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Intrachoroidal cavitation in myopic eyes

  • Ramesh VenkateshEmail author
  • Kushagra Jain
  • Aditya Aseem
  • Sabitabh Kumar
  • Naresh Kumar Yadav
Original Paper

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.

Keywords

Pathological myopia Intrachoroidal cavitation Chorioretinal atrophy Intrascleral vessels Optical coherence tomography 

Abbreviations

PM

Pathological myopia

OCT

Optical coherence tomography

ICC

Intrachoroidal cavitation

MTM

Myopic traction maculopathy

CNV

Choroidal neovascularisation

CRA

Chorioretinal atrophy

PVD

Posterior vitreous detachment

PS

Posterior staphyloma

SE

Spherical equivalent

AL

Axial length

Notes

Authors’ contributions

RV helped in conceptualising the study, data acquisition, analysing the data, interpreting the findings, writing and reviewing the manuscript; NKY involved in reviewing the manuscript; KAJ, ASM and SBH helped in data acquisition.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

Approval obtained from the Hospital institutional review board and ethics committee.

Consent for publication

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his/her images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. 1.
    Curtin BJ (1979) Physiologic vs pathologic myopia: genetics vs environment. Ophthalmology 86:681–691CrossRefGoogle Scholar
  2. 2.
    Faghihi H, Hajizadeh F, Riazi-Esfahani M (2010) Optical coherence tomographic findings in highly myopic eyes. J Ophthalmic Vis Res 5:110–121Google Scholar
  3. 3.
    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 Google Scholar
  4. 4.
    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 CrossRefGoogle Scholar
  5. 5.
    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 CrossRefGoogle Scholar
  6. 6.
    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 CrossRefGoogle Scholar
  7. 7.
    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 CrossRefGoogle Scholar
  8. 8.
    Freund KB, Ciardella AP, Yannuzzi LA et al (2003) Peripapillary detachment in pathologic myopia. Arch Ophthalmol Chic Ill 1960 121:197–204CrossRefGoogle Scholar
  9. 9.
    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 CrossRefGoogle Scholar
  10. 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 CrossRefGoogle Scholar
  11. 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 CrossRefGoogle Scholar
  12. 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 CrossRefGoogle Scholar
  13. 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 CrossRefGoogle Scholar
  14. 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 CrossRefGoogle Scholar
  15. 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 CrossRefGoogle Scholar
  16. 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 CrossRefGoogle Scholar
  17. 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 CrossRefGoogle Scholar
  18. 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 CrossRefGoogle Scholar
  19. 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 CrossRefGoogle Scholar
  20. 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 CrossRefGoogle Scholar
  21. 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 CrossRefGoogle Scholar
  22. 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 Google Scholar
  23. 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) CrossRefGoogle Scholar
  24. 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 CrossRefGoogle Scholar
  25. 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 CrossRefGoogle Scholar
  26. 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 CrossRefGoogle Scholar
  27. 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 CrossRefGoogle Scholar
  28. 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 CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Retina and VitreousNarayana NethralayaBangaloreIndia

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