eyes without staphyloma. There was no significant association between PS and with visual acuity, years of progression, retinal thickness nor FAF findings.
PS was present in 22% of non-highly myopic eyes with RP. Narrow macular staphyloma was the most common type observed in our series. A marked thinning of the choroid was noted in PS eyes when compared to RP eyes without PS, as well as the outer retina degeneration.
我们的目的是强调非高度近视性视网膜色素变性(RP)患者中后巩膜葡萄肿(PS)的存在及其发生率,并研究PS与脉络膜厚度(CT)之间的关系。
这是一项对77只眼(39例患者)进行的回顾性病例对照研究,这些患者患有RP,眼轴长度小于26mm,黄斑区临床保存。所有患者均接受了眼底照相、A超和B超眼部超声检查、眼底自发荧光(FAF)和扫频光学相干断层扫描(SS-OCT)。PS通过SS-OCT和B超上巩膜的向外弯曲来定义。确定了PS与SS-OCT各层厚度之间的关系。
在研究的39例患者的77只RP眼中,9例患者的17只眼(22%)发现有PS。15只眼有狭窄黄斑葡萄肿(NMS),2只眼有宽大黄斑葡萄肿(WMS)。该组患者的平均年龄为34.2岁(范围19 - 53岁),平均眼轴长度为23.60±0.61mm,平均CT为185.7±71μm,而无PS的眼中平均CT为259.7μm。葡萄肿边缘对应于SS-OCT上外层视网膜缺失区域,且大于FAF上的高自发荧光环。我们发现RP患者中PS与CT之间存在显著关联(p = 0.003)。与无葡萄肿的眼相比,PS眼中的平均CT明显更薄。PS与视力、病程年数、视网膜厚度及FAF表现之间无显著关联。
22%的非高度近视RP眼中存在PS。狭窄黄斑葡萄肿是我们系列中观察到的最常见类型。与无PS的RP眼相比,PS眼中脉络膜明显变薄,同时外层视网膜也发生变性。