Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Institute of Ophthalmology, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China.
Curr Eye Res. 2022 Apr;47(4):642-649. doi: 10.1080/02713683.2021.2009517. Epub 2021 Dec 14.
To evaluate the risk factors for myopic traction maculopathy (MTM) through inter-eye comparisons of asymmetric ocular features in patients with unilateral MTM.
Highly myopic patients with unilateral MTM were enrolled in the study. The results of comprehensive ophthalmologic examinations, color fundus images, and optical coherence tomography (OCT) were reviewed. MTM and myopic atrophic maculopathy was evaluated according to the ATN classification system. The status of the posterior vitreous detachment (PVD), posterior precortical vitreous pocket, vitreoretinal interface abnormalities, posterior staphyloma height (PSH), and the location of the protrusion of the sclera were assessed through OCT.
Among the 54 eyes of 27 patients 48.89 ± 12.78 years of age, the affected eyes had worse best-corrected visual acuity, a longer axial length (AXL), greater PSH, and higher rates of posterior staphylomas, vitreovascular traction and epiretinal membranes (ERMs) than the fellow eyes ( < .001; < .001; < .001; = .010; = .002; < .001). Thirteen cases present obvious anisometropia with an inter-eye AXL difference of more than 1 mm. In the 14 cases without obvious anisometropia, the eyes with MTM still had longer AXL, greater PSH and a higher ERMs rate than the fellow eyes ( = .039; = .017; = .001). Besides, in the 7 cases with an inter-eye AXL difference of less than 1 mm and asymmetrical stages of PVD, 5 cases with greater PVD in the affected eyes. Multiple risk factors coexisted in 96% of cases.
In patients with unilateral MTM, a longer AXL, greater PSH, posterior staphyloma, vitreovascular traction, and ERMs were the main factors contributing to the occurrence of MTM. The process of PVD might involve in MTM development.
通过对比单侧 MT 患者的双眼不对称眼部特征，评估近视牵引性黄斑病变（MTM）的危险因素。
本研究纳入了单侧 MTM 患者。回顾了全面眼科检查、眼底彩照和光学相干断层扫描（OCT）的结果。根据 ATN 分类系统评估 MTM 和近视性萎缩性黄斑病变。通过 OCT 评估后玻璃体脱离（PVD）、后皮质玻璃体袋、玻璃体视网膜界面异常、后葡萄肿高度（PSH）和巩膜突出位置。
在 27 名患者的 54 只眼中（48.89 ± 12.78 岁），患眼的最佳矫正视力更差，眼轴（AXL）更长，PSH 更大，后葡萄肿、血管性玻璃体牵引和视网膜前膜（ERM）的发生率更高（ < 0.001； < 0.001； < 0.001； = 0.010； = 0.002； < 0.001）。13 例存在明显的屈光参差，双眼 AXL 差值大于 1mm。在 14 例无明显屈光参差的患者中，MTM 眼的 AXL 仍较长，PSH 较大，ERM 发生率较高（ = 0.039； = 0.017； = 0.001）。此外，在 7 例双眼 AXL 差值小于 1mm 且 PVD 程度不对称的患者中，5 例患眼的 PVD 较大。96%的病例存在多种危险因素并存。
在单侧 MTM 患者中，较长的 AXL、较大的 PSH、后葡萄肿、血管性玻璃体牵引和 ERM 是导致 MTM 发生的主要因素。PVD 过程可能涉及 MTM 的发生。
