En face optical coherence tomography of the posterior pole in high myopia.
OBJECTIVE
To evaluate a large series of patients affected by high myopia using multiplanar imaging provided by en face optical coherence tomography (OCT).


METHODS
Observational cross-sectional study.


METHODS
En face OCT longitudinal cross-sectional B scans and coronal C scans were obtained in 200 eyes of 100 patients with myopia greater than -6 diopters and evidence of posterior staphyloma at fundus examination and at ultrasound B-scan evaluation.


RESULTS
A macular hole was present in three eyes (1.5%). We detected posterior retinal detachment in 37 cases (18.5%). In 15 eyes (7.5%) detachment was associated with a macular hole. In the remaining 22 eyes (11%), the detachment was located in the area of the staphyloma, and was associated with vitreoretinal traction in four eyes (18.2%) of 22 eyes. There was evidence of detachment of the internal limiting membrane (ILM) in 12 eyes (6%) and retinoschisis in 27 (13.5%) of 200 eyes. Retinal vascular microfolds were detected in 40 eyes (20%), and occurred in all cases of peripapillary retinal detachment, ILM detachment, and retinoschisis. Paravascular microcysts occurred in three eyes (1.5%), and peripapillary detachment of the pigment epithelium in 10 eyes (5%).


CONCLUSIONS
En face OCT provides accurate imaging of retinal abnormalities in high myopia and allows width measurement and point-to-point localization of alterations. Thus, it can represent a noninvasive way to detect minimal changes during follow-up. Posterior detachment in the absence of a macular hole seems to be related to vitreoretinal traction, staphyloma, and inward forces exerted by rigid retinal vessels and ILM. En face OCT-assisted surgery of macular holes could help to plan removal of premacular tractional structures.
Eye Department, University Federico II, Via Pansini 5, Naples, Italy. raifor@hotmail.com
Raimondo
R
Forte
Gilda
G
Cennamo
Fabrizia
F
Pascotto
Giuseppe
G
de Crecchio
D000368:Aged; D003430:Cross-Sectional Studies; D003560:Cysts / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D010857:Pigment Epithelium of Eye / Q000473:pathology; D012163:Retinal Detachment / Q000175:diagnosis; D012164:Retinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D012167:Retinal Perforations / Q000175:diagnosis; D012171:Retinal Vessels / Q000473:pathology; D041441:Retinoschisis / Q000175:diagnosis; D015422:Scleral Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D041623:Tomography, Optical Coherence; D014463:Ultrasonography