The Experts below are selected from a list of 2718 Experts worldwide ranked by ideXlab platform
Kyoko Ohnomatsui - One of the best experts on this subject based on the ideXlab platform.
-
development of macular atrophy after pars plana vitrectomy for myopic traction maculopathy and macular hole retinal detachment in Pathologic Myopia
Retina-the Journal of Retinal and Vitreous Diseases, 2020Co-Authors: Yuxin Fang, Tae Yokoi, Kengo Uramoto, Noriaki Shimada, Kosei Shinohara, Hiroyuki Takahashi, Kyoko OhnomatsuiAbstract:PURPOSE To determine the incidence and long-term outcome of macular atrophy (MA) after pars plana vitrectomy (PPV) in Pathologic Myopia. METHODS Highly myopic patients who underwent PPV for myopic traction maculopathy and macular hole retinal detachment at Tokyo Medical and Dental University between 2012 and 2016 were studied. Fundus photographs and/or optical coherence tomography were examined before and after PPV at every visit. RESULTS A total of 133 eyes were followed for 39 months with the mean age of 62.8 years and the mean axial length of 30.0 mm. Postoperatively, 14 eyes (10.5%) developed fovea-centered MA, observed initially as a small, isolated, whitish lesion at the center of fovea at 3.5 months after PPV. The appearance of the MA was distinctly different from the choroidal neovascularization-related MA or patchy atrophy-related MA. With time, the lesions enlarged circumferentially. In these 14 eyes, the final best-corrected visual acuity was worse than the baseline, although the difference was not significant. The occurrence of MA was significantly associated with the preoperative foveal status. CONCLUSION The development of MA can occur in 11% of highly myopic eyes after PPV for myopic traction maculopathy and macular hole retinal detachment. This postoperative MA might be a new complication of Pathologic Myopia.
-
clinical features of patchy chorioretinal atrophy in Pathologic Myopia
Retina-the Journal of Retinal and Vitreous Diseases, 2020Co-Authors: Yuxin Fang, Jost Bruno Jonas, Tae Yokoi, Takeshi Yoshida, Koju Kamoi, Kengo Uramoto, Hiroyuki Takahashi, Kyoko OhnomatsuiAbstract:Purpose To reveal clinical features of patchy atrophy in Pathologic Myopia and investigate the status of the Bruch membrane and retinal pigment epithelium by swept-source optical coherence tomography. Methods This study reviewed highly myopic patients who visited the high Myopia clinic between January 2015 and February 2018. Wide-field photographs and wide-field fundus autofluorescence fundus images were used as the primary method for identifying PAs, and swept-source optical coherence tomography images were used for investigating the retinochoroid status of PAs. Results Four hundred fifty-six PAs were detected in 137 eyes (118 patients). Patchy atrophys were located most often in the macular area (28.3%), followed by the inferior (25.9%), temporal (18.9%), nasal (14.5%), and superior (12.5%) region. All 210, PAs which had been fully or partially scanned by swept-source optical coherence tomography, showed a retinal pigment epithelium defect, and 174 (82.9%) PAs showed a Bruch membrane defect on the available scans. In 101 (82.8%) of 122 PAs with clearly detectable borders of the retinal pigment epithelium and Bruch membrane defect, the Bruch membrane defects were smaller than the retinal pigment epithelium defects. A dome-shape inward bulging of the sclera was observed in 10 PAs. Conclusion These morphological findings may provide a basis for exploring the biomechanical etiology of the PAs as part of the development of Pathologic Myopia.
-
posterior staphyloma in Pathologic Myopia
Progress in Retinal and Eye Research, 2018Co-Authors: Kyoko Ohnomatsui, Jost Bruno JonasAbstract:Abstract A posterior staphyloma is an outpouching of a circumscribed region of the posterior fundus and has been considered a hallmark of Pathologic Myopia. Occurring in highly myopic eyes, it is histologically characterized by a relatively abrupt scleral thinning starting at the staphyloma edge, a pronounced de-arrangement of scleral collagen fibrils and a marked choroidal thinning, which is the most marked at the staphyloma edge and which occurs in addition to the axial elongation-associated choroidal thinning. Besides in highly myopic eyes, a posterior staphyloma can be found in non-highly myopic eyes in association with retinitis pigmentosa or localized defects of Bruch's membrane in the cases of which it is not associated with a marked choroidal thinning. The diagnosis of posterior staphylomas is considered best made by wide-field optical coherence tomography, because wide-field optical coherence tomography encompasses the entire extent of the most predominant type of staphylomas (i.e., the wide macular type) and since it also has a sufficiently high resolution of images (in contrast to ultrasonography, computed tomography and three-dimensional magnetic resonance imaging). While the etiology of posterior staphylomas has remained unclear, local choroidal factors and a locally decreased biomechanical resistance of the sclera against a posteriorly expanding Bruch's membrane have been one of the assumed pathogenic parameters. For the therapy of staphylomas, scleral reinforcement strategies such as by posterior encircling bands, posterior scleral collagen cross-linking or scleral regeneration have been discussed or performed, however, with the pathogenesis being elusive, the therapy of staphylomas has remained undetermined.
