A Comparative Study Between The Factors Related To The Occuren-Ce Of Highly Myopic Macular Choroidal Neovascularization And Retinoschisis

Objectives:1To explore the relationship between highly myopicmacular choroidal neovascularization (CNV), highly myopic macularretinoschisis (RS) and diopter, axial length, posterior staphyloma, lacquercracks, vitreoretinal traction, choroidal thickness (CT).2To explore thedifference of diopter, axial length, the incidence of posterior staphyloma, theincidence of lacquer cracks, the incidence of vitreoretinal traction, choroidalthickness (CT) between highly myopic macular CNV and highly myopicmacular RS.Methods:1All patients were from the Ophthalmology department of The SecondHospital of Hebei Medical University between December2012and December2013. According to cycloplegic retinoscopy, fundus fluorescein angiography(FFA) and optical coherence tomography (OCT) confirmed the diagnosis of27patients with highly myopic macular CNV (30eyes), recorded as CNV group.According to cycloplegic retinoscopy and OCT confirmed the diagnosis of23patients with highly myopic macular RS (30eyes), recorded as RS group.According to the inspection results to select30eyes of30patients withoutCNV and RS, recorded as comparison group. All the cases were included inthis study.2All patients recorded the name, gender, age, measured diopter withcycloplegic retinoscopy, measured axial length with IOL-Master, detected thepresence of posterior staphyloma with A/B-mode ultrasound, detected thepresence of lacquer crack with FFA, detected the presence of vitreoretinaltraction with OCT(including epiretinal membrane, posterior vitreousdetachment, vitreoretinal traction syndrome). Using enhanced depth imaging (EDI) mode of OCT to scan and measure the subfoveal CT (SFCT) value.3All the data were collated and carried out statistical analysis usingSPSS17.0.Observed the difference of diopter, axial length, choroidal thickness, theincidence of posterior staphyloma, the incidence of lacquer cracks, theincidence of vitreoretinal traction within the three groups.Measurement data recorded asX±S, the difference betweenmeasurement data of multiple group were compared with single factoranalysis of variance, the comparison between two groups was performed withLSD West. Inspection leveal for α=0.05, P<0.05for difference has statisticalsignificance, P<0.01for difference has significant statistical significance.Count data recorded as rate, the difference between count data of multiplegroup were compared with chi-square test. Inspection leveal for α=0.05,P<0.05for difference has statistical significance, P<0.01for difference hassignificant statistical significance. The comparision between two groups wasperformed with four tables. Adjust the inspection level α`=α/(3+1)=0.0125,P<0.0125for difference has statistical significance, P<0.0025for differencehas significant statistical significance.Results:1Diopter comparision within three groups: the diopter of CNV groupwas (-12.68±2.46)D, the diopter of RS group was (-12.33±3.17)D, the diopterof comparison group was (-9.72±2.50)D. The difference within the threegroups had significant statistical significance (P<0.01); the difference betweenCNV group, RS group and comparison group had significant statisticalsignificance (P<0.01), the myopic degree of CNV group and RS group werehigher; the difference between CNV group and RS group hadn’t statisticalsignificance (P>0.05).2Axial length comparision within three groups: the axial length of CNVgroup was (29.04±1.10)mm, the axial length of RS group was(28.87±1.62)mm, the axial length of comparison group was (27.96±1.14)mm.The difference within the three groups had significant statistical significance (P<0.01); the difference between CNV group, RS group and comparisongroup had significant statistical significance (P<0.01), the axial length of CNVgroup and RS group were longer; the difference between CNV group and RSgroup hadn’t statistical significance (P>0.05).3SFCT comparision within three groups: the SFCT of CNV group was(167.39±51.47)μm, the SFCT of RS group was (238.15±14.43)μm, the SFCTof comparison group was (279.33±33.82μm). The difference within the threegroups had significant statistical significance (P<0.01); the difference betweenCNV group, RS group and comparison group had significant statisticalsignificance (P<0.01), the SFCT of CNV group and RS group were thinner;the difference between CNV group and RS group had significant statisticalsignificance (P<0.01), the SFCT of CNV group was thinner.4Incidence of posterior staphyloma comparision within three groups:there were12eyes with posterior staphyloma in30eyes of27patients in CNVgroup, the incidence was40%, there were23eyes with posterior staphylomain30eyes of23patients in RS group, the incidence was76.7%, there were8eyes with posterior staphyloma in30eyes of30patients in comparison group,the incidence was26.7%. The difference within the three groups hadsignificant statistical significance (P<0.01). The difference between CNVgroup and comparison group hadn’t statistical significance (P>0.0125); thedifference between RS group and comparison group had significant statisticalsignificance (P<0.0025), the incidence of posterior staphyloma of RS groupwas higher; the difference between CNV group and RS group had statisticalsignificance (P<0.0125), the incidence of posterior staphyloma of RS groupwas higher.5Incidence of lacquer cracks comparision within three groups: therewere8eyes with lacquer cracks in30eyes of27patients in CNV group, theincidence was26.7%, there was one eye with lacquer cracks in30eyes of23patients in RS group, the incidence was3.3%, there was one eye with lacquercracks in30eyes of30patients in comparison group, the incidence was3.3%.The difference within the three groups had significant statistical significance (P<0.01); the difference between CNV group and comparison group hadsignificant statistical significance (P<0.0025), the incidence of lacquer cracksof CNV group was higher; the difference between RS group and comparisongroup hadn’t statistical significance (P>0.0125), the difference between CNVgroup and RS group had statistical significance (P<0.0125), the incidence ofCNV group was higher.6Incidence of vitreoretinal traction comparision within three groups:there were2eyes with vitreoretinal traction in30eyes of27patients in CNVgroup, the incidence was6.7%, while all with posterior vitreous detachment;there were29eyes with vitreoretinal traction in30eyes of23patients in RSgroup, the incidence was96.7%, while19eyes with epiretinal membrance and7eyes with posterior vitreous detachment and3eyes with vitreoretinaltraction syndrome; there were3eyes with vitreoretinal traction in30eyes of30patients in comparison group, the incidence was10%, while one eye withepiretinal membrance and2eyes with posterior vitreous detachment. Thedifference within the three groups had significant statistical significance(P<0.01); the difference between CNV group and comparison group hadn’tstatistical significance (P>0.0125); the difference between RS group andcomparison group had significant statistical significance (P<0.0025), theincidence of vitreoretinal traction of RS group was higher; the differencebetween CNV group and RS group had statistical significance (P<0.0125), theincidence of RS group was higher.Conclusions: Increased myopia, axial growth, choroid atrophy thinning,were the common participation factors for the formation of highly myopicmacular CNV and highly myopic macular RS; lacquer cracks was importantparticipation factor for the formation of highly myopic macular CNV;posterior staphyloma, vitreoretinal traction were important participationfactors for the formation of highly myopic macular RS.