The diagnostic value of multicolor scanning laser imaging combined with swept-source optical coherence tomography for lacquer cracks and myopia stretch lines of pathological myopia_Chinese Journal of Ocular Fundus Diseases

Authors：

Hua Yihong , Chen Qiuying , Zhou Hao , Wang Kai , Sun Haolong , Wang Weijun ,  Fan Ying

Department of Ophthalmology, The First People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai 200080, China;

Corresponding author：

Fan Ying, Email: fanying0129@163.com

Keywords：

Myopia, degenerative/diagnosis; Microscopy, confocal; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2019.05.003

Video：

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Objective To analyze the diagnostic value of multicolor scanning laser imaging (confocal scanning laser ophthalmoscopy, cSLO) combined with swept-source optical coherence tomography (SS-OCT) for lacquer cracks (LC) and myopia stretch lines (MSL) of pathological myopia.Methods A observational study. A total of 83 eyes of 58 patients with pathological myopia were recruited from May 2017 to January 2018 in Department of Ophthalmology of The First People’s Hospital Affiliated to Shanghai Jiao Tong University. Among 58 patients, 20 were males (30 eyes) and 38 were females (53 eyes). The mean age was 50.65±12.02 (range from 24 to 70) years old; the average BCVA was 0.37±0.32; the average diopter was −11.38±4.96 D; and the average axial length was 28.91±2.15 mm. All participants underwent FFA and ICGA examination to obtain FFA, ICGA, infrared light reflection (IR) and autofluorescence (AF) images. SS-OCT was applied for scanning macular and optic disc at 9 mm × 9 mm range. cSLO was performed with macular as the center. All images were inspected carefully by three independent observers and the consistency test was detect. LC were diagnosed as hyperreflective line in FFA and hypofluorescent linear lesions in late ICGA. MSL were defined as both hypofluorescent linear lesions in FFA and late ICGA. The accuracy of each inspection item in the diagnosis of LC was detected. The optimal technique was applied with SS-OCT to further explore the detection rate of LC.Results The intra-observer reproducibility was good to excellent for all measurements (Kappa=0.938, P＜0.01). The positive detection rate of LC and MSL was highest in the standard images of cSLO (77.1%), followed by SS-OCT red free (73.1%), fundus photography (72.3%), IR (72.3%) and AF (49.4%). The cSLO was optimal in the test consistency (Kappa=0.520, P＜0.01) and accuracy (the area under the receiver operating characteristic was 0.750). SS-OCT and cSLO were jointly applied to diagnosis of LC and MSL in high myopia. The positive detection rate of LC, MSL and LC+MSL were 91.7%, 91.2% and 93.3% respectively. The characteristics of LC in SS-OCT were irregularities and discontinuous of the RPE-Bruch membrane line, discontinuous inner ellipsoid zone, thinner choroid, an increased light penetrance into deeper tissues, and RPE fracture in severe cases. MSL was mainly manifested as RPE clumps, visible large choroidal vessels protruding and pushing the overlying RPE toward the vitreous.Conclusions The diagnosis rate of LC in pathological myopia by cSLO is 77.1%. The standard images of cSLO combined with SS-OCT can diagnose LC, MSL and LC+MSL at rates of 91.7%, 91.2% and 93.3% respectively.

Citation： Hua Yihong, Chen Qiuying, Zhou Hao, Wang Kai, Sun Haolong, Wang Weijun, Fan Ying. The diagnostic value of multicolor scanning laser imaging combined with swept-source optical coherence tomography for lacquer cracks and myopia stretch lines of pathological myopia. Chinese Journal of Ocular Fundus Diseases, 2019, 35(5): 435-440. doi: 10.3760/cma.j.issn.1005-1015.2019.05.003 Copy