-
peripapillary diffuse chorioretinal atrophy in children as a sign of eventual Pathologic Myopia in adults
Ophthalmology, 2016Co-Authors: Tae Yokoi, Muka Moriyama, Natsuko Nagaoka, Takeshi Yoshida, Noriaki Shimada, Jost B Jonas, Kyoko OhnomatsuiAbstract:Purpose To search for a morphologic biomarker to differentiate between Pathologic Myopia and simple childhood Myopia. Design Retrospective case series. Participants The study included children (age ≤15 years) with high Myopia (as defined by the Japanese Ministry of Health and Welfare) who attended the High Myopia Clinic between April 1982 and March 1994, had undergone fundus photography, and had a follow-up of 20 years or more. Methods Fundus photographs obtained in childhood and adulthood were examined for presence of Pathologic Myopia, defined by high Myopia (myopic refractive error >8 diopters or axial length ≥26.5 mm) and the presence of stage 2 or higher myopic maculopathy. Main Outcome Measures Myopic maculopathy in childhood. Results The study included 56 eyes of 29 patients with a mean age of 10.2±3.6 years at the initial visit and an age of 36.0±7.6 years at the last visit. Mean axial length was 27.0±1.4 mm at baseline and 29.7±2.0 mm at the last visit. At the last visit, 19 eyes (34%) had tessellated fundus alone, 31 eyes (55%) had diffuse chorioretinal atrophy, 3 eyes (5%) showed patchy chorioretinal atrophy, and 1 eye (2%) had macular atrophy. Thus, 35 eyes (63%) had Pathologic Myopia in adulthood. Among the 35 eyes, 29 (83%) already had diffuse chorioretinal atrophy at the initial visit in childhood and the remaining 6 eyes (17%) showed tessellated fundus in childhood. The diffuse chorioretinal atrophy seen in childhood was restricted to the area temporal to the peripapillary region. Conclusions The presence of peripapillary diffuse chorioretinal atrophy in children with high axial Myopia may be an indicator for the eventual development of advanced myopic chorioretinal atrophy in later life. These features in children may be helpful for differentiating simple childhood Myopia from eventual Pathologic Myopia.
-
areas of nonperfusion in peripheral retina of eyes with Pathologic Myopia detected by ultra widefield fluorescein angiography
Investigative Ophthalmology & Visual Science, 2014Co-Authors: Yuichiro Kaneko, Muka Moriyama, Shuichiro Hirahara, Yuichiro Ogura, Kyoko OhnomatsuiAbstract:PURPOSE We investigated the vascular system in the far peripheral retina in eyes with Pathologic Myopia by ultra-widefield fluorescein angiography (FA). METHODS We analyzed retrospectively 230 with Pathologic Myopia (myopic refractive error >8 diopters [D] or axial length >26.5 mm) and 42 emmetropic (refractive error < ± 2 D) controls who were examined with ultra-widefield FA by the Optos P200 system. Far peripheral retina was defined as the area anterior to the ampullae of the vortex veins. RESULTS Retinal capillary telangiectasia was observed in the far periphery of 34 of 42 (81.0%) emmetropic eyes and in 90 of 115 (78.3%) highly myopic eyes. Retinal capillary microaneurysms were observed in 13 of 42 (31.0%) emmetropic eyes and in 60 of 115 (52.2%) eyes with Pathologic Myopia. The differences in the incidences of these two lesions were not significant. Areas of nonperfusion in the far periphery were found in two of 42 (4.8%) emmetropic eyes and in 95 of 115 (82.6%) eyes with Pathologic Myopia. In these myopic eyes, the arterioles and venules had an abrupt ending, and in advanced cases, the perfused area was limited to just beyond the staphyloma border. None of the eyes developed retinal neovascularization. Statistical analyses showed that the highly myopic patients with avascular areas in the far periphery were significantly older, and had significantly longer axial length. CONCLUSIONS Areas of nonperfusion in the far periphery are common in eyes with Pathologic Myopia. Retinal vasculature in the far periphery is significantly altered in eyes with Pathologic Myopia, and this may be due to a mechanical stretching.
Kyoko Ohno-matsui - One of the best experts on this subject based on the ideXlab platform.
