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Kyoko Ohnomatsui - One of the best experts on this subject based on the ideXlab platform.
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prevalence risk factors and impact of posterior Staphyloma diagnosed from wide field optical coherence tomography in singapore adults with high myopia
Acta Ophthalmologica, 2020Co-Authors: Feihui Zheng, Kyoko Ohnomatsui, Chee Wai Wong, Charumathi Sabanayagam, Yin Bun Cheung, Saiko Matsumura, Jacqueline Chua, Tien Yin Wong, Chingyu Cheng, Ecosse L LamoureuxAbstract:PURPOSE To investigate the prevalence and risk factors of posterior Staphyloma using wide-field optical coherence tomography (WF-OCT) in adults with high myopia in Singapore. DESIGN Population-based cross-sectional study. METHODS Adults with spherical equivalent (SE) ≤ -5D in either eye at the first visit of Singapore Epidemiology of Eye Diseases study and Singapore Prospective Study Program study were recruited. Posterior Staphyloma was diagnosed using WF-OCT (PLEX® Elite9000, Carl Zeiss Meditec). Myopic macular degeneration (MMD), myopic traction maculopathy (MTM) and vision-related quality of life (VRQoL) were assessed using fundus photographs, DRI-Triton OCT (Topcon) and the Impact of Vision Impairment (IVI) questionnaire, respectively. Factors associated with posterior Staphyloma were identified with multilevel, multivariable logistic regression. Impact of posterior Staphyloma on MMD, MTM and visual function was analysed with multilevel, multivariable logistic regression and linear mixed model, respectively. RESULTS Among the 225 eyes [mean SE = -6.5 ± 2.2 D, mean axial length (AL) = 26.2 ± 1.5 mm] of 117 participants (mean age = 60.3 ± 7.1 years), posterior Staphyloma was detected in 47 (20.9%) eyes of 38 (32.5%) participants. Older age [odds ratio (OR), 1.18; 95% confidence interval (CI), 1.10-1.26], more myopic SE (0.63; 0.51-0.77) and increased AL (2.51; 1.69-3.73) were associated with higher prevalence of posterior Staphyloma (all p < 0.001). Adults with posterior Staphyloma had higher odds of MMD (2.67; 1.23-5.82; p = 0.013), MTM (3.79; 1.13-12.68; p = 0.031) and worse IVI Reading (β = -1.44; -2.31 to 0.58; p = 0.001) scores. CONCLUSIONS About one in three adults with high myopia had posterior Staphyloma, which was associated with increased odds of having myopic maculopathy and a detrimental impact on VRQoL.
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posterior Staphyloma in pathologic myopia
Progress in Retinal and Eye Research, 2018Co-Authors: Kyoko Ohnomatsui, Jost B. 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.
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ultrawide field oct to investigate relationships between myopic macular retinoschisis and posterior Staphyloma
Ophthalmology, 2018Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Noriko Tanaka, Kyoko OhnomatsuiAbstract: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 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.
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chorioretinal folds in eyes with myopic Staphyloma
American Journal of Ophthalmology, 2015Co-Authors: Tomoka Ishida, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Kosei Shinohara, Yuichiro Tanaka, Kei Morohoshi, Kyoko OhnomatsuiAbstract:Purpose To determine the frequency and clinical characteristics of chorioretinal folds emanating from the edge of a Staphyloma in highly myopic patients. Design Observational case series. Methods Eight hundred and eighty-three eyes of 463 patients with an axial length ≥26.5 mm in at least 1 eye were studied. The fellow eyes of patients with unilateral high myopia were also included. Wide-field fundus images and fundus autofluorescence images were used to detect chorioretinal folds emanating from the Staphyloma edge. In 100 patients, the eye shape was analyzed by 3-dimensional magnetic resonance imaging (3D MRI). Results A posterior Staphyloma was found in 459 of the 883 eyes (52.0%). Choroidal folds radiating from the Staphyloma edge were found in 6 of the 459 eyes (1.3%) with a posterior Staphyloma in wide-field autofluorescent images. The axial length varied greatly from 24.3 mm to 32.5 mm. Regardless of the axial length, all of the 6 eyes had a wide, macular type of Staphyloma. Chorioretinal folds emanated from the upper or upper-temporal Staphyloma edge. 3D MRI images showed the presence of a notch along the upper or temporal edge of the outpouching, and the eye curvature became flatter toward the steep edge of the outpouching. Conclusions Chorioretinal folds can emanate from the Staphyloma edge in highly myopic patients even though the edge was away from the macula. Some directional force toward the steeper edge of the Staphyloma might be related to the development of chorioretinal folds.
