后葡萄肿是导致近视性黄斑病变的决定因素。

Posterior Staphyloma as Determining Factor for Myopic Maculopathy.

机构信息

Puerta de Hierro-Majadahonda University Hospital (J.M.R.-M., M.P., I.F.-M., E.A.-A., M.G-Z., J.R.-M), Madrid, Spain; Department of Ophthalmology (J.M.R.-M.), Castilla La Mancha University, Albacete, Spain; Miranza Corporation (J.M.R.-M., J.R.-M), Madrid, Spain.

Puerta de Hierro-Majadahonda University Hospital (J.M.R.-M., M.P., I.F.-M., E.A.-A., M.G-Z., J.R.-M), Madrid, Spain.

出版信息

Am J Ophthalmol. 2023 Aug;252:9-16. doi: 10.1016/j.ajo.2023.02.017. Epub 2023 Mar 2.

DOI:10.1016/j.ajo.2023.02.017

PMID:36868340

Abstract

PURPOSE

The aim of this study was to determine the influence of posterior staphyloma (PS) on the development of myopic maculopathy.

DESIGN

Cross-sectional study.

METHODS

A total of 467 highly myopic eyes (axial length [AL] ≥26 mm) of 246 patients were included. Patients underwent a complete ophthalmological examination, including multimodal imaging. Presence of PS was defined as the main variable analyzed between groups (PS vs non-PS): age, AL, best-corrected visual acuity (BCVA), atrophy/traction/neovascularization (ATN) components, and presence of severe pathologic myopia (PM). Two different cohorts were studied (age-matched and AL-matched) comparing PS vs non-PS eyes.

RESULTS

In all, 325 eyes (69.59%) presented with PS. Eyes without PS were younger and had lower AL, ATN components, and prevalence of severe PM than those with PS (P < .001). Moreover, non-PS eyes had better BCVA (P < .001). Analyzing the age-matched cohort (P = .96); mean AL, A, and T components, and severe PM were significantly higher in the PS group (P < .001), as well as the N component (P < .005), showing worse BCVA (P < .001). Regarding the AL-matched cohort (P = .93), the PS group showed worse BCVA (P < .01), older age (P < .001), A (P < .001), and T components (P < .01), and severe PM (P < .01). The risk of PS increased by 10% per year of age (odds ratio = 1.109, P < .001) and by 132% per each millimeter of growth of AL (odds ratio = 2.318, P < .001).

CONCLUSIONS

Posterior staphyloma is associated with myopic maculopathy, worse visual acuity, and higher prevalence of severe PM. AL and age, in this order, constitute the main factors associated with the onset of PS.

摘要

目的

本研究旨在探讨后葡萄肿（PS）对近视性黄斑病变发展的影响。

设计

横断面研究。

方法

共纳入 246 例患者的 467 只高度近视眼（眼轴长度[AL]≥26mm）。患者接受全面眼科检查，包括多模态成像。PS 的存在定义为组间分析的主要变量（PS 与非 PS）：年龄、AL、最佳矫正视力（BCVA）、萎缩/牵引/新生血管（ATN）成分和严重病理性近视（PM）的存在。研究了两个不同的队列（年龄匹配和 AL 匹配），比较 PS 与非 PS 眼。

结果

共有 325 只眼（69.59%）出现 PS。与无 PS 的眼相比，PS 眼的年龄较大，AL 较短，ATN 成分更多，严重 PM 的发生率更高（P<.001）。此外，无 PS 的眼 BCVA 更好（P<.001）。分析年龄匹配的队列（P=.96）；PS 组的平均 AL、A 和 T 成分以及严重 PM 明显更高（P<.001），N 成分也更高（P<.005），BCVA 更差（P<.001）。关于 AL 匹配的队列（P=.93），PS 组的 BCVA 更差（P<.01），年龄更大（P<.001），A（P<.001）和 T 成分（P<.01），以及严重 PM（P<.01）。PS 的风险每年增加 10%（优势比=1.109，P<.001），AL 每增加 1 毫米增加 132%（优势比=2.318，P<.001）。