Peculiar arcuate scotoma in pathologic myopia--optical coherence tomography to detect peripapillary neural tissue loss over the disc crescent.
BACKGROUND
Optical coherence tomography (OCT) was used to detect peripapillary neural tissue loss (PPNTL) over the disc crescent in pathologic myopia. The retinal neural tissue loss located inside the disc crescent in pathologic myopia is a newly recognized fundus lesion.


METHODS
Review of ten eyes of ten patients with peripapillary yellowish-white retinal lesions who underwent OCT for evaluation of the nature of PPNTL in pathologic myopia. OCT, fluorescein angiography, automated visual fields, axial length measurement with ultrasound A scan, and ultrasound B scan were performed.


RESULTS
Ten eyes of ten patients were identified during a 14-year period to have findings characteristic of PPNTL. The mean age of the patients was 46 years. They were followed up for an average of 9 years. The mean spherical equivalent correction was -10.50 diopters (D) (range -6.0--16.0 D). The mean axial length was 28.6 mm (range 26.30-31.50 mm). In each case, OCT showed a complete retinal discontinuity in the PPNTL lesion. Automated visual field examination showed corresponding arcuate scotoma. During the follow-up period, the inner retina layer of the retinal defect margin was elevated by posterior hyaloid and partial retinal detachment developed in one eye.


CONCLUSIONS
PPNTL in pathologic myopia is a relatively asymptomatic, yellowish-white peripapillary retinal discontinuity. Recognition of this lesion is important because the visual field defect may mimic glaucomatous changes owing to the loss of nerve fiber layer. Progressive partial retinal detachment may ensue as one of the complications of the peripapillary lesion.
Ho
Tzyy-Chang
TC
Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, 7, Chung-Shan South Road, 100 Taipei, Taiwan. hotc@ha.mc.ntu.edu.tw
Shih
Yung-Feng
YF
Lin
Szu-Yung
SY
Lin
Luke L-K
LL
Chen
Muh-Shy
MS
D000328:Adult; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000175:diagnosis*; D009412:Nerve Fibers / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012607:Scotoma / Q000175:diagnosis*; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields