Atrophic, Tractional, and Neovascular Grading System in a Dome-Shaped Macula and Ridge-Shaped Macula Highly Myopic Cohort.

IF 2.1 4区医学 Q2 OPHTHALMOLOGY

Ophthalmologica Pub Date : 2023-01-01 DOI:10.1159/000528993

María García-Zamora, Ignacio Flores-Moreno, Jorge Ruiz-Medrano, Mariluz Puertas, Elena Almazán-Alonso, Rocío Vega-González, Lucía González-Buendía, José M Ruiz-Moreno

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引用次数: 0

Abstract

Introduction: The aim of this study was to analyze the atrophic, tractional, and neovascular (ATN) components grading in highly myopic patients with dome-shaped macula (DSM) and ridge-shaped macula (RSM).

Methods: This was a cross-sectional, noninterventional study. 57 eyes of 38 different patients were included. They were classified as DSM or RSM based on the number of radial scans that showed an inward protrusion ≥50 µm in the swept-source optical coherence tomography (SS-OCT) (12 = DSM; <12 = RSM). All patients underwent a complete ophthalmological examination in addition to SS-OCT. They were graded using the ATN system for myopic maculopathy by 2 masked retina specialists that assessed the atrophic (A), tractional (T), and neovascular (N) components in order to analyze the differences between the groups. As complementary measurements, age, axial length, and best-corrected visual acuity were collected. Height and orientation of the macular bulge and the presence of Bruch's membrane defects, scleral perforating vessels, and staphyloma were recorded.

Results: Out of total 57 eyes, 13 eyes (22.8%) were classified as DSM. Regarding the atrophic component (A), there were statistically significant differences between groups, with DSM group showing a greater stage of atrophy (predominantly stage A3 in 69.2% of the sample) compared to the RSM group (predominantly stage A2 in 61.3% of the sample) (p < 0.05). For the T and N components, there were no significant differences between groups. The presence of Bruch's membrane defects was more frequently seen in DSM (p < 0.05).

Conclusions: DSM group showed more Bruch's membrane defects and a greater stage of the atrophy component, based on the ATN grading system, compared with RSM group. As Bruch's membrane may have biomechanical properties in terms of strength, the defects found around the macula, added to the major atrophic component, may be a cause of a local relaxation that induce a central bulge forming the dome.

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穹状黄斑和脊状黄斑高度近视队列的萎缩、牵拉和新生血管分级系统。

本研究的目的是分析高度近视伴有圆丘状黄斑(DSM)和脊状黄斑(RSM)患者的萎缩性、牵拉性和新生血管(ATN)成分的分级。方法:这是一项横断面、非介入性研究。包括38名不同患者的57只眼睛。根据扫描源光学相干断层扫描(SS-OCT)显示向内突出≥50µm的径向扫描次数将其分类为DSM或RSM (12 = DSM;<12 = RSM)。除SS-OCT外，所有患者均接受了完整的眼科检查。两位蒙面视网膜专家使用ATN系统对他们进行近视黄斑病变评分，评估萎缩(A)、牵拉(T)和新生血管(N)成分，以分析两组之间的差异。作为补充测量，收集年龄，眼轴长度和最佳矫正视力。记录黄斑隆起的高度和方向、布鲁氏膜缺损、巩膜穿孔血管和葡萄肿的存在。结果:57只眼中13只眼(22.8%)为DSM。关于萎缩成分(A)，组间差异有统计学意义，与RSM组相比，DSM组萎缩阶段更大(以A3期为主，占69.2%)(以A2期为主，占61.3%)(p <0.05)。T和N成分组间差异不显著。布鲁氏膜缺陷在DSM中更为常见(p <0.05)。结论:根据ATN分级系统，与RSM组相比，DSM组出现更多的Bruch膜缺损，萎缩成分的分期更大。由于布鲁赫膜在强度方面可能具有生物力学特性，黄斑周围发现的缺陷，加上主要的萎缩成分，可能是局部松弛的原因，导致中央隆起形成穹窿。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ophthalmologica 医学-眼科学

CiteScore

5.10

自引率

3.80%

发文量

审稿时长

3 months

期刊介绍： Published since 1899, ''Ophthalmologica'' has become a frequently cited guide to international work in clinical and experimental ophthalmology. It contains a selection of patient-oriented contributions covering the etiology of eye diseases, diagnostic techniques, and advances in medical and surgical treatment. Straightforward, factual reporting provides both interesting and useful reading. In addition to original papers, ''Ophthalmologica'' features regularly timely reviews in an effort to keep the reader well informed and updated. The large international circulation of this journal reflects its importance.