Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Ophthalmology. 2021 Feb;128(2):256-265. doi: 10.1016/j.ophtha.2020.06.063. Epub 2020 Jul 11.
To examine most postequatorial retina in eyes with myopic macular retinoschisis (MRS) by ultra-widefield (UWF) OCT and to determine whether paravascular vitreal adhesions play a role in the development of MRS.
Retrospective single-center observational case series.
One hundred fifty highly myopic participants who were older than 50 years with and without an MRS were studied. High myopia was defined as an eye with an axial length of more than 26.5 mm.
All participants underwent UWF OCT imaging with a scan width of 23 mm and a depth of 5 mm using a prototype swept-source OCT device. The vitreoretinal adhesions to the foveal retina and retinal vessels and paravascular abnormalities, including paravascular retinal cysts, paravascular retinoschisis, and paravascular lamellar holes, were analyzed in the UWF OCT images. The findings in eyes with an MRS were compared with those in eyes without an MRS.
The relationships between MRS and vitreal adhesions to the retinal vessels or to the fovea were determined.
An MRS was found in 49 of the 150 eyes (33%). Vitreal adhesions to the retinal vessels were found more frequently in eyes with an MRS than in eyes without an MRS (63% vs. 44%; P = 0.04). In contrast, the number of eyes with adhesions to the fovea in eyes with an MRS was not significantly different from that in eyes without an MRS (57% vs. 59%). Paravascular lesions, for example, retinal cysts, retinoschisis, and lamellar holes, were more common in eyes with an MRS than in eyes without an MRS (71% vs. 36%, 61% vs. 17 %, and 20% vs. 8% [P < 0.001, P < 0.001, and P = 0.03], respectively). Multivariate analysis showed that the presence of paravascular vitreal adhesions was a significant predictor for MRS development (odds ratio, 2.56; P = 0.02).
Paravascular vitreal adhesions may be related to the development of the different types of paravascular lesions including retinal cysts and retinoschisis, and play a more important role in the development of an MRS than vitreal adhesions to the fovea.
通过超广角（UWF）OCT 检查研究近视性黄斑视网膜劈裂（MRS）患者的后赤道部视网膜，并确定脉络膜玻璃体粘连是否在 MRS 的发生中起作用。
回顾性单中心观察性病例系列研究。
研究了 150 名年龄大于 50 岁的高度近视患者，这些患者有或没有 MRS。高度近视定义为眼轴长度大于 26.5 毫米。
所有参与者均使用原型扫频源 OCT 设备进行 UWF OCT 成像，扫描宽度为 23 毫米，深度为 5 毫米。分析 UWF OCT 图像中的视网膜血管与黄斑视网膜的玻璃体视网膜粘连以及脉络膜旁异常，包括脉络膜旁视网膜囊肿、脉络膜旁视网膜劈裂和脉络膜旁层状裂孔。比较 MRS 眼与无 MRS 眼的发现。
确定 MRS 与视网膜血管或黄斑的玻璃体粘连之间的关系。
在 150 只眼中发现 49 只（33%）存在 MRS。与无 MRS 眼相比，MRS 眼中更常发现视网膜血管的玻璃体粘连（63%比 44%；P=0.04）。相反，MRS 眼中与黄斑粘连的眼数与无 MRS 眼无显著差异（57%比 59%）。与无 MRS 眼相比，MRS 眼中更常出现脉络膜旁病变，例如视网膜囊肿、视网膜劈裂和层状裂孔（71%比 36%，61%比 17%，20%比 8%[P<0.001，P<0.001 和 P=0.03]）。多变量分析显示，脉络膜玻璃体粘连的存在是 MRS 发生的显著预测因素（优势比，2.56；P=0.02）。
脉络膜玻璃体粘连可能与包括视网膜囊肿和视网膜劈裂在内的不同类型脉络膜旁病变的发生有关，并且与黄斑玻璃体粘连相比，在 MRS 的发生中起更重要的作用。