-
Definition of Pathologic Myopia (PM)
Atlas of Pathologic Myopia, 2020Co-Authors: Kyoko Ohno-matsuiAbstract:The definition of Pathologic Myopia had not been standardized for a long time, and Pathologic Myopia was often confused with high Myopia. These two are distinctly different; “high Myopia” is defined as an eye with a high degree of myopic refractive error, and “Pathologic Myopia” is defined as myopic eyes with the presence of Pathologic lesions in the posterior fundus. The changes are the presence of myopic maculopathy equal to or more serious than diffuse chorioretinal atrophy and/or the presence of a posterior staphyloma.
-
Novel Paravascular Lesions with Abnormal Autofluorescence in Pathologic Myopia.
Ophthalmology, 2020Co-Authors: Yuxin Fang, Takeshi Yoshida, Takashi Watanabe, Yuka Onishi, Tomoka Ishida, Shiqi Xie, Tae Igarashi-yokoi, Kyoko Ohno-matsuiAbstract:Abstract Novel paravascular lesions with abnormal autofluorescence (AF) were found in eyes with Pathologic Myopia. Most lesions were uniform hypo-AF, followed by hyper-AF, and granular hypo-AF. Optical coherence tomography showed retinal thinning with or without defects of the retinal pigment epithelium. Pathologic Myopia (PM) is characterized by an increase in the axial length of the eye and formation of posterior staphylomas. Much attention has been paid to the macular lesions in the clinical management of patients with PM. However, recent studies have shown that wider areas of the fundus can be affected such as radial tracts that emanate from the upper staphyloma edges and peripheral avascular zones. These findings suggested that PM may not simply be a macular disorder but a disorder with various pathologies in wide areas of the fundus including the far periphery.
-
Understanding Pathologic Myopia
Updates on Myopia, 2020Co-Authors: Kyoko Ohno-matsui, Jost Bruno JonasAbstract:Fundus complications due to Pathologic Myopia are a major cause of visual impairment and blindness worldwide, especially in East Asian countries. The patients with Pathologic Myopia develop loss of the best-corrected vision due to various lesions occurring in the macula and the optic nerve. In the META-PM (meta analyses of Pathologic Myopia) study classification, Pathologic Myopia has been defined by the presence of myopic chorioretinal atrophy equal to or more serious than diffuse atrophy and/or the presence of posterior staphyloma. In addition, the advent of new imaging technologies, such as optical coherence tomography (OCT), ultra wide-field OCT, and three-dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to Pathologic Myopia. In addition, new pathology such as dome-shaped macula has been clarified. Therapeutic approaches such as intravitreal injections of anti-vascular endothelial growth factor agents and the vitreoretinal surgeries for myopic macular retinoschisis have greatly improved the prognosis of patients with Pathologic Myopia. In the future, therapies targeting staphylomas are expected.
-
Imaging of Pathologic Myopia.
Asia-Pacific journal of ophthalmology (Philadelphia Pa.), 2019Co-Authors: Kyoko Ohno-matsui, Kengo Uramoto, Kosei Shinohara, Yuxin Fang, Hiroyuki Takahashi, Tae YokoiAbstract:Pathologic Myopia (PM) is a major cause of irreversible visual impairment worldwide and especially in East Asian countries. The complications of PM include myopic maculopathy, myopic macular retinoschisis, dome-shaped macula, and myopic optic neuropathy. Posterior staphyloma is an important component of the diagnosis of PM and one of the hallmarks of PM. The photographic classification and grading system for myopic maculopathy has already been determined. Conventionally optical coherence tomography (OCT) was commonly used in PM and enabled investigators to image deeper tissue such as choroid and sclera. Today, the technological advances in OCT imaging including ultra-widefield OCT and 3-dimensional construction of OCT have given clinicians a novel insight on variable morphology in the PM.
-
Diagnosis and treatment guideline for myopic choroidal neovascularization due to Pathologic Myopia
Progress in retinal and eye research, 2017Co-Authors: Kyoko Ohno-matsui, Yasushi Ikuno, Timothy Y. Y. Lai, Chui Ming Gemmy CheungAbstract:Pathologic Myopia is a leading cause of visual impairment. Development of myopic choroidal neovascularization (CNV) is one of the most common complications that leads to central vision loss in patients with Pathologic Myopia. If left untreated, it can cause scarring with expanding macular atrophy leading to irreversible visual loss in a period as short as 5 years. Advancements in multimodal imaging technology have furthered our understanding of the condition; however, further studies are necessary to extend its utility in the diagnosis of myopic CNV. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy has become the standard-of-care and the recommended first-line treatment option for myopic CNV. Long-term studies have demonstrated that early treatment of confirmed myopic CNV cases with an intravitreal anti-VEGF agent is useful to avoid late-stage complications. This strategy has also been shown to achieve visual outcome improvements for up to 4 years and visual stabilization up to 6 years. This review article provides an overview of the current knowledge on myopic CNV and discusses recent updates in the diagnosis and management of the condition. Furthermore, treatment recommendations are provided based on the authors' expert opinions.
