Top

International Ophthalmology

Published in:

01-01-2020 | Original Paper

Intrachoroidal cavitation in myopic eyes

Authors: Ramesh Venkatesh, Kushagra Jain, Aditya Aseem, Sabitabh Kumar, Naresh Kumar Yadav

Published in: International Ophthalmology | Issue 1/2020

Abstract

Purpose

To determine the incidence and characteristics of intrachoroidal cavitation (ICC) in the eyes with high myopia.

Methods

In this retrospective, non-interventional, comparative study, we analysed the case records of 108 eyes with and without pathological myopia (PM). PM was defined as having a refractive error (spherical equivalent) of ≥ − 6.0 D or axial length ≥ 26 mm. The presence of other features like posterior vitreous detachment, myopic traction maculopathy, posterior staphyloma, focal/patchy chorioretinal atrophy (CRA), choroidal neovascularisation and retinoschisis was looked for on OCT. The association of these features with ICC was analysed using statistical tests.

Results

In this study, 38 out of 68 eyes with PM and 4 out of 40 eyes with non-PM showed the bowing of the posterior sclera and the presence of ICC. On statistical analysis with Chi-square test and multiple variable linear regression analysis tests, it was identified that the presence of focal/patchy CRA (p = 0.005) and intrascleral vessels (p = 0.018) in and around the cavitation was important features noted in eyes with ICC. The OCT features of macular and peripapillary ICC were similar. The transudation of fluid from the dilated intrascleral vessels in and around the ICC could be one other mechanism responsible for the development of ICC.

Conclusion

ICC is seen in 55.8% of highly myopic eyes with the presence of focal CRA or myopic conus and/or presence of intrascleral vessels near the cavitation. These findings suggest that patchy atrophy affects the scleral contour within posterior staphyloma beyond the funduscopically identified patchy atrophy by ICC. The presence of intrascleral vessels could also contribute to the ICC development. Eyes with patchy CRA or myopic conus needs to be checked on further follow-up visits for the development of macular or peripapillary ICC.

Curtin BJ (1979) Physiologic vs pathologic myopia: genetics vs environment. Ophthalmology 86:681–691CrossRef

Faghihi H, Hajizadeh F, Riazi-Esfahani M (2010) Optical coherence tomographic findings in highly myopic eyes. J Ophthalmic Vis Res 5:110–121PubMedPubMedCentral

Gohil R, Sivaprasad S, Han LT et al (2015) Myopic foveoschisis: a clinical review. Eye Lond Engl 29:593–601. https://doi.org/10.1038/eye.2014.311 CrossRef

Marticorena-Álvarez P, Clement-Fernández F, Iglesias-Ussel L (2014) Peripapillary intrachoroidal cavitation in pathological myopia. Arch Soc Esp Oftalmol 89:316–319. https://doi.org/10.1016/j.oftal.2013.06.008 CrossRefPubMed

Fellman RL, Grover DS (2012) Myopic peripapillary sinkhole: prolapse of retinal nerve fiber layer and posterior vitreous into a sclerochoroidal hollow causing peripapillary choroidal thickening and cavitation. Arch Ophthalmol Chic Ill 1960 130:1220–1221. https://doi.org/10.1001/archophthalmol.2012.441 CrossRef

Bruyère E, Miere A, Cohen SY et al (2017) Neovascularization secondary to high myopia imaged by optical coherence tomography angiography. Retina Phila Pa 37:2095–2101. https://doi.org/10.1097/IAE.0000000000001456 CrossRef

Melikhova MV, Gatsu MV, Boiko EV et al (2018) Dome-shaped macula: features of differential diagnostics with clinical examples. Vestn oftalmol 134:86–94. https://doi.org/10.17116/oftalma2018134386 CrossRefPubMed

Freund KB, Ciardella AP, Yannuzzi LA et al (2003) Peripapillary detachment in pathologic myopia. Arch Ophthalmol Chic Ill 1960 121:197–204CrossRef

Toranzo J, Cohen SY, Erginay A, Gaudric A (2005) Peripapillary intrachoroidal cavitation in myopia. Am J Ophthalmol 140:731–732. https://doi.org/10.1016/j.ajo.2005.03.063 CrossRefPubMed

10.

Wei Y-H, Yang C-M, Chen M-S et al (2009) Peripapillary intrachoroidal cavitation in high myopia: reappraisal. Eye Lond Engl 23:141–144. https://doi.org/10.1038/sj.eye.6702961 CrossRef

11.

Spaide RF, Akiba M, Ohno-Matsui K (2012) Evaluation of peripapillary intrachoroidal cavitation with swept source and enhanced depth imaging optical coherence tomography. Retina Phila Pa 32:1037–1044. https://doi.org/10.1097/IAE.0b013e318242b9c0 CrossRef

12.

Shimada N, Ohno-Matsui K, Nishimuta A et al (2007) Peripapillary changes detected by optical coherence tomography in eyes with high myopia. Ophthalmology 114:2070–2076. https://doi.org/10.1016/j.ophtha.2007.01.016 CrossRefPubMed

13.

Ohno-Matsui K, Akiba M, Moriyama M et al (2012) Intrachoroidal cavitation in macular area of eyes with pathologic myopia. Am J Ophthalmol 154:382–393. https://doi.org/10.1016/j.ajo.2012.02.010 CrossRefPubMed

14.

