Clinical care
Spectral domain optical coherence tomography of myopic traction maculopathy

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Abstract

Purpose

Here we document 2 cases of macular schisis-like appearance in high myopia analyzed with spectral domain optical coherence tomography (SDOCT).

Methods

In Case 1, a 58-year-old patient with high myopia manifesting a recent onset of decreased vision in the right eye (OD) is presented. In Case 2, a 45-year-old patient with a lifelong history of no light perception and high myopia OD is presented.

Results

In Case 1, biomicroscopy found a posterior staphyloma associated with subtle retinal thickening in the patient’s right eye. SDOCT confirmed the presence of macular traction associated with a schisis-like appearance. In Case 2, a posterior staphyloma associated with significant macular thickening was observed during biomicroscopy. SDOCT found macular traction and a schisis-like appearance.

Conclusions

These presentations are consistent with myopic traction maculopathy. Few myopic traction maculopathy cases have been studied with SDOCT. The time domain optical coherence tomography and SDOCT analysis suggests that the etiology of this condition may be secondary to preretinal and extraretinal traction exhibited in degenerative high myopia.

Section snippets

Case 1

A 58-year-old black man presented to the Nova Southeastern University Eye Care Institute for an evaluation of recently decreased vision in the right eye. He stated that he noticed a progressive and drastic decrease in vision over the prior 6 months in that eye. According to the patient, his last eye examination was 7 years earlier. He was wearing rigid gas-permeable contact lenses at the time of the examination.

His medical history was remarkable for type 2 diabetes mellitus for which he was

Discussion

Chorioretinal changes associated with degenerative myopia have been attributed to a congenital-derived weakness of the sclera.1, 2, 3, 4, 5 This structural defect leads to the progressive stretching of the sclera and development of a posterior staphyloma. Accompanying complications of the degenerative myopic ectasia may include atrophy of the choroid and its capillary network, Bruch’s membrane fractures, posterior retinal detachment, choroidal neovascularization, and foveal hemorrhages. Takano

Conclusion

MTM is a recently characterized maculopathy included in the spectrum of myopic degenerative disorders. It may be difficult to appreciate on biomicroscopy and can present with a variety of visual deteriorations. TDOCT or SDOCT may facilitate the diagnosis of MTM in patients with a high level of myopia and a posterior staphyloma. Detecting this condition early, and referring the patient to a retinal specialist for evaluation and treatment when appropriate, may prevent further vision loss,

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  • Cited by (0)

    Disclosure: The author has no financial or other relationships that might lead to a conflict of interest.

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