Atlas of Ophthalmology

Myopic Maculopathy with Atrophy of Retinal Pigment Epithelium (Colour Photography Posterior Pole , SD-OCT, FFA)

Retina -> Congenital Abnormalities and Syndromes
Patient: 75 years of age, male, BCVA light perception at OD, 0.3 at OS, IOP 14/15 mmHg. General Medical History: arterial hypertension. Ocular Medical History: myopia with -9dpt at OD and OS, cataract surgery in OD and OS in 1999. Purpose: to present lack of retinal pigment epithelium and of choriocapillaris in high myopia. Methods: Colour Photography Posterior Pole , SD-OCT, FFA. Findings: Colour Photography Posterior Pole: grayish-white, well-defined, sharply demarcated atrophy of retinal pigment epithelium, multiple lesions of patchy atrophy, posterior staphyloma. OCT: areas of patchy atrophy with remnants of Bruch membrane, mostly defective Bruch membrane. FFA: lack of the choriocapillaris and of the retinal pigment epithelium, single large choroidal vessels, choroidal filling defects. Discussion: Myopic maculopathy is a hallmark of pathologic myopia. Ohno-Matsui et al. (1) reported, that pathologic myopia is a major cause of irreversible vision loss and blindness worldwide. They described a grading system for myopic maculopathy: category 0, with no macular lesions; category 1, with tessellated fundus; category 2, characterized by diffuse chorioretinal atrophy; category 3, with patchy chorioretinal atrophy; and category 4, showing macular atrophy. Literature: (1) Ohno-Matsui K, Jonas JB, Spaide RF. Macular Bruch Membrane Holes in Highly Myopic Patchy Chorioretinal Atrophy. Am J Ophthalmol. 2016 Jun;166:22-8.

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