Noriaki Shimada - One of the best experts on this subject based on the ideXlab platform.
-
development of macular atrophy after pars plana vitrectomy for myopic traction maculopathy and macular hole retinal detachment in Pathologic Myopia
Retina-the Journal of Retinal and Vitreous Diseases, 2020Co-Authors: Yuxin Fang, Tae Yokoi, Kengo Uramoto, Noriaki Shimada, Kosei Shinohara, Hiroyuki Takahashi, Kyoko OhnomatsuiAbstract:PURPOSE To determine the incidence and long-term outcome of macular atrophy (MA) after pars plana vitrectomy (PPV) in Pathologic Myopia. METHODS Highly myopic patients who underwent PPV for myopic traction maculopathy and macular hole retinal detachment at Tokyo Medical and Dental University between 2012 and 2016 were studied. Fundus photographs and/or optical coherence tomography were examined before and after PPV at every visit. RESULTS A total of 133 eyes were followed for 39 months with the mean age of 62.8 years and the mean axial length of 30.0 mm. Postoperatively, 14 eyes (10.5%) developed fovea-centered MA, observed initially as a small, isolated, whitish lesion at the center of fovea at 3.5 months after PPV. The appearance of the MA was distinctly different from the choroidal neovascularization-related MA or patchy atrophy-related MA. With time, the lesions enlarged circumferentially. In these 14 eyes, the final best-corrected visual acuity was worse than the baseline, although the difference was not significant. The occurrence of MA was significantly associated with the preoperative foveal status. CONCLUSION The development of MA can occur in 11% of highly myopic eyes after PPV for myopic traction maculopathy and macular hole retinal detachment. This postoperative MA might be a new complication of Pathologic Myopia.
-
peripapillary diffuse chorioretinal atrophy in children as a sign of eventual Pathologic Myopia in adults
Ophthalmology, 2016Co-Authors: Tae Yokoi, Muka Moriyama, Natsuko Nagaoka, Takeshi Yoshida, Noriaki Shimada, Jost B Jonas, Kyoko OhnomatsuiAbstract:Purpose To search for a morphologic biomarker to differentiate between Pathologic Myopia and simple childhood Myopia. Design Retrospective case series. Participants The study included children (age ≤15 years) with high Myopia (as defined by the Japanese Ministry of Health and Welfare) who attended the High Myopia Clinic between April 1982 and March 1994, had undergone fundus photography, and had a follow-up of 20 years or more. Methods Fundus photographs obtained in childhood and adulthood were examined for presence of Pathologic Myopia, defined by high Myopia (myopic refractive error >8 diopters or axial length ≥26.5 mm) and the presence of stage 2 or higher myopic maculopathy. Main Outcome Measures Myopic maculopathy in childhood. Results The study included 56 eyes of 29 patients with a mean age of 10.2±3.6 years at the initial visit and an age of 36.0±7.6 years at the last visit. Mean axial length was 27.0±1.4 mm at baseline and 29.7±2.0 mm at the last visit. At the last visit, 19 eyes (34%) had tessellated fundus alone, 31 eyes (55%) had diffuse chorioretinal atrophy, 3 eyes (5%) showed patchy chorioretinal atrophy, and 1 eye (2%) had macular atrophy. Thus, 35 eyes (63%) had Pathologic Myopia in adulthood. Among the 35 eyes, 29 (83%) already had diffuse chorioretinal atrophy at the initial visit in childhood and the remaining 6 eyes (17%) showed tessellated fundus in childhood. The diffuse chorioretinal atrophy seen in childhood was restricted to the area temporal to the peripapillary region. Conclusions The presence of peripapillary diffuse chorioretinal atrophy in children with high axial Myopia may be an indicator for the eventual development of advanced myopic chorioretinal atrophy in later life. These features in children may be helpful for differentiating simple childhood Myopia from eventual Pathologic Myopia.
-
PERIPHERAL PIGMENTED STREAKS IN EYES WITH Pathologic Myopia.
Retina (Philadelphia Pa.), 2016Co-Authors: Kosei Shinohara, Takeshi Yoshida, Muka Moriyama, Noriaki Shimada, Kyoko Ohno-matsuiAbstract:PURPOSE To determine the incidence and the characteristics of peripheral pigmented streaks in the eyes with Pathologic Myopia. METHODS The widefield fundus images of 375 eyes (203 patients) with Pathologic Myopia were examined. The characteristics of the pigmented streaks existing in the peripheral fundus were analyzed. The spatial relationships between the steep edge of a staphyloma and the distribution of the streaks were also determined. RESULTS Peripheral streaks were observed in 165 of the 375 eyes (44.0%) as dark, pigmented, radially oriented lesions resembling octopus tentacles. The streaks ran from the mid periphery to the equator. Large choroidal vessels were observed in the corresponding sites, so the streaks probably existed in the layer of the large choroidal vessels or deeper. The patients with streak lesions were significantly older and had a posterior staphyloma more frequently than the eyes without the streaks. The streaks were observed mainly in the area opposite the steep edge of a staphyloma. CONCLUSION Peripheral pigmented streaks are seen in approximately 44% of eyes with Pathologic Myopia. The streaks existed in the layer of large choroidal vessels or deeper, and the thinning of the choroid-retina in highly myopic eyes contributes to the visibility of such deep lesions.
