The Preliminarily Discussion Of The High Myopic Eye Shapes And The Clinical Classifications Of Myopic Choroidal Neovascularization

ObjectiveAnalyze the shapes and features of high myopic eyes by 3D-MRI exanmination.To investigate 3D-MRI exanmination methods and imaging manifestations of high myopic eyes,and to evaluate its clinical values when comparing with other diagnostic imaging facilities.Analyze the shapes and features of myopic CNV,and divided them into morphologic classifications according to the result.To compare the clinical significance and the susceptibility of anti-VEGF treatments of different morphologic classifications.MethodsA total of 267 eyes of 139 cases were selected,240 eyes of 124 cases were high myopic patients(the myopia spherical diopter was equal or less than-6.00 diopter,and the eye axial length was equal or more than26mm).All the patients accepted the routine ophthalmologic examination and orbit MRI examination,among which,195 eyes of 100 cases accepted B-scan exanmination.The MRI imaging were processed into 3Dmodels.Patients were divided into groups by age,spherical diopter,eye axial length,fundus lesions.The correlation between eye shapes and case data were analyzed by chi square test.The differences of diameter lines between eye shapes were analyzed by Kruskal-Wallis test.The detection rate of posterior staphylomas detected by MRI examination and B-scan were analyzed by McNemar test.87 eyes of 77 cases of myopic cnv patients accepted the routine ophthalmologic examination and Angio-OCT examination.Patients were divided into groups by age,fundus category,lesion location,and the response of anti-VEGF treatment.The correlation between morphologic classifications and the Prognosis of anti-VEGF treatments of different morphologic classifications were analyzed by chi square test.ResultsThe shape of non-high myopia eyeball was close to spheroidal,the high myopia eye were expansion of all radial lines.The shapes of high myopia eyeball can be divided into five types: spherical,conical,bowl,column,and irregular.The impression of extra ocular muscles was set for the “ additional ” part.The distribution of the five types of high myopic eye in the sexual group(c2=35.572,P=0.006),age group(c2=57.194,P=0.023),eye axial group(c2=87.355,P=0.041),the fundus category group(c2=22.473,P=0.002),and the fundus lesions group(c2=56.897,P=0.009)had significant difference,and had nosignificant difference in the spherical diopter group(c2=67.935,P=0.056).There was a significant difference of the vertical length(H=102.739,P=0.033),horizontal length(H=53.802,P=0.027),axial length(H=20.093,P=0.042),vertical length/ horizontal length(H=140.332,P=0.009),vertical length/axial length(H=163.350,P=0.016)of thefive types of high myopic eye.The detection rate of the posteriorstaphyloma detected by B-scan and MRI examination had significantdifference(P=0.001).In some cases,irregular uplift and depression can be seen on the 3D-MRI model,but can not be accurately displayed in the B-scan.The morphologic classifications of myopic CNV can be divided into three types:guttate,branched and clustered.The distribution of the three types of myopic CNV in the sexual group(c2=68.847,P=0.021),age group(c2=25.473,P=0.034),fundus category group(c2=32.594,P=0.029)and the lesion location group(c2=44.028,P=0.040)had significant difference.The quantity of the fundus accompanied by lacquer crack of different types had significant difference(c2=72.759,P=0.040).There was a significant difference of the the prognosis of anti-VEGF treatments of different types of myopic CNV(c2=23.296,P=0.012).ConclusionThe shapes of myopic eyes have their own independent clinical features,and were related with different fundus lesions.3D-MRI modelcan demonstrate high myopia eyeball shapes and the location and characteristics of posterior staphyloma.It has a higher diagnostic accuracy compared with ophthalmic B-type ultrasound and can be taken as a new method of high myopia eye examination.Myopic CNV has its own independent clinical features,the susceptibility of anti-VEGF treatments of different types are different.Angio-OCT could find the myopic CNV at early stage,but it’s overly-sensitive and the activity of the lesion could not be distinguished.Ango-OCT isn’t ready to replace FFA+ICGA.ObjectiveAnalyze the shapes and features of myopic CNV,and divided them into morphologic classifications according to the result.To compare the clinical significance and the susceptibility of anti-VEGF treatments of different morphologic classifications.Methods87 eyes of 77 cases of myopic cnv patients(the spherical diopter was equal or less than-6.00 diopter,and the eye axial length was equal or more than 26mm)accepted the routine ophthalmologic examination and Angio-OCT examination.Patients were divided into groups by age((1)<50years(2)≥50years),fundus category((1)no myopic retinal lesions(2)tessellated fundus only(3)diffuse chorioretinal atrophy(4)patchy chorioretinal atrophy(5)macular atrophy),lesion location((1)subfoveal(2)juxtafoveal(3)extrafoveal),and the response of anti-VEGF treatment((1)effective(the area of myopic CNV decrease)(2)stable(the area of myopic CNV invariant)(3)invalid(the area of myopic CNV increase).The correlation between morphologic classifications and the prognosis of anti-VEGF treatments of different morphologic classifications were analyzed by chi square test.ResultsThe morphologic classifications of myopic CNV can be divided into three types:guttate,branched and clustered.The distribution of the three types of myopic CNV in the sexual group(c2=68.847,P=0.021),age group(c2=25.473,P=0.034),fundus category group(c2=32.594,P=0.029)and the lesion location group(c2=44.028,P=0.040)had significant difference.The quantity of the fundus accompanied by lacquer crack of different types had significant difference(c2=72.759,P=0.040).There was a significant difference of the the prognosis of anti-VEGF treatments of different types of myopic CNV(c2=23.296,P=0.012).ConclusionMyopic CNV has its own independent clinical features,the susceptibility of anti-VEGF treatments of different types are different.Angio-OCT could find the myopic CNV at early stage,but it’s overly-sensitive and the activity of the lesion could not be distinguished.Ango-OCT isn’t ready to replace FFA+ICGA.