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Staphyloma ii analyses of morphological features of posterior Staphyloma in pathologic myopia analyzed by a combination of wide view fundus observation and 3d mri analyses
2014Co-Authors: Kyoko Ohnomatsui, Muka MoriyamaAbstract:Posterior Staphyloma is an integral condition for pathologic myopia. Curtin classified a posterior Staphyloma into ten distinct types, and his classification has been widely used to date. Types I through V are primary Staphyloma, and types VI through X are compound Staphyloma which accompanies irregular curvature within the outermost line of primary Staphyloma. However, with the advent of new imaging modalities like OCT, it has been found that the irregularities of scleral curvature within the area of Staphyloma are much more complicated than it was expected. Recently, wider area of the fundus can be beautifully analyzed by using Optos, and also by using 3D MRI technique, it has recently been possible to analyze the entire shape of globe.
Takeshi Yoshida - One of the best experts on this subject based on the ideXlab platform.
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Posterior Staphylomas and scleral curvature in highly myopic children and adolescents investigated by ultra-widefield optical coherence tomography
PLOS ONE, 2019Co-Authors: Noriko Tanaka, Takeshi Yoshida, Kosei Shinohara, Tae Yokoi, Kengo Uramoto, Hiroyuki Takahashi, Yuka Onishi, Shintaro Horie, Kyoko Ohno-matsuiAbstract:Purpose To determine the early signs of posterior Staphylomas in highly myopic eyes of younger subjects by swept-source ultra-widefield optical coherence tomography (WF-OCT). Methods This was an observational case series study. Highly myopic subjects younger than 20 years old who were examined consecutively by prototype WF-OCT were studied. High myopia was defined according to the Ministry of Health and Welfare, Japan classification. A posterior displacement of the sclera and two OCT features indicating the Staphyloma edges were used as markers of a Staphyloma. Results Fifty-five eyes of 30 patients with the mean age of 12.3 years, and the mean axial length of 27.9 mm were studied. Seven of the 55 eyes (12.7%) had a posterior displacement of the sclera and were diagnosed as having a Staphyloma. Among the two OCT features of the Staphyloma edges, a gradual thinning of the choroid toward the Staphyloma edge and gradual re-thickening of choroid from the Staphyloma edge toward the posterior pole were found in these 7 eyes. However, the other feature of an inward protrusion of the sclera at the Staphyloma edge, was obvious in only 2 eyes. The subfoveal choroid and choroid nasal to the optic disc were significantly thinner in eyes with a Staphyloma than those without it. Conclusions The changes of the choroidal thickness toward the Staphyloma edge with the posterior displacement of the sclera were considered an early sign which precedes an inward protrusion of sclera at the Staphyloma edge.
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ultrawide field oct to investigate relationships between myopic macular retinoschisis and posterior Staphyloma
Ophthalmology, 2018Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Noriko Tanaka, Kyoko OhnomatsuiAbstract: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 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.
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Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography.
Investigative Ophthalmology & Visual Science, 2017Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Nagahisa Yoshimura, Kyoko Ohno-matsuiAbstract:Purpose: To examine posterior Staphylomas by widefield optical coherence tomography (WF-OCT) and three-dimensional magnetic resonance imaging (3D-MRI). Methods: Highly myopic patients (myopic refractive error >8.0 diopters or axial length >26.5 mm) who had previously undergone orbital 3D-MRI were examined by WF-OCT. Results: The study included 100 eyes of 57 patients with a mean age of 67.9 ± 10.7 years (range, 44-85 years) and mean axial length of 30.0 ± 2.3 mm (range, 25.1-36.5 mm). All Staphylomas detected on the 3D-MRI, except for two very large Staphylomas, were visualized on the WF-OCT images. Morphologic hallmarks of the Staphylomas were smoothly configured Staphyloma border with a gradual thinning of the choroid and an inward protrusion of the sclera at the Staphyloma edge. Comparing the detectability of the Staphylomas on the WF-OCT images versus 3D-MRI revealed no significant difference between both techniques (P = 0.12; χ2 test). Comparing the Staphyloma classification between both techniques showed a good concordance with a concordance index kappa of 0.61 (95% confidence interval: 0.50-0.72). A spatial relationship between the Staphylomatous areas and the macula and optic nerve head was observed by WF-OCT. Conclusions: WF-OCT can provide tomographic images of posterior Staphylomas in a resolution and size unachievable so far, and may replace 3D-MRI in assessing posterior Staphylomas. Future studies using WF-OCT may explore the detailed morphologic characteristics of posterior Staphylomas and give clues to the etiology of Staphylomas.
