![]() ![]() We performed OCT examinations with commercially available OCT equipment (Humphrey-Zeiss, Dublin, Calif) developed from the prototype described by Hee et al 5 and Puliafito et al. Furthermore, color fundus photographs were obtained and each patient underwent fluorescein angiographic examination, A-scan axial length measurement, B-scan ultrasound evaluation of the posterior segment, and OCT examination of the peripapillary area. Each patient underwent a complete ophthalmologic examination, including best-corrected visual acuity measurement, intraocular pressure measurement, anterior segment biomicroscopy, and dilated fundus examination. All of the patients were asked to return to the retinal research department of the Manhattan Eye, Ear, and Throat Hospital (New York, NY) for a follow-up visit. A-scan axial length measurements and results of B-scan ultrasound examination, color fundus photography, visual field testing, and fluorescein angiographic examination, when present, were recorded. Medical records from these patients were reviewed for the following data: age at initial examination, sex, race, number of eyes involved, refractive error, best-corrected visual acuity, visual symptoms, and associated myopic fundus changes, such as tilted disc, posterior staphyloma, myopic conus, lacquer cracks, and Fuchs spot. This report summarizes our experience during almost 2 decades with this peculiar fundus abnormality in pathologic myopia.ĭuring a 17-year period from January 1984 to December 2001, 15 patients with pathologic myopia and PDPM in one or both eyes were identified. 4 For this study, the original patients as well as additional cases identified since were asked to return for further assessment, including optical coherence tomographic (OCT) examination of the area of PDPM. We first reported the presence of a PDPM lesion in a smaller case series, which was presented at the Association for Research in Vision and Ophthalmology annual meeting in 1995. We called this lesion"peripapillary detachment in pathologic myopia" (PDPM). When viewed stereoscopically, it appeared to be a small localized retinal elevation or thickening. This lesion appeared to be subretinal because the retinal vessels passed over it. In 1984, we first noticed the presence of an elevated, well-circumscribed, dome-shaped, yellow-orange lesion inferior to the optic disc along the inferior margin of the myopic conus. The purpose of this report is to describe a newly observed lesion at the inferior margin of the peripapillary conus in a series of patients with pathologic myopia. The clinical features of the myopic fundus have been well described. The expansion of the globe with scleral thinning leads to the formation of a posterior staphyloma and optic disc myopic conus. 2įundus changes in pathologic myopia are numerous and are related to the degree of myopia, axial length, and the presence of a posterior staphyloma. 1 Progressive chorioretinal degeneration is often associated with pathologic myopia. Pathologic myopia is defined by a refractive error of −6.00 diopters (D) or greater and an axial length of the globe of more than 26 mm. MYOPIA IS the most common ocular abnormality. Recognition of this lesion is important to distinguish it from other fundus pathologic conditions, such as tumors or choroidal neovascularization, which require further investigation and treatment. No apparent negative effect on visual function was noted.Ĭonclusions Peripapillary detachment in pathologic myopia is an asymptomatic, yellow-orange peripapillary detachment of the retinal pigment epithelium and retina in pathologic myopia. During the follow-up period, the lesion remained stable in all cases except for 1. In each case, ophthalmic coherence tomographic examination showed a localized detachment of the retinal pigment epithelium and retina corresponding to the PDPM lesion. The mean axial length was 27.4 mm (range, 25.3-28.9 mm). The mean spherical equivalent correction was −11.00 diopters (D) (range, −6.00 to−16.00 D). They were followed up for an average of 6 years. The mean age of the patients was 58 years. Results Twenty eyes of 15 patients were identified during a 17-year period to have characteristic findings of PDPM. Methods We evaluated a series of myopic eyes that had a yellow-orange elevation of the retina and retinal pigment epithelium at the inferior border of the myopic conus. Objective To describe peripapillary detachment in pathologic myopia (PDPM), a newly recognized fundus lesion.ĭesign Retrospective medical record review. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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