Progress on the morphology of paravascular vitreoretinal interface abnormality in high myopia_Chinese Journal of Ocular Fundus Diseases

Authors：

Shen Yingjiao ¹ , Tao Jiwei ¹ ,  Shen Lijun ^1,2

1. Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China;
2. Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou 310000, China;

Corresponding author：

Shen Lijun, Email: ljshenysg@163.com

Keywords：

Myopia, degenerative; Vitreous detachment; Retinal perforations; Retinoschisis; Retinal detachment; Review

DOI：

10.3760/cma.j.cn511434-20210615-00318

Video：

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High myopia (HM) is one of the main causes of vision loss. In recent years, optical coherence tomography and other techniques have shown a variety of vitreoretinal interface abnormalities (VRIA) in highly myopic eyes. Posterior vitreous detachment and paravascular abnormality are the relatively common manifestations of VRIA. Posterior vitreous detachment is classified in several different ways in HM eyes, the onset age of which is earlier in HM. Paravascular abnormality mainly includes paravascular microfold, paravascular cyst, paravascular lamellar hole, and paravascular retinoschisis. The former two are early-stage lesions, the latter two are advanced lesions. VRIA is closely related to many HM's fundus complications, such as myopic retinoschisis, macular hole, retinal detachment and so on. VRIA may develop into myopic retinoschisis, which in turn develop into full-thickness macular hole, and even retinal detachment. Therefore, the examination and judgment of VRIA in HM patients are of great significance for the early prevention and treatment of clinical retina diseases.

Citation： Shen Yingjiao, Tao Jiwei, Shen Lijun. Progress on the morphology of paravascular vitreoretinal interface abnormality in high myopia. Chinese Journal of Ocular Fundus Diseases, 2022, 38(6): 518-521. doi: 10.3760/cma.j.cn511434-20210615-00318 Copy