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FEATURES OF POSTERIOR StaphylomaS ANALYZED IN WIDE-FIELD FUNDUS IMAGES IN PATIENTS WITH UNILATERAL AND BILATERAL PATHOLOGIC MYOPIA.
Retina-the Journal of Retinal and Vitreous Diseases, 2017Co-Authors: Kyoko Ohno-matsui, Muka Moriyama, Micol Alkabes, Cecilia Salinas, Carlos Mateo, Takeshi YoshidaAbstract:PURPOSE: Pigmentary alterations along the presumed edge of Staphyloma in wide-field fundus images have been reported to be highly correlated with the eye shape in three-dimensional magnetic resonance images. The purpose of this study was to analyze Optos images in a large series of highly myopic patients to determine the prevalence, types, and features of Staphylomas. METHODS: One thousand and sixty eyes of 541 patients with high myopia (axial length ≥ 26.5 mm) in at least one eye were retrospectively analyzed in Japan and Spain. To determine the presence and types of Staphyloma, the authors focused on pigmentary abnormalities along the presumed edge of Staphylomas with at least one positive finding in fundus images, autofluorescent images, and infrared images by Optos. RESULTS: Posterior Staphyloma was detected in 552 of 1,060 eyes (55%) in Optos images. Wide macular type was the most common (79%), followed by narrow macular (15%), then peripapillary (3%), inferior, and finally nasal. In the 60 non-highly myopic eyes of patients with unilateral high myopia, Staphyloma was detected in 40%, suggesting that unilateral high myopia might be a bilateral disorder with marked differences in the degree of Staphyloma between the two eyes. Combined Staphylomas such as the peripapillary type within the wide macular type were also found. CONCLUSION: Posterior Staphyloma was found in 55% of 1,060 eyes with bilateral or unilateral pathologic myopia. Wide macular was the most common type, although there were much more variations in the shape of Staphylomas than that had been previously believed.
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Characteristics of Peripapillary Staphylomas Associated With High Myopia Determined by Swept-Source Optical Coherence Tomography
American Journal of Ophthalmology, 2016Co-Authors: Kosei Shinohara, Muka Moriyama, Noriaki Shimada, Takeshi Yoshida, Kyoko Ohno-matsuiAbstract:Purpose To analyze the morphologic features of peripapillary Staphylomas associated with high myopia by swept-source optical coherence tomography (OCT). Design Validity analysis. Methods Highly myopic patients (refractive error >8.0 diopters or axial length >26.5 mm) with a peripapillary Staphyloma who had undergone swept-source OCT were studied. The non–highly myopic fellow eyes in patients with unilateral high myopia were also studied. The presence of a peripapillary Staphyloma was determined by stereoscopic ophthalmoscopic examinations. The OCT features of the peripapillary Staphylomas and other peripapillary lesions were evaluated. Results Twenty-five eyes of 16 patients were studied. Twenty-two eyes were highly myopic and the remaining 3 eyes of the patients with unilateral high myopia were non–highly myopic. A peripapillary Staphyloma was seen in the swept-source OCT images as a gently sloping excavation around the optic disc in all 25 eyes. The posterior sclera in the area of a peripapillary Staphyloma was observed to bow posteriorly, with the local curvature steeper than the curvature of the adjacent scleral regions. The sclera at the edge of a peripapillary Staphyloma appeared to be elevated inward from the surrounding sclera, and the choroid at the Staphyloma edge appeared to be compressed and thinned. A peripapillary intrachoroidal cavitation was a frequent complication and was found in 13 eyes with a peripapillary Staphyloma (52.5%). Conclusions Swept-source OCT can detect the slight changes of the sclera and choroid in the area of a peripapillary Staphyloma, and we recommend its use in determining the presence of a peripapillary Staphyloma.