-
myopic stretch lines linear lesions in fundus of eyes with Pathologic Myopia that differ from lacquer cracks
Retina-the Journal of Retinal and Vitreous Diseases, 2014Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Yuichiro Tanaka, Kyoko OhnomatsuiAbstract:Purpose:To clarify the pathophysiology of linear hypofluorescent lesions observed by fluorescein angiography (FA) in the posterior fundus of eyes with Pathologic Myopia and to compare the features of these lesions with those of lacquer cracks.Methods:Medical records of 117 eyes of 81 highly myopic p
-
topographic analyses of shape of eyes with Pathologic Myopia by high resolution three dimensional magnetic resonance imaging
Ophthalmology, 2011Co-Authors: Muka Moriyama, Takashi Tokoro, Kyoko Ohnomatsui, Takeshi Yoshida, Noriaki Shimada, Kengo Hayashi, Ikuo MoritaAbstract:Objective To analyze the topography of human eyes with Pathologic Myopia by high-resolution magnetic resonance imaging (MRI) with volume rendering of the acquired images. Design Observational case series. Participants Eighty-six eyes of 44 patients with high Myopia (refractive error ≥−8.00 diopters [D] or axial length >26.5 mm) were studied. Forty emmetropic eyes were examined as controls. Methods The participants were examined with an MRI scanner (Signa HDxt 1.5T, GE Healthcare, Waukesha, WI), and T 2 -weighted cubes were obtained. Volume renderings of the images from high-resolution 3-dimensional (3D) data were done by computer workstation. The margins of globes were then identified semiautomatically by the signal intensity, and the tissues outside the globes were removed. Main Outcome Measures The 3D topographic characteristic of the globes and the distribution of the 4 distinct shapes of globes according to the symmetry and the radius of curvature of the contour of the posterior segment: the barrel, cylindric, nasally distorted, and temporally distorted types. Results In 69.8% of the patients with bilateral high Myopia, both eyes had the same ocular shape. The most protruded part of the globe existed along the central sagittal axis in 78.3% of eyes and was slightly inferior to the central axis in the remaining eyes. In 38 of 68 eyes (55.9%) with bilateral Pathologic Myopia, multiple protrusions were observed. The eyes with 2 protrusions were subdivided into those with nasal protrusions and those with temporal protrusions. The eyes with 3 protrusions were subdivided into nasal, temporal superior, and temporal inferior protrusions. The eyes with visual field defects that could not be explained by myopic fundus lesions significantly more frequently had a temporally distorted shape. Eyes with ≥2 protrusions had myopic chorioretinal atrophy significantly more frequently than eyes with ≤1 protrusion. Conclusions Our results demonstrate that it is possible to obtain a complete topographic image of human eyes by high-resolution MRI with volume-rendering techniques. The results showed that there are different ocular shapes in eyes with Pathologic Myopia, and that the difference in the ocular shape is correlated with the development of vision-threatening conditions in eyes with Pathologic Myopia. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Manabu Mochizuki - One of the best experts on this subject based on the ideXlab platform.