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4.	Sarrafizadeh R, Hassan TS, Ruby AJ, et al. Incidence of retinal detachment and visual outcome in eyes presenting with posterior vitreous separation and dense fundus-obscuring vitreous hemorrhage[J]. Ophthalmology, 2001, 108(12): 2273-2278. DOI: 10.1016/s0161-6420(01)00822-3.
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6.	Gishti O, van den Nieuwenhof R, Verhoekx J, et al. Symptoms related to posterior vitreous detachment and the risk of developing retinal tears: a systematic review[J]. Acta Ophthalmol, 2019, 97(4): 347-352. DOI: 10.1111/aos.14012.
7.	Takahashi H, Tanaka N, Shinohara K, et al. Ultra-widefield optical coherence tomographic imaging of posterior vitreous in eyes with high myopia[J]. Am J Ophthalmol, 2019, 206: 102-112. DOI: 10.1016/j.ajo.2019.03.011.
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10.	Itakura H, Kishi S, Li D, et al. Vitreous changes in high myopia observed by swept-source optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2014, 55(3): 1447-1452. DOI: 10.1167/iovs.13-13496.
11.	Wang X, Shen M, Wang R, et al. Posterior precortical vitreous pockets in high myopia observed by enhanced vitreous imaging of spectral domain optical coherence tomography[J]. Retina, 2019, 39(6): 1100-1109. DOI: 10.1097/IAE.0000000000002101.
12.	Tsukahara M, Mori K, Gehlbach PL, et al. Posterior vitreous detachment as observed by wide-angle OCT imaging[J]. Ophthalmology, 2018, 125(9): 1372-1383. DOI: 10.1016/j.ophtha.2018.02.039.
13.	Kamal-Salah R, Morillo-Sanchez MJ, Rius-Diaz F, et al. Relationship between paravascular abnormalities and foveoschisis in highly myopic patients[J]. Eye (Lond), 2015, 29(2): 280-285. DOI: 10.1038/eye.2014.255.
14.	Li T, Wang X, Zhou Y, et al. Paravascular abnormalities observed by spectral domain optical coherence tomography are risk factors for retinoschisis in eyes with high myopia[J/OL]. Acta Ophthalmol, 2018, 96(4): e515-e523[2017-11-24]. https://pubmed.ncbi.nlm.nih.gov/29171725/. DOI: 10.1111/aos.13628.
15.	Vela JI, Sánchez F, Díaz-Cascajosa J, et al. Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain OCT[J]. Int Ophthalmol, 2016, 36(2): 247-252. DOI: 10.1007/s10792-015-0110-6.
16.	Liu HY, Hsieh YT, Yang CM. Paravascular abnormalities in eyes with idiopathic epiretinal membrane[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(9): 1723-1729. DOI: 10.1007/s00417-016-3276-3.
17.	Curtin BJ. Posterior staphyloma development in pathologic myopia[J]. Ann Ophthalmol, 1982, 14(7): 655-658.
18.	Ohno-Matsui K. Proposed classification of posterior staphylomas based on analyses of eye shape by three-dimensional magnetic resonance imaging and wide-field fundus imaging[J]. Ophthalmology, 2014, 121(9): 1798-1809. DOI: 10.1016/j.ophtha.2014.03.035.
19.	Benhamou N, Massin P, Haouchine B, et al. Macular retinoschisis in highly myopic eyes[J]. Am J Ophthalmol, 2002, 133(6): 794-800. DOI: 10.1016/s0002-9394(02)01394-6.
20.	Takahashi H, Tanaka N, Shinohara K, et al. Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J]. Ophthalmology, 2021, 128(2): 256-265. DOI: 10.1016/j.ophtha.2020.06.063.
21.	VanderBeek BL, Johnson MW. The diversity of traction mechanisms in myopic traction maculopathy[J]. Am J Ophthalmol, 2012, 153(1): 93-102. DOI: 10.1016/j.ajo.2011.06.016.
22.	Baba T, Ohno-Matsui K, Futagami S, et al. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia[J]. Am J Ophthalmol, 2003, 135(3): 338-342. DOI: 10.1016/s0002-9394(02)01937-2.
23.	Yokota R, Hirakata A, Hayashi N, et al. Ultrastructural analyses of internal limiting membrane excised from highly myopic eyes with myopic traction maculopathy[J]. Jpn J Ophthalmol, 2018, 62(1): 84-91. DOI: 10.1007/s10384-017-0542-9.
24.	Garoon RB, Smiddy WE, Flynn HW. Treated retinal breaks: clinical course and outcomes[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(6): 1053-1057. DOI: 10.1007/s00417-018-3950-8.
25.	Uhr JH, Obeid A, Wibbelsman TD, et al. Delayed retinal breaks and detachments after acute posterior vitreous detachment[J]. Ophthalmology, 2020, 127(4): 516-522. DOI: 10.1016/j.ophtha.2019.10.020.
26.	Muraoka Y, Tsujikawa A, Hata M, et al. Paravascular inner retinal defect associated with high myopia or epiretinal membrane[J]. JAMA Ophthalmol, 2015, 133(4): 413-420. DOI: 10.1001/jamaophthalmol.2014.5632.
27.	Miyoshi Y, Tsujikawa A, Manabe S, et al. Prevalence, characteristics, and pathogenesis of paravascular inner retinal defects associated with epiretinal membranes[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(10): 1941-1949. DOI: 10.1007/s00417-016-3343-9.
28.	Chen L, Wang K, Esmaili DD, et al. Rhegmatogenous retinal detachment due to paravascular linear retinal breaks over patchy chorioretinal atrophy in pathologic myopia[J]. Arch Ophthalmol, 2010, 128(12): 1551-1554. DOI: 10.1001/archophthalmol.2010.284.
29.	Rizzo S, Tartaro R, Barca F, et al. Autologous internal limiting membrane fragment transplantation for rhegmatogenous retinal detachment due to paravascular or juxtapapillary retinal breaks over patchy chorioretinal atrophy in pathologic myopia[J]. Retina, 2018, 38(1): 198-202. DOI: 10.1097/iae.0000000000001636.
30.	Hsieh YT, Yang CM. Retinal detachment due to paravascular abnormalities-associated breaks in highly myopic eyes[J]. Eye (Lond), 2019, 33(4): 572-579. DOI: 10.1038/s41433-018-0255-4.
31.	Gaucher D, Haouchine B, Tadayoni R, et al. Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome[J]. Am J Ophthalmol, 2007, 143(3): 455-462. DOI: 10.1016/j.ajo.2006.10.053.
32.	Sun CB, Liu Z, Xue AQ, et al. Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes[J]. Eye (Lond), 2010, 24(12): 1787-1791. DOI: 10.1038/eye.2010.123.

1. Ikuno Y. Overview of the complications of high myopia[J]. Retina, 2017, 37(12): 2347-2351. DOI: 10.1097/iae.0000000000001489.
2. Duker JS, Kaiser PK, Binder S, et al. The international vitreomacular traction study group classification of vitreomacular adhesion, traction, and macular hole[J]. Ophthalmology, 2013, 120(12): 2611-2619. DOI: 10.1016/j.ophtha.2013.07.042.
3. Shimada N, Ohno-Matsui K, Nishimuta A, et al. Detection of paravascular lamellar holes and other paravascular abnormalities by optical coherence tomography in eyes with high myopia[J]. Ophthalmology, 2008, 115(4): 708-717. DOI: 10.1016/j.ophtha.2007.04.060.
4. Sarrafizadeh R, Hassan TS, Ruby AJ, et al. Incidence of retinal detachment and visual outcome in eyes presenting with posterior vitreous separation and dense fundus-obscuring vitreous hemorrhage[J]. Ophthalmology, 2001, 108(12): 2273-2278. DOI: 10.1016/s0161-6420(01)00822-3.
5. la Cour M, Friis J. Macular holes: classification, epidemiology, natural history and treatment[J]. Acta Ophthalmol Scand, 2002, 80(6): 579-587. DOI: 10.1034/j.1600-0420.2002.800605.x.
6. Gishti O, van den Nieuwenhof R, Verhoekx J, et al. Symptoms related to posterior vitreous detachment and the risk of developing retinal tears: a systematic review[J]. Acta Ophthalmol, 2019, 97(4): 347-352. DOI: 10.1111/aos.14012.
7. Takahashi H, Tanaka N, Shinohara K, et al. Ultra-widefield optical coherence tomographic imaging of posterior vitreous in eyes with high myopia[J]. Am J Ophthalmol, 2019, 206: 102-112. DOI: 10.1016/j.ajo.2019.03.011.
8. Itakura H, Kishi S. Evolution of vitreomacular detachment in healthy subjects[J]. JAMA Ophthalmol, 2013, 131(10): 1348-1352. DOI: 10.1001/jamaophthalmol.2013.4578.
9. Hayashi K, Manabe SI, Hirata A, et al. Posterior vitreous detachment in highly myopic patients[J]. Invest Ophthalmol Vis Sci, 2020, 61(4): 33. DOI: 10.1167/iovs.61.4.33.
10. Itakura H, Kishi S, Li D, et al. Vitreous changes in high myopia observed by swept-source optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2014, 55(3): 1447-1452. DOI: 10.1167/iovs.13-13496.
11. Wang X, Shen M, Wang R, et al. Posterior precortical vitreous pockets in high myopia observed by enhanced vitreous imaging of spectral domain optical coherence tomography[J]. Retina, 2019, 39(6): 1100-1109. DOI: 10.1097/IAE.0000000000002101.
12. Tsukahara M, Mori K, Gehlbach PL, et al. Posterior vitreous detachment as observed by wide-angle OCT imaging[J]. Ophthalmology, 2018, 125(9): 1372-1383. DOI: 10.1016/j.ophtha.2018.02.039.
13. Kamal-Salah R, Morillo-Sanchez MJ, Rius-Diaz F, et al. Relationship between paravascular abnormalities and foveoschisis in highly myopic patients[J]. Eye (Lond), 2015, 29(2): 280-285. DOI: 10.1038/eye.2014.255.
14. Li T, Wang X, Zhou Y, et al. Paravascular abnormalities observed by spectral domain optical coherence tomography are risk factors for retinoschisis in eyes with high myopia[J/OL]. Acta Ophthalmol, 2018, 96(4): e515-e523[2017-11-24]. https://pubmed.ncbi.nlm.nih.gov/29171725/. DOI: 10.1111/aos.13628.
15. Vela JI, Sánchez F, Díaz-Cascajosa J, et al. Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain OCT[J]. Int Ophthalmol, 2016, 36(2): 247-252. DOI: 10.1007/s10792-015-0110-6.
16. Liu HY, Hsieh YT, Yang CM. Paravascular abnormalities in eyes with idiopathic epiretinal membrane[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(9): 1723-1729. DOI: 10.1007/s00417-016-3276-3.
