Purpose

To investigate the relationships between myopic macular retinoschisis (MRS) and posterior staphylomas and to reveal the characteristics of other retinal lesions associated with MRS.

Design

Retrospective, observational case series.

Participants

Seven hundred twenty-nine eyes of 420 patients with high myopia, which was defined as myopic refractive error of more than –8.0 diopters or an axial length longer than 26.5 mm.

Methods

Highly myopic eyes were examined by ultrawide-field (UWF) swept-source (SS) OCT with scan width of up to 23 mm and scan depth of 5 mm. The OCT features of MRS and posterior staphylomas and their spatial relationship were examined in UWF SS OCT images.

Main Outcome Measures

Associations between MRS and staphylomas.

Results

In 729 eyes with mean axial length of 30.2±2.1 mm, posterior staphyloma was detected in 482 eyes (66.1%) and MRS was detected in 136 eyes (18.7%). All 136 eyes with an MRS showed outer retinoschisis, and 40 eyes (29.4%) also showed inner retinoschisis. Posterior staphyloma was detected significantly more frequently in eyes with MRS (117/136 [86.0%]) than in eyes without MRS (365/593 [61.6%]; P < 0.001). In all eyes with both staphyloma and outer retinoschisis, the area of the outer retinoschisis was restricted to the area within the staphyloma. In 1 of the 19 eyes with outer retinoschisis but without staphyloma, the outer retinoschisis extended beyond the range of the scanned fundus area. Among the 40 eyes with inner retinoschisis, the inner retinoschisis was located within the region of the outer retinoschisis in 39 eyes (97.5%). In all eyes with inner retinoschisis, retinal lesions causing an inward-directed tractional force were found within the area of the inner retinoschisis.

Conclusions

In highly myopic eyes, the sites of the MRS and staphylomas were spatially related to each other. Posterior-directed force in association with staphylomas, and an inward-directed force resulting from epiretinal membranes or vitreoretinal attachments, may act as causative factors for MRS. However, the exact mechanisms related to the development of an MRS are probably diverse and complex.

中文翻译：

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超广角OCT研究近视黄斑视网膜裂隙与后葡萄球菌之间的关系。

目的

目的探讨近视性黄斑视网膜裂隙症（MRS）与后葡萄球菌之间的关系，并揭示与MRS相关的其他视网膜病变的特征。

设计

回顾性，观察性病例系列。

参加者

420名高度近视患者的279眼被定义为近视屈光度大于–8.0屈光度或轴长大于26.5 mm。

方法

通过超宽视野（UWF）扫描源（SS）OCT检查高度近视眼，扫描宽度最大为23 mm，扫描深度为5 mm。在UWF SS OCT图像中检查了MRS和后葡萄球瘤的OCT特征及其空间关系。

主要观察指标

MRS和葡萄球菌之间的关联。

结果

在平均轴长为30.2±2.1 mm的729眼中，在482眼中检出后葡萄球菌（66.1％），在136眼中检出MRS（18.7％）。患有MRS的所有136眼均表现为外部视网膜分裂症，其中40眼（占29.4％）也表现为内部视网膜分裂症。检测后巩膜葡萄显著更频繁地在眼睛MRS（136分之117[86.0％]）比眼睛无MRS（593分之365[61.6％]; P<0.001）。在所有具有葡萄球菌和外部视网膜骨分裂症的眼中，外部视网膜骨分裂症的区域被限制在葡萄球菌内的区域。在19眼有外部视网膜骨分裂症但无葡萄球瘤的眼中，外部视网膜骨分裂症的范围超出了眼底区域的范围。在40只具有内部视网膜分裂的眼中，内部视网膜分裂位于39只眼的外部视网膜分裂的区域内（97.5％）。在所有具有内视神经分裂症的眼中，在内视神经分裂症区域内发现了引起向内牵引力的视网膜病变。

结论

在高度近视眼中，MRS和葡萄状瘤的部位在空间上彼此相关。与葡萄球菌相关的后向力，以及由视网膜前膜或玻璃体视网膜附件引起的向内力可能是MRS的致病因素。但是，与MRS的发展有关的确切机制可能是多种多样且复杂的。