-
prevalence of strabismus in patients with Pathologic Myopia
Journal of medical and dental sciences, 2010Co-Authors: Akiko Tanaka, Takashi Tokoro, Kyoko Ohnomatsui, Takeshi Yoshida, Noriaki Shimada, Kengo Hayashi, Yuko Shibata, Makiko Yamashita, Manabu MochizukiAbstract:Background: To determine the prevalence and clinical features of strabismus in patients with Pathologic Myopia.Methods: Medical records of a total of 636 highly myopic patients were retrospectively reviewed. Pathologic Myopia was defined as spherical equivalent (SE) of at least -8D, or axial length >26.5 mm in patients older than 9 years, <-4D in those younger than 5 years, <-6D in those aged from 6 to 8 years. Myopic refractive degree, axial length measurements, best-corrected visual acuity and eye position were then analyzed.Results: Among 636 patients with Pathologic Myopia, 520 (81.8%) had orthophoria, 85 (13.4%) had exotropia and 31 (4.9%) had esotropia at near distance. At long distance, 499 (86.5%) had orthophoria, 51 (8.8%) had exotropia and 27 (4.7%) had esotropia. Vertical heterotropia was seen in 103 patients (16.2%). The mean axial length was significantly longer and the mean age was higher in esotropia than orthophoria and in patients with vertical heterotropia than without vertical heterotropia. There were 16 patients with myopic strabismus fixus or acquired progressive esotropia.Conclusions: This study confirmed the relatively high prevalence of horizontal and vertical strabismus in patients with Pathologic Myopia.Key Words: Pathologic Myopia, complication, strabismus, axial lengthIntroduction Pathologic Myopia is one of the major causes of blindness worldwide. [1, 2] Pathologic Myopia reportedly causes not only Pathological complications, such as retinal detachment, macular degeneration and optic disc abnormalities, [3] but also functional problems, such as misalignment of eye position. According to our clinical experience, horizontal and/or vertical strabismus is often observed in patients with Pathologic Myopia. In Curtin’s review of the motility clinic, high Myopia was disproportionately frequent when compared to lower grades in every classification of horizontal tropia, [4] but vertical strabismus was not discussed. To the best of our knowledge, there have been no previous studies describing the general characteristics of eye position in high myopes. Progressive esotropia is known in high myopes. Hugonnier and Magnard were the first to direct attention to restrictive motility disturbances in severe Myopia. [5] Esodeviation in high Myopia was estimated to be an acquired condition, and progressed into convergent strabismus and, in severe cases, myopic strabismus fixus. One cause of progressive esotropia is the disproportional size of the orbit and the volume of an elongated eyeball due to Pathologic Myopia, which may be secondary to displacement of the lateral rectus muscle pulley system. [6] As surgical treatment of myopic strabismus fixus is challenging, numerous studies have reported surgical outcomes. Options for correction range from conventional combined recession-resection surgery to innovative surgical procedures aimed at correcting the deviated muscle paths. [6-10] To our knowledge there is little information regarding the general clinical features of strabismus in high myopes. This study was therefore designed to
-
Prevalence of strabismus in patients with Pathologic Myopia.
Journal of medical and dental sciences, 2010Co-Authors: Akiko Tanaka, Kyoko Ohno-matsui, Takashi Tokoro, Takeshi Yoshida, Noriaki Shimada, Kengo Hayashi, Yuko Shibata, Makiko Yamashita, Manabu MochizukiAbstract:Background: To determine the prevalence and clinical features of strabismus in patients with Pathologic Myopia.Methods: Medical records of a total of 636 highly myopic patients were retrospectively reviewed. Pathologic Myopia was defined as spherical equivalent (SE) of at least -8D, or axial length >26.5 mm in patients older than 9 years,
-
macular retinal detachment associated with peripapillary detachment in Pathologic Myopia
International Ophthalmology, 2009Co-Authors: Noriaki Shimada, Takashi Tokoro, Kyoko Ohnomatsui, Yoichi Iwanaga, Manabu MochizukiAbstract:Purpose A peripapillary detachment in Pathologic Myopia (PDPM) appears as a yellowish-orange lesion around the optic disc in highly myopic eyes. We report a case in which a macular retinal detachment (RD) accompanied a PDPM. Method A case report was used in this study. Results The right eye in a 48-year-old man showed a macular RD and a PDPM. Fluorescein fundus angiography showed no dye leakage, suggestive of an optic pit within the optic disc. Optical coherence tomography (OCT) examination revealed that there was a full-thickness tissue defect in the retina overlying PDPM, the vitreous cavity was connected to PDPM through this defect, and the PDPM was continuous with the RD through the subretinal path at the conus area. Conclusions These findings suggest that this eye had a macular RD associated with a PDPM, and eyes with a PDPM might be at risk of developing macular RD.
-
photodynamic therapy with verteporfin for choroidal neovascularization of Pathologic Myopia in japanese patients comparison with nontreated controls
American Journal of Ophthalmology, 2008Co-Authors: Kengo Hayashi, Takashi Tokoro, Kyoko Ohnomatsui, Muka Moriyama, Takeshi Yoshida, Noriaki Shimada, Satoshi Teramukai, Wakako Hara, Manabu MochizukiAbstract:Purpose To examine the effects of photodynamic therapy (PDT) with verteporfin on subfoveal or juxtafoveal choroidal neovascularization (CNV) secondary to Pathologic Myopia in Japanese patients and to compare the visual outcomes of PDT-treated patients with that of age-matched and visual acuity-matched untreated controls. Design Prospective, open-label, consecutive, interventional case series. Methods We prospectively followed up 43 eyes of 42 consecutive patients with Pathologic Myopia (>6 diopters or axial length >26.5 mm) who received PDT for myopic CNV. In addition, the visual outcomes of these patients who were followed up for more than one year were compared with those of age- and initial visual acuity-matched untreated controls. Results The average follow-up was 15.0 ± 7.0 months. Patients received an average of 1.40 ± 0.73 treatments during follow-up, and 30 eyes (69.8%) required only one treatment. The best-corrected visual acuity (BCVA) improved by more than two Snellen lines in seven eyes (16.3%), decreased in six eyes (14.0%), and remained stable in 30 eyes (69.7%). In three eyes with a juxtafoveal CNV, CNV could not be detected ophthalmoscopically or angiographically after PDT. Statistical analysis showed that the PDT-treated patients had significantly better visual acuity at one year after PDT than the age- and initial BCVA-matched untreated controls. Conclusions These results indicate that PDT was beneficial for maintaining vision in Japanese patients with myopic CNV. The visual outcome after PDT was better than the natural course of the disease as determined from untreated controls. The effect on chorioretinal atrophy around CNV should be investigated with a long-term study.
