Characteristics of Peripapillary Staphylomas Associated With High Myopia Determined by Swept-Source Optical Coherence Tomography.

PURPOSE: To analyze the morphologic features of peripapillary staphylomas associated with high myopia by swept-source optical coherence tomography (OCT).

DESIGN

Validity analysis.

METHODS

Highly myopic patients (refractive error >8.0 diopters or axial length >26.5 mm) with a peripapillary staphyloma who had undergone swept-source OCT were studied. The non-highly myopic fellow eyes in patients with unilateral high myopia were also studied. The presence of a peripapillary staphyloma was determined by stereoscopic ophthalmoscopic examinations. The OCT features of the peripapillary staphylomas and other peripapillary lesions were evaluated.

RESULTS

Twenty-five eyes of 16 patients were studied. Twenty-two eyes were highly myopic and the remaining 3 eyes of the patients with unilateral high myopia were non-highly myopic. A peripapillary staphyloma was seen in the swept-source OCT images as a gently sloping excavation around the optic disc in all 25 eyes. The posterior sclera in the area of a peripapillary staphyloma was observed to bow posteriorly, with the local curvature steeper than the curvature of the adjacent scleral regions. The sclera at the edge of a peripapillary staphyloma appeared to be elevated inward from the surrounding sclera, and the choroid at the staphyloma edge appeared to be compressed and thinned. A peripapillary intrachoroidal cavitation was a frequent complication and was found in 13 eyes with a peripapillary staphyloma (52.5%).

CONCLUSIONS

Swept-source OCT can detect the slight changes of the sclera and choroid in the area of a peripapillary staphyloma, and we recommend its use in determining the presence of a peripapillary staphyloma.