Muka Moriyama - One of the best experts on this subject based on the ideXlab platform.
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ultrawide field oct to investigate relationships between myopic macular retinoschisis and posterior Staphyloma
Ophthalmology, 2018Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Noriko Tanaka, Kyoko OhnomatsuiAbstract: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 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.
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Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography.
Investigative Ophthalmology & Visual Science, 2017Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Nagahisa Yoshimura, Kyoko Ohno-matsuiAbstract:Purpose: To examine posterior Staphylomas by widefield optical coherence tomography (WF-OCT) and three-dimensional magnetic resonance imaging (3D-MRI). Methods: Highly myopic patients (myopic refractive error >8.0 diopters or axial length >26.5 mm) who had previously undergone orbital 3D-MRI were examined by WF-OCT. Results: The study included 100 eyes of 57 patients with a mean age of 67.9 ± 10.7 years (range, 44-85 years) and mean axial length of 30.0 ± 2.3 mm (range, 25.1-36.5 mm). All Staphylomas detected on the 3D-MRI, except for two very large Staphylomas, were visualized on the WF-OCT images. Morphologic hallmarks of the Staphylomas were smoothly configured Staphyloma border with a gradual thinning of the choroid and an inward protrusion of the sclera at the Staphyloma edge. Comparing the detectability of the Staphylomas on the WF-OCT images versus 3D-MRI revealed no significant difference between both techniques (P = 0.12; χ2 test). Comparing the Staphyloma classification between both techniques showed a good concordance with a concordance index kappa of 0.61 (95% confidence interval: 0.50-0.72). A spatial relationship between the Staphylomatous areas and the macula and optic nerve head was observed by WF-OCT. Conclusions: WF-OCT can provide tomographic images of posterior Staphylomas in a resolution and size unachievable so far, and may replace 3D-MRI in assessing posterior Staphylomas. Future studies using WF-OCT may explore the detailed morphologic characteristics of posterior Staphylomas and give clues to the etiology of Staphylomas.
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FEATURES OF POSTERIOR StaphylomaS ANALYZED IN WIDE-FIELD FUNDUS IMAGES IN PATIENTS WITH UNILATERAL AND BILATERAL PATHOLOGIC MYOPIA.
Retina-the Journal of Retinal and Vitreous Diseases, 2017Co-Authors: Kyoko Ohno-matsui, Muka Moriyama, Micol Alkabes, Cecilia Salinas, Carlos Mateo, Takeshi YoshidaAbstract:PURPOSE: Pigmentary alterations along the presumed edge of Staphyloma in wide-field fundus images have been reported to be highly correlated with the eye shape in three-dimensional magnetic resonance images. The purpose of this study was to analyze Optos images in a large series of highly myopic patients to determine the prevalence, types, and features of Staphylomas. METHODS: One thousand and sixty eyes of 541 patients with high myopia (axial length ≥ 26.5 mm) in at least one eye were retrospectively analyzed in Japan and Spain. To determine the presence and types of Staphyloma, the authors focused on pigmentary abnormalities along the presumed edge of Staphylomas with at least one positive finding in fundus images, autofluorescent images, and infrared images by Optos. RESULTS: Posterior Staphyloma was detected in 552 of 1,060 eyes (55%) in Optos images. Wide macular type was the most common (79%), followed by narrow macular (15%), then peripapillary (3%), inferior, and finally nasal. In the 60 non-highly myopic eyes of patients with unilateral high myopia, Staphyloma was detected in 40%, suggesting that unilateral high myopia might be a bilateral disorder with marked differences in the degree of Staphyloma between the two eyes. Combined Staphylomas such as the peripapillary type within the wide macular type were also found. CONCLUSION: Posterior Staphyloma was found in 55% of 1,060 eyes with bilateral or unilateral pathologic myopia. Wide macular was the most common type, although there were much more variations in the shape of Staphylomas than that had been previously believed.