-
Characteristics of Peripapillary Detachment in Pathologic Myopia
Archives of ophthalmology (Chicago Ill. : 1960), 2006Co-Authors: Noriaki Shimada, Kyoko Ohno-matsui, Takashi Tokoro, Soh Futagami, Takeshi Yoshida, Kenjiro Yasuzumi, Ariko Kojima, Kanako Kobayashi, Manabu MochizukiAbstract: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.
Muka Moriyama - One of the best experts on this subject based on the ideXlab platform.
-
deep learning approach for automated detection of myopic maculopathy and Pathologic Myopia in fundus images
Ophthalmology Retina, 2021Co-Authors: D U Ran, Muka Moriyama, Yuxin Fang, Shiqi Xie, Tae Igarashiyokoi, Satoko Ogata, Tatsuhiko Tsunoda, Takashi Kamatani, Shinji Yamamoto, Chingyu ChengAbstract:Abstract Purpose To determine whether eyes with Pathologic Myopia can be identified and whether each type of myopic maculopathy lesion in fundus photographs can be diagnosed by deep learning (DL) algorithms. Design A DL algorithm was developed to recognize myopic maculopathy features and to automatically categorize the myopic maculopathy. Subjects We examined 7020 fundus images from 4432 highly myopic eyes obtained from the Advanced Clinical Center for Myopia. Methods DL algorithms were developed to recognize the key features of myopic maculopathy with 5176 fundus images of 2588 highly myopic eyes. These algorithms were also used to develop a META-PM categorizing system (META-PM CS) by adding a specific processing layer. Models and system were evaluated by 1844 fundus images of 1844 highly myopic eyes. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve, the sensitivity, and specificity were used to determine the performance of each DL algorithm. The rate of correct predictions was used to determine the performance of the META-PM CS. Main Outcome Measures Four trained DL models were able to recognize the lesions of myopic maculopathy accurately with high sensitivity and specificity. The META-PM CS also had a high accuracy and was qualified to be used in a semi-automated way during screening for myopic maculopathy in highly myopic eyes. Results The sensitivity of the DL models was 84.44% for diffuse atrophy, 87.22% for patchy atrophy, 85.10% for macular atrophy, and 37.07% for choroidal neovascularization, and the AUC values with 95% CI of 0.970 (0.966-0.974), 0.978 (0.967-0.987), 0.982 (0.971-0.994) and 0.881 (0.854-0.902), respectively. The rate of total correct predictions from META-PM CS was 87.53%, with rates of 90.18%, 95.28%, 97.50%, and 91.14% respectively for each type of lesion. The META-PM CS had an overall rate of 92.08% in detecting Pathologic Myopia correctly which was defined as having myopic maculopathy equal to or more serious than diffuse atrophy. Conclusions The novel DL models and systems can achieve high sensitivity and specificity in identifying the different types of lesions of myopic maculopathy. These results will assist in the screening for Pathologic Myopia and subsequent protection of patients against low vision and blindness caused by myopic maculopathy.