17. Curtin BJ. Posterior staphyloma development in pathologic myopia[J]. Ann Ophthalmol, 1982, 14(7): 655-658.
18. Ohno-Matsui K. Proposed classification of posterior staphylomas based on analyses of eye shape by three-dimensional magnetic resonance imaging and wide-field fundus imaging[J]. Ophthalmology, 2014, 121(9): 1798-1809. DOI: 10.1016/j.ophtha.2014.03.035.
19. Benhamou N, Massin P, Haouchine B, et al. Macular retinoschisis in highly myopic eyes[J]. Am J Ophthalmol, 2002, 133(6): 794-800. DOI: 10.1016/s0002-9394(02)01394-6.
20. Takahashi H, Tanaka N, Shinohara K, et al. Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J]. Ophthalmology, 2021, 128(2): 256-265. DOI: 10.1016/j.ophtha.2020.06.063.
21. VanderBeek BL, Johnson MW. The diversity of traction mechanisms in myopic traction maculopathy[J]. Am J Ophthalmol, 2012, 153(1): 93-102. DOI: 10.1016/j.ajo.2011.06.016.
22. Baba T, Ohno-Matsui K, Futagami S, et al. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia[J]. Am J Ophthalmol, 2003, 135(3): 338-342. DOI: 10.1016/s0002-9394(02)01937-2.
23. Yokota R, Hirakata A, Hayashi N, et al. Ultrastructural analyses of internal limiting membrane excised from highly myopic eyes with myopic traction maculopathy[J]. Jpn J Ophthalmol, 2018, 62(1): 84-91. DOI: 10.1007/s10384-017-0542-9.
24. Garoon RB, Smiddy WE, Flynn HW. Treated retinal breaks: clinical course and outcomes[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(6): 1053-1057. DOI: 10.1007/s00417-018-3950-8.
25. Uhr JH, Obeid A, Wibbelsman TD, et al. Delayed retinal breaks and detachments after acute posterior vitreous detachment[J]. Ophthalmology, 2020, 127(4): 516-522. DOI: 10.1016/j.ophtha.2019.10.020.
26. Muraoka Y, Tsujikawa A, Hata M, et al. Paravascular inner retinal defect associated with high myopia or epiretinal membrane[J]. JAMA Ophthalmol, 2015, 133(4): 413-420. DOI: 10.1001/jamaophthalmol.2014.5632.
27. Miyoshi Y, Tsujikawa A, Manabe S, et al. Prevalence, characteristics, and pathogenesis of paravascular inner retinal defects associated with epiretinal membranes[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(10): 1941-1949. DOI: 10.1007/s00417-016-3343-9.
28. Chen L, Wang K, Esmaili DD, et al. Rhegmatogenous retinal detachment due to paravascular linear retinal breaks over patchy chorioretinal atrophy in pathologic myopia[J]. Arch Ophthalmol, 2010, 128(12): 1551-1554. DOI: 10.1001/archophthalmol.2010.284.
29. Rizzo S, Tartaro R, Barca F, et al. Autologous internal limiting membrane fragment transplantation for rhegmatogenous retinal detachment due to paravascular or juxtapapillary retinal breaks over patchy chorioretinal atrophy in pathologic myopia[J]. Retina, 2018, 38(1): 198-202. DOI: 10.1097/iae.0000000000001636.
30. Hsieh YT, Yang CM. Retinal detachment due to paravascular abnormalities-associated breaks in highly myopic eyes[J]. Eye (Lond), 2019, 33(4): 572-579. DOI: 10.1038/s41433-018-0255-4.
31. Gaucher D, Haouchine B, Tadayoni R, et al. Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome[J]. Am J Ophthalmol, 2007, 143(3): 455-462. DOI: 10.1016/j.ajo.2006.10.053.
32. Sun CB, Liu Z, Xue AQ, et al. Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes[J]. Eye (Lond), 2010, 24(12): 1787-1791. DOI: 10.1038/eye.2010.123.

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