1.	Ikuno Y, Sayanagi K, Soga K, et al. Lacquer crack formation and choroidal neovascularization in pathologic myopia[J]. Retina, 2008, 28(8): 1124-1131. DOI: 10.1097/IAE.0b013e318174417a.
2.	Ohno-Matsui K, Yoshida T, Futagami S, et al. Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularisation in pathological myopia[J]. Br J Ophthalmol, 2003, 87(5): 570-573. DOI: 10.1136/bjo.87.5.570.
3.	Wang NK, Lai CC, Chu HY, et al. Classification of early dry-type myopic maculopathy with macular choroidal thickness[J]. Am J Ophthalmol, 2012, 153(4): 669-677. DOI: 10.1016/j.ajo.2011.08.039.
4.	Fang Y, Yokoi T, Nagaoka N, et al. Progression of myopic maculopathy during 18-year follow-up[J]. Ophthalmology, 2018, 125(6): 863-877. DOI: 10.1016/j.ophtha.2017.12.005.
5.	Hayashi K, Ohno-Matsui K, Shimada N, et al. Long-term pattern of progression of myopic maculopathy: a natural history study[J]. Ophthalmology, 2010, 117(8): 1595-1611. DOI: 10.1016/j.ophtha.2009.11.003.
6.	Hung KC, Chen MS, Yang CM, et al. Multimodal imaging of linear lesions in the fundus of pathologic myopic eyes with macular lesions[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(1): 71-81. DOI: 10.1007/s00417-017-3833-4.
7.	Liu CF, Liu L, Lai CC, et al. Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes[J]. Eye (Lond), 2014, 28(12): 1437-1445. DOI: 10.1038/eye.2014.221.
8.	Ohno-Matsui K, Lai TY, Lai CC, et al. Updates of pathologic myopia[J]. Prog Retin Eye Res, 2016, 52: 156-187. DOI: 10.1016/j.preteyeres.2015.12.001.
9.	Shinohara K, Moriyama M, Shimada N, et al. Myopic stretch lines: linear lesions in fundus of eyes with pathologic myopia that differ from lacquer cracks[J]. Retina, 2014, 34(3): 461-469. DOI: 10.1097/IAE.0b013e3182a6b494.
10.	Ohno-Matsui K, Morishima N, Ito M, et al. Indocyanine green angiographic findings of lacquer cracks in pathologic myopia[J]. Jpn J Ophthalmol, 1998, 42(4): 293-299. DOI: 10.1016/S0021-5155(98)00008-2.
11.	Kirkpatrick JN, Manivannan A, Gupta AK, et al. Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope[J]. Br J Ophthalmol, 1995, 79(10): 892-899. DOI: 10.1136/bjo.79.10.892.
12.	Elsner AE, Burns SA, Weiter JJ, et al. Infrared imaging of sub-retinal structures in the human ocular fundus[J]. Vision Res, 1996, 36(1): 191-205. DOI: 10.1016/0042-6989(95)00100-E.
13.	Schmitz-Valckenberg S, Holz FG, Bird AC, et al. Fundus autofluorescence imaging: review and perspectives[J]. Retina, 2008, 28(3): 385-409. DOI: 10.1097/IAE.0b013e318164a907.
14.	Xu X, Fang Y, Uramoto K, et al. Clinical features of lacquer cracks in eyes with pathologic myopia[J]. Retina, 2019, 39(7): 1265-1277. DOI: 10.1097/IAE.0000000000002168.

1. Ikuno Y, Sayanagi K, Soga K, et al. Lacquer crack formation and choroidal neovascularization in pathologic myopia[J]. Retina, 2008, 28(8): 1124-1131. DOI: 10.1097/IAE.0b013e318174417a.
2. Ohno-Matsui K, Yoshida T, Futagami S, et al. Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularisation in pathological myopia[J]. Br J Ophthalmol, 2003, 87(5): 570-573. DOI: 10.1136/bjo.87.5.570.
3. Wang NK, Lai CC, Chu HY, et al. Classification of early dry-type myopic maculopathy with macular choroidal thickness[J]. Am J Ophthalmol, 2012, 153(4): 669-677. DOI: 10.1016/j.ajo.2011.08.039.
4. Fang Y, Yokoi T, Nagaoka N, et al. Progression of myopic maculopathy during 18-year follow-up[J]. Ophthalmology, 2018, 125(6): 863-877. DOI: 10.1016/j.ophtha.2017.12.005.
5. Hayashi K, Ohno-Matsui K, Shimada N, et al. Long-term pattern of progression of myopic maculopathy: a natural history study[J]. Ophthalmology, 2010, 117(8): 1595-1611. DOI: 10.1016/j.ophtha.2009.11.003.
6. Hung KC, Chen MS, Yang CM, et al. Multimodal imaging of linear lesions in the fundus of pathologic myopic eyes with macular lesions[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(1): 71-81. DOI: 10.1007/s00417-017-3833-4.
7. Liu CF, Liu L, Lai CC, et al. Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes[J]. Eye (Lond), 2014, 28(12): 1437-1445. DOI: 10.1038/eye.2014.221.
8. Ohno-Matsui K, Lai TY, Lai CC, et al. Updates of pathologic myopia[J]. Prog Retin Eye Res, 2016, 52: 156-187. DOI: 10.1016/j.preteyeres.2015.12.001.
9. Shinohara K, Moriyama M, Shimada N, et al. Myopic stretch lines: linear lesions in fundus of eyes with pathologic myopia that differ from lacquer cracks[J]. Retina, 2014, 34(3): 461-469. DOI: 10.1097/IAE.0b013e3182a6b494.
10. Ohno-Matsui K, Morishima N, Ito M, et al. Indocyanine green angiographic findings of lacquer cracks in pathologic myopia[J]. Jpn J Ophthalmol, 1998, 42(4): 293-299. DOI: 10.1016/S0021-5155(98)00008-2.
11. Kirkpatrick JN, Manivannan A, Gupta AK, et al. Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope[J]. Br J Ophthalmol, 1995, 79(10): 892-899. DOI: 10.1136/bjo.79.10.892.
12. Elsner AE, Burns SA, Weiter JJ, et al. Infrared imaging of sub-retinal structures in the human ocular fundus[J]. Vision Res, 1996, 36(1): 191-205. DOI: 10.1016/0042-6989(95)00100-E.
13. Schmitz-Valckenberg S, Holz FG, Bird AC, et al. Fundus autofluorescence imaging: review and perspectives[J]. Retina, 2008, 28(3): 385-409. DOI: 10.1097/IAE.0b013e318164a907.
14. Xu X, Fang Y, Uramoto K, et al. Clinical features of lacquer cracks in eyes with pathologic myopia[J]. Retina, 2019, 39(7): 1265-1277. DOI: 10.1097/IAE.0000000000002168.

Chinese Journal of Ocular Fundus Diseases

The diagnostic value of multicolor scanning laser imaging combined with swept-source optical coherence tomography for lacquer cracks and myopia stretch lines of pathological myopia

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