-
Cilioretinal Arteries and Cilioretinal Veins in Eyes with Pathologic Myopia
Nature Publishing Group, 2019Co-Authors: Takashi Watanabe, Muka Moriyama, Soh Futagami, Tae Yokoi, Kengo Uramoto, Yuxin Fang, Kaori Kasahara, Yuka Onishi, Takeshi YoshidaAbstract:Abstract We investigated the clinical characteristics of cilioretinal arteries (CAs) and cilioretinal veins (CVs) in eyes with Pathologic Myopia. Ninety-five eyes with Pathologic Myopia and CAs were studied. The retrobulbar vessels from which the CAs originated were identified by indocyanine green angiography (ICGA). The results showed that 114 CAs were identified in the 95 eyes. ICGA showed that 60% of the CAs branched directly off the short posterior ciliary arteries (SPCAs) and 40% originated from the Zinn-Haller arterial circle (ZHAC). The SPCA-derived CAs tended to be located superiorly and served a large retinal area whereas the ZHAC-associated CAs tended to be located temporally and served mainly the macular area. In 15% of the 95 eyes, the CVs were observed to run parallel to the CAs. The CVs exited the eye at the same point where the CAs entered the eye. This study showed that CAs in eyes with Pathologic Myopia can be divided into those that are SPCA-derived and tend to emerge in the superior optic disc sector, and those that are ZHAC-associated and usually emerge temporally. An elongating peripapillary scleral flange in eyes with progressive axial Myopia may lead to a change of chorioretinal vascular system
-
Characteristics of higher-order aberrations and anterior segment tomography in patients with Pathologic Myopia
International ophthalmology, 2016Co-Authors: Kaori Kasahara, Muka Moriyama, Naoyuki Maeda, Takashi Fujikado, Makoto Tomita, Mutsumi Fuchihata, Kyoko Ohno-matsuiAbstract:Purpose To investigate prospectively the characteristics in the higher-order aberrations and anterior segment tomography in patients with Pathologic Myopia.
-
peripapillary diffuse chorioretinal atrophy in children as a sign of eventual Pathologic Myopia in adults
Ophthalmology, 2016Co-Authors: Tae Yokoi, Muka Moriyama, Natsuko Nagaoka, Takeshi Yoshida, Noriaki Shimada, Jost B Jonas, Kyoko OhnomatsuiAbstract:Purpose To search for a morphologic biomarker to differentiate between Pathologic Myopia and simple childhood Myopia. Design Retrospective case series. Participants The study included children (age ≤15 years) with high Myopia (as defined by the Japanese Ministry of Health and Welfare) who attended the High Myopia Clinic between April 1982 and March 1994, had undergone fundus photography, and had a follow-up of 20 years or more. Methods Fundus photographs obtained in childhood and adulthood were examined for presence of Pathologic Myopia, defined by high Myopia (myopic refractive error >8 diopters or axial length ≥26.5 mm) and the presence of stage 2 or higher myopic maculopathy. Main Outcome Measures Myopic maculopathy in childhood. Results The study included 56 eyes of 29 patients with a mean age of 10.2±3.6 years at the initial visit and an age of 36.0±7.6 years at the last visit. Mean axial length was 27.0±1.4 mm at baseline and 29.7±2.0 mm at the last visit. At the last visit, 19 eyes (34%) had tessellated fundus alone, 31 eyes (55%) had diffuse chorioretinal atrophy, 3 eyes (5%) showed patchy chorioretinal atrophy, and 1 eye (2%) had macular atrophy. Thus, 35 eyes (63%) had Pathologic Myopia in adulthood. Among the 35 eyes, 29 (83%) already had diffuse chorioretinal atrophy at the initial visit in childhood and the remaining 6 eyes (17%) showed tessellated fundus in childhood. The diffuse chorioretinal atrophy seen in childhood was restricted to the area temporal to the peripapillary region. Conclusions The presence of peripapillary diffuse chorioretinal atrophy in children with high axial Myopia may be an indicator for the eventual development of advanced myopic chorioretinal atrophy in later life. These features in children may be helpful for differentiating simple childhood Myopia from eventual Pathologic Myopia.
-
PERIPHERAL PIGMENTED STREAKS IN EYES WITH Pathologic Myopia.
Retina (Philadelphia Pa.), 2016Co-Authors: Kosei Shinohara, Takeshi Yoshida, Muka Moriyama, Noriaki Shimada, Kyoko Ohno-matsuiAbstract:PURPOSE To determine the incidence and the characteristics of peripheral pigmented streaks in the eyes with Pathologic Myopia. METHODS The widefield fundus images of 375 eyes (203 patients) with Pathologic Myopia were examined. The characteristics of the pigmented streaks existing in the peripheral fundus were analyzed. The spatial relationships between the steep edge of a staphyloma and the distribution of the streaks were also determined. RESULTS Peripheral streaks were observed in 165 of the 375 eyes (44.0%) as dark, pigmented, radially oriented lesions resembling octopus tentacles. The streaks ran from the mid periphery to the equator. Large choroidal vessels were observed in the corresponding sites, so the streaks probably existed in the layer of the large choroidal vessels or deeper. The patients with streak lesions were significantly older and had a posterior staphyloma more frequently than the eyes without the streaks. The streaks were observed mainly in the area opposite the steep edge of a staphyloma. CONCLUSION Peripheral pigmented streaks are seen in approximately 44% of eyes with Pathologic Myopia. The streaks existed in the layer of large choroidal vessels or deeper, and the thinning of the choroid-retina in highly myopic eyes contributes to the visibility of such deep lesions.