Holak SA, Holak N, Holak HM (2014) Peripapillary choroidal cavitation. Ophthalmology 121:e6–e7. https://doi.org/10.1016/j.ophtha.2013.09.039 CrossRefPubMed

15.

Agorogiannis EI, Parkes C (2019) Optic disc pit with peripapillary retinoschisis misdiagnosed as glaucoma. JAMA Ophthalmol 137:e183851. https://doi.org/10.1001/jamaophthalmol.2018.3851 CrossRefPubMed

16.

Gregory-Roberts EM, Mateo C, Corcóstegui B et al (2013) Optic disk pit morphology and retinal detachment: optical coherence tomography with intraoperative correlation. Retina Phila Pa 33:363–370. https://doi.org/10.1097/IAE.0b013e318263d0a6 CrossRef

17.

Yoshikawa T, Nishimura T, Minamino K, Takahashi K (2013) A long-term follow-up of peripapillary retinoschisis with optic disc hypoplasia. Int Ophthalmol 33:425–428. https://doi.org/10.1007/s10792-012-9673-7 CrossRefPubMed

18.

Akimoto M, Akagi T, Okazaki K, Chihara E (2012) Recurrent macular detachment and retinoschisis associated with intrachoroidal cavitation in a normal eye. Case Rep Ophthalmol 3:169–174. https://doi.org/10.1159/000339292 CrossRefPubMedPubMedCentral

19.

Farjad H, Besada E, Frauens BJ (2010) Peripapillary schisis with serous detachment in advanced glaucoma. Optom Vis Sci Off Publ Am Acad Optom 87:E205–E217. https://doi.org/10.1097/OPX.0b013e3181d1dad5 CrossRef

20.

Lee EJ, Kim T-W, Kim M, Choi YJ (2014) Peripapillary retinoschisis in glaucomatous eyes. PLoS ONE 9:e90129. https://doi.org/10.1371/journal.pone.0090129 CrossRefPubMedPubMedCentral

21.

Yeh S-I, Chang W-C, Wu C-H et al (2013) Characteristics of peripapillary choroidal cavitation detected by optical coherence tomography. Ophthalmology 120:544–552. https://doi.org/10.1016/j.ophtha.2012.08.028 CrossRefPubMed

22.

Ito-Ohara M, Seko Y, Morita H et al (1998) Clinical course of newly developed or progressive patchy chorioretinal atrophy in pathological myopia. Ophthalmol J Int Ophtalmol Int J Ophthalmol Z Augenheilkd 212:23–29. https://doi.org/10.1159/000027254 CrossRef

23.

Hayashi K, Ohno-Matsui K, Shimada N et al (2010) Long-term pattern of progression of myopic maculopathy: a natural history study. Ophthalmology 117:1595–1611. https://doi.org/10.1016/j.ophtha.2009.11.003(1611.e1–4) CrossRefPubMed

24.

Örnek N, Örnek K (2018) Full-thickness macular hole with macular intrachoroidal cavitation in a patient with pathologic myopia. Retin Cases Brief Rep 1:1. https://doi.org/10.1097/ICB.0000000000000720 CrossRef

25.

Ohno-Matsui K, Akiba M, Ishibashi T, Moriyama M (2012) Observations of vascular structures within and posterior to sclera in eyes with pathologic myopia by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci 53:7290–7298. https://doi.org/10.1167/iovs.12-10371 CrossRefPubMed

26.

Chen Q, He J, Hua Y, Fan Y (2017) Exploration of peripapillary vessel density in highly myopic eyes with peripapillary intrachoroidal cavitation and its relationship with ocular parameters using optical coherence tomography angiography. Clin Experiment Ophthalmol 45:884–893. https://doi.org/10.1111/ceo.12986 CrossRefPubMed

27.

Mazzaferro A, Carnevali A, Zucchiatti I et al (2017) Optical coherence tomography angiography features of intrachoroidal peripapillary cavitation. Eur J Ophthalmol 27:e32–e34. https://doi.org/10.5301/ejo.5000901 CrossRefPubMed

28.

Gopal L, Khan B, Jain S, Prakash VS (2007) A clinical and optical coherence tomography study of the margins of choroidal colobomas. Ophthalmology 114:571–580. https://doi.org/10.1016/j.ophtha.2006.06.048 CrossRefPubMed

Title: Intrachoroidal cavitation in myopic eyes
Authors: Ramesh Venkatesh
Kushagra Jain
Aditya Aseem
Sabitabh Kumar
Naresh Kumar Yadav
Publication date: 01-01-2020
Publisher: Springer Netherlands
Published in: International Ophthalmology / Issue 1/2020
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-019-01146-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intrachoroidal cavitation in myopic eyes

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2020

Surgical treatment of corneal dermoid by using intrastromal lenticule obtained from small-incision lenticule extraction

Evaluation of the lamina cribrosa thickness and depth in patients with migraine

Comparing the inverted internal limiting membrane flap with autologous blood technique to internal limiting membrane insertion for the repair of refractory macular hole

Relationship between tear eotaxin-2 and MMP-9 with ocular allergy and corneal topography in keratoconus patients

Combined retro-peribulbar and subconjunctival anesthesia for evisceration surgery

Comparative analysis of biomechanically corrected intraocular pressure with corneal visualization Scheimpflug technology versus conventional noncontact intraocular pressure