Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Key Laboratory of Lens Research of Liaoning Province, Shenyang 110005,China
Objective To evaluate the effects of postocular vascular hemodynamics and choroidal thickness after posterior scleral reinforcement for pathological myopia. Methods From January 2012 to June 2013, 34 patients (55 eyes) were enrolled in this prospective study and underwent posterior scleral reinforcement surgery. Two years after the procedure, visual acuity, refraction and axial length were measured, as well as choroidal thickness using enhanced depth imaging optical coherence tomography (EDI-OCT) and postocular vascular hemodynamics using Doppler imagining (CDI). A paired repeated measures ANOVA was used to analyze the differences. Results There was a statistically significant improvement in postoperative best-corrected visual acuity (BCVA) at 1, 3, 6, 12 and 24 months compared with preoperative eyes (F=3.960, P＜0.01). Postoperative spherical equivalent (SE), axial length and intraocular pressure remained stable, and no statistically significant differences were found (F=1.374, 1.382, 1.193, P＞0.05). After the 1, 3, 6, 12 and 24 months observations periods, there was a statistically significant enhancement of postoperative peak systolic velocity (PSV) and end diastolic velocity (EDV) as well as a statistically significant decrease in the resistance index (RI) of the short posterior ciliary artery (SPCA) and central retinal artery (CRA) (SPCA: F=2.376, P<0.05; F=4.476, P<0.01; F=4.238, P<0.01. CRA: F=2.316, P<0.05; F=3.335, P<0.01; F=9.770, P<0.01). Significant differences in subfoveal choroidal thickness (SFCT) were found before and after the operation (F=2.875, P<0.05). The preoperative subfoveal choroidal thickness (SFCT) was 122.4±31.9 µm, which increased to 134.4±32.9 µm at 1 month, 139.0±35.7 µm at 3 months, 136.5±33.8 µm at 6 months, 134.9±31.5 µm at 12 months, and 135.9±35.4 µm at 24 months. The differences were statistically significant (P<0.05). Conclusion Scleral reinforcement surgery can improve visual acuity, prevent refractive progression and axial length elongation, increase postocular vascular hemodynamics and choroidal thickness so as to stabilize the progression of pathological myopia.
Neelam K, Cheung CM, Ohno-Matsui K, et al. Choroidal neovascularization in pathological myopia[J]. Prog Retin Eye Res,2012,31(5):495-525. DOI:10.1016/j.preteyeres.2012.04.001.
[2]
Mitry D, Zambarakji H. Recent trends in the management of maculopathy secondary to pathological myopia[J]. Graefes Arch Clin Exp Ophthalmol,2012,250(1):3-13. DOI:10.1007/s00417-011-1889-0.
[3]
Sun CB, Liu Z, Xue AQ, et al. Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes[J]. Eye (Lond),2010,24(12):1787-1791. DOI:10.1038/eye.2010.123.
[4]
Xu L, Wang Y, Li Y, et al. Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study[J]. Ophthalmology,2006,113(7):1134.e1-11. DOI:10.1016/j.ophtha.2006.01.035.
Snyder AA, Thompson FB. A simplified technique for surgical treatment of degenerative myopia[J]. Am J Ophthalmol,1972,74(2):273-277.
[10]
Ruiz-Moreno JM, Montero JA. Long-term visual acuity after argon green laser photocoagulation of juxtafoveal choroidal neovascularization in highly myopic eyes[J]. Eur J Ophthalmol,2002,12(2):117-122.
[11]
Chan MP, Grossi CM, Khawaja AP, et al. Associations with intraocular pressure in a large cohort: Results from the UK Biobank[J]. Ophthalmology,2016,123(4):771-782. DOI:10.1016/j.ophtha.2015.11.031.
Wildsoet C, Wallman J. Choroidal and scleral mechanisms of compensation for spectacle lenses in chicks[J]. Vision Res,1995, 35(9):1175-1194. DOI:0042-6989(94)00233-C.
Ikuno Y, Maruko I, Yasuno Y, et al. Reproducibility of retinal and choroidal thickness measurements in enhanced depth imaging and high-penetration optical coherence tomography[J]. Invest Ophthalmol Vis Sci,2011,52(8):5536-5540. DOI:10.1167/iovs.10-6811.
[17]
El Matri L, Bouladi M, Chebil A, et al. Choroidal thickness measurement in highly myopic eyes using SD-OCT[J]. Ophthalmic Surg Lasers Imaging,2012,43(6 Suppl):S38-43. DOI:10.3928/154 28877-20121001-02.
[18]
Flores-Moreno I, Lugo F, Duker JS, et al. The relationship between axial length and choroidal thickness in eyes with high myopia[J]. Am J Ophthalmol,2013,155(2):314-319. DOI:10.1016/j.ajo.2012.07.015.
[19]
Atkinson J, Braddick O, Robier B, et al. Two infant vision screening programmes: prediction and prevention of strabismus and amblyopia from photo- and videorefractive screening[J]. Eye (Lond),1996,10(Pt 2):189-198. DOI:10.1038/eye.1996.46.
[20]
Kim M, Kim SS, Kwon HJ, et al. Association between choroidal thickness and ocular perfusion pressure in young, healthy subjects: enhanced depth imaging optical coherence tomography study[J]. Invest Ophthalmol Vis Sci,2012,53(12):7710-7717. DOI:10.1167/iovs.12-10464.
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