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Characteristics of Peripapillary Staphylomas Associated With High Myopia Determined by Swept-Source Optical Coherence Tomography
American Journal of Ophthalmology, 2016Co-Authors: Kosei Shinohara, Muka Moriyama, Noriaki Shimada, Takeshi Yoshida, Kyoko Ohno-matsuiAbstract:Purpose To analyze the morphologic features of peripapillary Staphylomas associated with high myopia by swept-source optical coherence tomography (OCT). Design Validity analysis. Methods Highly myopic patients (refractive error >8.0 diopters or axial length >26.5 mm) with a peripapillary Staphyloma who had undergone swept-source OCT were studied. The non–highly myopic fellow eyes in patients with unilateral high myopia were also studied. The presence of a peripapillary Staphyloma was determined by stereoscopic ophthalmoscopic examinations. The OCT features of the peripapillary Staphylomas and other peripapillary lesions were evaluated. Results Twenty-five eyes of 16 patients were studied. Twenty-two eyes were highly myopic and the remaining 3 eyes of the patients with unilateral high myopia were non–highly myopic. A peripapillary Staphyloma was seen in the swept-source OCT images as a gently sloping excavation around the optic disc in all 25 eyes. The posterior sclera in the area of a peripapillary Staphyloma was observed to bow posteriorly, with the local curvature steeper than the curvature of the adjacent scleral regions. The sclera at the edge of a peripapillary Staphyloma appeared to be elevated inward from the surrounding sclera, and the choroid at the Staphyloma edge appeared to be compressed and thinned. A peripapillary intrachoroidal cavitation was a frequent complication and was found in 13 eyes with a peripapillary Staphyloma (52.5%). Conclusions Swept-source OCT can detect the slight changes of the sclera and choroid in the area of a peripapillary Staphyloma, and we recommend its use in determining the presence of a peripapillary Staphyloma.
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chorioretinal folds in eyes with myopic Staphyloma
American Journal of Ophthalmology, 2015Co-Authors: Tomoka Ishida, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Kosei Shinohara, Yuichiro Tanaka, Kei Morohoshi, Kyoko OhnomatsuiAbstract:Purpose To determine the frequency and clinical characteristics of chorioretinal folds emanating from the edge of a Staphyloma in highly myopic patients. Design Observational case series. Methods Eight hundred and eighty-three eyes of 463 patients with an axial length ≥26.5 mm in at least 1 eye were studied. The fellow eyes of patients with unilateral high myopia were also included. Wide-field fundus images and fundus autofluorescence images were used to detect chorioretinal folds emanating from the Staphyloma edge. In 100 patients, the eye shape was analyzed by 3-dimensional magnetic resonance imaging (3D MRI). Results A posterior Staphyloma was found in 459 of the 883 eyes (52.0%). Choroidal folds radiating from the Staphyloma edge were found in 6 of the 459 eyes (1.3%) with a posterior Staphyloma in wide-field autofluorescent images. The axial length varied greatly from 24.3 mm to 32.5 mm. Regardless of the axial length, all of the 6 eyes had a wide, macular type of Staphyloma. Chorioretinal folds emanated from the upper or upper-temporal Staphyloma edge. 3D MRI images showed the presence of a notch along the upper or temporal edge of the outpouching, and the eye curvature became flatter toward the steep edge of the outpouching. Conclusions Chorioretinal folds can emanate from the Staphyloma edge in highly myopic patients even though the edge was away from the macula. Some directional force toward the steeper edge of the Staphyloma might be related to the development of chorioretinal folds.
Jost B. Jonas - One of the best experts on this subject based on the ideXlab platform.
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posterior Staphyloma in pathologic myopia
Progress in Retinal and Eye Research, 2018Co-Authors: Kyoko Ohnomatsui, Jost B. 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.
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ultrawide field oct to investigate relationships between myopic macular retinoschisis and posterior Staphyloma
Ophthalmology, 2018Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Noriko Tanaka, Kyoko OhnomatsuiAbstract: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 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.
