Zhang Ke, Yang Xiaohan, Wang Zengyi, Yu Yanping, Yu Yajie, Liu Lingzi, Qi Biying, Wu Xijin, Liu Wu
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1, Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
Beijing Ophthalmology and Visual Science Key Lab., Beijing, China.
Graefes Arch Clin Exp Ophthalmol. 2023 Jan;261(1):57-65. doi: 10.1007/s00417-022-05766-8. Epub 2022 Jul 22.
To observe the characteristics of highly myopic macular holes (HMMHs) with macular retinoschisis (MRS) by optical coherence tomography (OCT) and explore the possible relationship between HMMHs and different types of MRS.
We consecutively reviewed the clinical data and OCT images of the patients with HMMHs from June 2015 to February 2021. Then we picked eyes with MRS from these HMMHs for analysis. The minimum linear diameter (MLD), basal diameter (BD), and height (H) of HMMHs were measured. HMMHs were grouped according to the extent or layer involvement of the concomitant MRS and the characteristics were compared among groups. The impact of MRS on the MLD of macular hole was analyzed with multivariable linear regression.
We included 127 patients with MRS from 168 HMMHs (75.5%) for analysis. According to the different classification systems, the most frequent type of MRS in HMMHs was S3 (foveal but not entire macular area MRS) (62.2%) and both inner- and outer- (I/O-MRS) involved types. In our study, HMMHs with more extensive MRS had larger MLD, larger BD, larger H, and poorer best-corrected visual acuity (BCVA). Meanwhile, HMMHs with outer layer-involved MRS (outer MRS and I/O-MRS) had larger BD than HMMH with only inner layer-involved MRS. (All P < 0.05) Multivariable linear regression further illustrated only the extent of MRS was significantly associated with the MLD of HMMH, while there was no significant correlation between the involved retinal layers and the MLD of HMMH.
HMMH with MRS presented as a predominant type in HMMHs. The MRS was always with a relatively large extent and involved both inner and outer layers. MLD of HMMH was mainly affected by the extent of MRS.
通过光学相干断层扫描（OCT）观察伴有黄斑视网膜劈裂（MRS）的高度近视黄斑裂孔（HMMH）的特征，并探讨HMMH与不同类型MRS之间的可能关系。
我们连续回顾了2015年6月至2021年2月期间HMMH患者的临床资料和OCT图像。然后从这些HMMH中挑选出伴有MRS的眼睛进行分析。测量HMMH的最小线性直径（MLD）、基底直径（BD）和高度（H）。根据伴随MRS的累及范围或层次对HMMH进行分组，并比较各组之间的特征。采用多变量线性回归分析MRS对黄斑裂孔MLD的影响。
我们纳入了168只HMMH中的127例伴有MRS的患者（75.5%）进行分析。根据不同的分类系统，HMMH中最常见的MRS类型是S3（仅累及黄斑中心凹而非整个黄斑区的MRS）（62.2%）以及内层和外层均累及的类型（I/O-MRS）。在我们的研究中，伴有更广泛MRS的HMMH具有更大的MLD、更大的BD、更大的H以及更差的最佳矫正视力（BCVA）。同时，外层累及MRS的HMMH（外层MRS和I/O-MRS）的BD比仅内层累及MRS的HMMH更大。（所有P < 0.05）多变量线性回归进一步表明，仅MRS的范围与HMMH的MLD显著相关，而视网膜累及层次与HMMH的MLD之间无显著相关性。
伴有MRS的HMMH是HMMH中的主要类型。MRS通常范围相对较大，且累及内层和外层。HMMH的MLD主要受MRS范围的影响。
