Characteristics of peripapillary detachment in pathologic myopia.
OBJECTIVE
To evaluate the prevalence and clinical features of a newly recognized peripapillary lesion specific to high myopia, peripapillary detachment in pathologic myopia (PDPM), in a large series of patients with high myopia.


METHODS
Three hundred twenty-four patients (632 eyes) with high myopia were enrolled in this study. We examined the prevalence, range, fluorescein and indocyanine green angiographic findings, and optical coherence tomography findings of PDPM for these patients. Visual field testing (Goldmann kinetic perimetry and the Humphrey 30-2 program) was also performed in the patients with PDPM.


RESULTS
Peripapillary detachment in pathologic myopia was identified in 31 of 632 highly myopic eyes (4.9%). The optical coherence tomographic scan across the PDPM lesion revealed a localized detachment of retinal pigment epithelium adjacent to the optic nerve. Although PDPM was always situated adjacent to the inferior edge of the optic disc, in some patients it surrounded almost the entire optic disc. There was a steep excavation of the inferior myopic conus adjacent to the PDPM, and the inferotemporal retinal vein was markedly bent at the transition from the PDPM to the excavated myopic conus. Glaucomatous visual field defects were frequently detected in eyes with PDPM (71.0%).


CONCLUSIONS
The findings of this study indicate that PDPM is not uncommon among highly myopic eyes. Although its pathogenesis and pathologic significance require further classification, PDPM might be another indicator of visual field defects in high myopia.
Shimada
Noriaki
N
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113, Japan.
Ohno-Matsui
Kyoko
K
Yoshida
Takeshi
T
Yasuzumi
Kenjiro
K
Kojima
Ariko
A
Kobayashi
Kanako
K
Futagami
Soh
S
Tokoro
Takashi
T
Mochizuki
Manabu
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D009898:Optic Disk / Q000473:pathology*; D015995:Prevalence; D012163:Retinal Detachment / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields
D007208:Indocyanine Green