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congenital contractile peripapillary Staphyloma with rhegmatogenous retinal detachment
Retinal Cases & Brief Reports, 2018Co-Authors: Xiao Yan Peng, Li Bin Jiang, Jost B. JonasAbstract:PURPOSE: To describe the occurrence of a congenital contractile peripapillary Staphyloma in association with a rhegmatogenous retinal detachment. METHODS: The clinical course of a 17-year-old patient with a contractile peripapillary Staphyloma and undergoing pars plana vitrectomy for repair of an associated retinal detachment was studied. RESULTS: The left eye showed a peripapillary Staphyloma which during the ophthalmoscopical examination revealed contractile movements after the presentation of a light stimulus to either eye. The contraction of the peripapillary Staphyloma was not correlated with a Valsalva maneuver, neck venous compression, forced lid closure, or respiratory movements. Because of a retinal detachment involving the inferior, nasal, and temporal retina, best-corrected visual acuity was 20/100. During pars plana vitrectomy under systemic anesthesia, the contractions of the peripapillary Staphyloma subsided in the early phase of surgery, and reoccurred at approximately 80 minutes after the start of general anesthesia, when the posterior pole was touched with an aspiration syringe. CONCLUSION: The etiology of the movements of the congenital peripapillary Staphyloma in our patient may include a misbalance between intraocular pressure and orbital cerebrospinal fluid pressure or contractions of extraocular muscles. The observations may give information about the physiology and pathophysiology of the optic nerve head.
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Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography.
Investigative Ophthalmology & Visual Science, 2017Co-Authors: Kosei Shinohara, Noriaki Shimada, Muka Moriyama, Takeshi Yoshida, Jost B. Jonas, Nagahisa Yoshimura, Kyoko Ohno-matsuiAbstract:Purpose: To examine posterior Staphylomas by widefield optical coherence tomography (WF-OCT) and three-dimensional magnetic resonance imaging (3D-MRI). Methods: Highly myopic patients (myopic refractive error >8.0 diopters or axial length >26.5 mm) who had previously undergone orbital 3D-MRI were examined by WF-OCT. Results: The study included 100 eyes of 57 patients with a mean age of 67.9 ± 10.7 years (range, 44-85 years) and mean axial length of 30.0 ± 2.3 mm (range, 25.1-36.5 mm). All Staphylomas detected on the 3D-MRI, except for two very large Staphylomas, were visualized on the WF-OCT images. Morphologic hallmarks of the Staphylomas were smoothly configured Staphyloma border with a gradual thinning of the choroid and an inward protrusion of the sclera at the Staphyloma edge. Comparing the detectability of the Staphylomas on the WF-OCT images versus 3D-MRI revealed no significant difference between both techniques (P = 0.12; χ2 test). Comparing the Staphyloma classification between both techniques showed a good concordance with a concordance index kappa of 0.61 (95% confidence interval: 0.50-0.72). A spatial relationship between the Staphylomatous areas and the macula and optic nerve head was observed by WF-OCT. Conclusions: WF-OCT can provide tomographic images of posterior Staphylomas in a resolution and size unachievable so far, and may replace 3D-MRI in assessing posterior Staphylomas. Future studies using WF-OCT may explore the detailed morphologic characteristics of posterior Staphylomas and give clues to the etiology of Staphylomas.
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Tilted disk syndrome with superior Staphyloma.
Retinal Cases & Brief Reports, 2020Co-Authors: Salomon Y. Cohen, Gabriel QuentelAbstract:Background Tilted disk syndrome is a common condition that consists of inferonasal tilting of the optic disk and is usually associated with Staphyloma in the inferonasal fundus. Case report We describe a 50-year-old woman whose fundus exhibited, in both eyes, all the characteristics of tilted disk syndrome but in an upside-down pattern: superior instead of inferior Staphyloma and thinning of the retinal pigment epithelium, a superior instead of an inferonasal crescent, and an inferior instead of a superior visual field defect. Conclusion We have no satisfactory explanation for this unusual case.
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chorioretinal folds as a consequence of inferior Staphyloma associated with tilted disc syndrome
Graefes Archive for Clinical and Experimental Ophthalmology, 2006Co-Authors: Salomon Y. Cohen, Gabriel QuentelAbstract:Tilted disc syndrome is a common condition which is usually associated with an inferior Staphyloma. Observational case report. An 82-year-old woman presented with features typical of tilted disc syndrome, as well as chorioretinal folds orientated radially to the upper edge of the inferior Staphyloma. The orientation of the folds suggested that the progressive increase of the inferior Staphyloma exerted traction on the RPE, Bruch’s membrane and choriocapillaris complex, leading to chorioretinal folds radiating from the upper edge of the Staphyloma.
