Posterior Staphylomas in Pathologic Myopia Imaged by Widefield Optical Coherence Tomography

摘要

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, 44a??85 years) and mean axial length of 30.0 ?± 2.3 mm (range, 25.1a??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; ??2 test). Comparing the staphyloma classification between both techniques showed a good concordance with a concordance index kappa of 0.61 (95% confidence interval: 0.50a??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.