Papillary and Peripapillary Hemorrhages in Eyes With Pathologic Myopia.
Xiong Jianping, Du Ran, Xie Shiqi, Lu Hongshuang, Chen Changyu, Lgarashi-Yokoi Tae, Uramoto Kengo, Onishi Yuka, Yoshida Takeshi, Kamoi Koju
AI Summary
This study found papillary hemorrhages in 4.05% of pathologic myopia eyes, often temporal, with axial elongation and potential glaucoma increasing recurrence risk, highlighting the need for monitoring.
Abstract
Purpose
To determine the prevalence, characteristics, and causes of papillary and peripapillary hemorrhages (PPHs) in eyes with pathologic myopia (PM).
Methods
PM patients were retrospectively studied between 2011 and 2018. Fundus images were used to diagnose and classify the PPHs. Fundus fluorescein angiographic (FFA) and optical coherence tomographic (OCT) images were used to determine the status of the retinal vessels and tissue at and around the PPH sites. Visual field data determined by Goldmann perimetry and Humphrey visual field analyzer were also analyzed.
Results
A total of 2171 PM patients (3774 eyes) were examined. Eighty-eight patients (97 eyes) had PPHs (mean age 66.8 ± 11.9 years; mean axial length 30.79 ± 2.17 mm) for a prevalence of 4.05%. Thirty (30.9%) eyes recurred. Among the 90 eyes with a single-site PPH, the most common type and location were the conus type (49 eyes, 54.4%) and the temporal side (66 eyes, 73.3%), respectively. Regression analysis showed that patchy atrophy reduced the risk of recurrences than diffuse atrophy (P < 0.05), whereas a longer axial length and potential glaucoma increased the risk (both P < 0.05). FFA and OCT showed that PPHs developed in the area of straightened retinal arterioles (24 eyes), at or beside the peak of a ridge (10 eyes), in an area of compressed retinal tissue (two eyes).
Conclusions
PPHs are present in 4.05% of PM eyes, and they are most often located in the temporal peripapillary atrophic region of the retina. Axial elongation, mild myopic maculopathy, and potential glaucoma are risk factors for recurrences.
MeSH Terms
Shields Classification
Key Concepts5
The prevalence of papillary and peripapillary hemorrhages (PPHs) in eyes with pathologic myopia (PM) was 4.05% among 2171 PM patients (3774 eyes) studied between 2011 and 2018.
Among 90 eyes with a single-site papillary and peripapillary hemorrhage (PPH) in patients with pathologic myopia, the most common type was the conus type (49 eyes, 54.4%) and the most common location was the temporal side (66 eyes, 73.3%).
In eyes with pathologic myopia and papillary and peripapillary hemorrhages (PPHs), regression analysis showed that patchy atrophy reduced the risk of PPH recurrences compared to diffuse atrophy (P < 0.05).
In eyes with pathologic myopia and papillary and peripapillary hemorrhages (PPHs), regression analysis indicated that a longer axial length and potential glaucoma increased the risk of PPH recurrences (both P < 0.05).
Fundus fluorescein angiographic (FFA) and optical coherence tomographic (OCT) images of eyes with pathologic myopia and papillary and peripapillary hemorrhages (PPHs) showed that PPHs developed in areas of straightened retinal arterioles (24 eyes), at or beside the peak of a ridge (10 eyes), and in areas of compressed retinal tissue (two eyes).
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