| Purpose:To investigate the prevalence,composition,distribution,influnce factors of retinal paravascular abnormalities and retinoschisis and the relationship between them in young myopic population.Design:Observational case series.Methods: One thousand and forty-six eyes of 523 patients with different diopters of myopia were included in this study.The participants had a complete ophthalmologic examination,including best corrected visual acuity,axial length measurement,refractive error,color fundus photography and spectral domain optical coherence tomography(SD-OCT)examinations.Multiple SD-OCT scans were made along the upper and lower arcades and across the fovea in each patient.Results:Of the 1046 different diopters of myopia eyes,there were 227 eyes in mild myopia,405 eyes in moderate myopia and 414 eyes in high myopia.Retinal paravascular abnormalities and / or retinoschisis were detected by SD-OCT in 43 eyes(4.1%,43/1046).The prevalence of high myopia was9.7%(40/414)and moderate myopia was 0.7%(3/405).No retinal paravascular abnormalities were observed in mild myopia.In the 43 eyes,the median age was 22.0(14.0)years,the average refractive error was-8.4±1.9D(range﹣3.5to﹣13.0 D),the average axial length was 27.4±1.0 mm(range 24.7 to 29.0mm)and the best corrected visual acuity was 20/20(Log MAR=0).In the 43 eyes with retinal paravascular abnormalities and / or retinoschisis,40 eyes were associated with retinal paravascular abnormalities,30 eyes with paravascular retinoschisis,myopic macular retinoschisis were never detected.Of 40 eyes with retinal paravascular abnormalities,paravascular cysts in all 40eyes(100%),paravascular microfolds in 28 eyes(70.0%)and paravascular lamellar holes in 13 eyes(32.5%).Full-thickness holes were never detected.Paravascular microfolds and paravascular lamellar holes were always accompanied by paravascular cysts.All three subtypes of retinal paravascular abnormalities were observed more frequently along the temporal vascular arcades than along the nasal vascular arcades(P<0.001).Paravascular retinoschisis was classified into three different subtypes: inner,middle and outer retinoschisis,according to the specific layer of the splitting.The overall prevalence of three subtypes of paravascular retinoschisis in young myopic population was 2.9%,0.8% and 1.5% respectively.Of 30 eyes with retinoschisis,inner retinoschisis in all 30 eyes(100%),middle retinoschisis in8 eyes(26.7%),outer retinoschisis in 16 eyes(53.3%).We observed a similar distribution pattern of retinoschisis at vascular arcades with markedly higher frequency along the temporal arcades in all three subtypes of retinoschisis.Eyes with all three subtypes of retinal paravascular abnormalities had the higher incidence of outer retinoschisis at vascular arcades(P< 0.05).In the 43 eyes of retinal paravascular abnormalities and / or paravascular retinoschisis,we found 6 eyes with paravascular inner retinal defects(PIRDs).Conclusion:1.Retinal paravascular abnormalities and retinoschisis tend to occur in high myopia among the youth.However,moderate myopia can also appeared retinal paravascular abnormalities and retinoschisis in young people.2.Paravascular cysts may be the earliest lesions of retinal paravascular abnormalities.3.All three subtypes of retinal paravascular abnormalities and retinoschisis were most frequently observed along the temporal vascular arcades.4.Inner retinoschisis may be the predominant subtype of paravascular retinoschisis in young people.5.Traction of posterior vitreous cortex played an important role in retinal paravascular abnormalities and retinoschisis.6.The factor in determining the extent of the inner retinoschisis is the status of the posterior vitreous cortex.7.Eyes with all three subtypes of retinal paravascular abnormalities had the higher incidence of outer retinoschisis at vascular arcades.8.PIRDs are more serious retinal paravascular lesions on the basis of paravascular cysts,microfolds and lamellar holes. |
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