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RIDGE-SHAPED MACULA IN YOUNG MYOPIC PATIENTS AND ITS DIFFERENTIATION FROM TYPICAL DOME-SHAPED MACULA IN ELDERLY MYOPIC PATIENTS

Xu, Xian, MD*,†; Fang, Yuxin, MD*; Jonas, Jost B., MD; Du, Ran, MD*; Shinohara, Kosei, MD*; Tanaka, Noriko, MD*; Yokoi, Tae, MD*; Onishi, Yuka, MD*; Uramoto, Kengo, MD*; Kamoi, Koju, MD*; Yoshida, Takeshi, MD*; Ohno-Matsui, Kyoko, MD, PhD*

doi: 10.1097/IAE.0000000000002395
Original Study: PDF Only

Purpose: To assess and compare clinical features of a ridge-shaped macula (defined as macular elevation only in one meridian across the fovea) in individuals younger than 20 years with those of a dome-shaped macula (DSM) in patients aged 20+ years.

Methods: The retrospective observational case series study included 185 highly myopic eyes of 100 consecutive patients younger than 20 years, who were compared with highly myopic patients with DSMs, aged 20+ years and examined in previous studies.

Results: Seventeen (9.2%) eyes of the highly myopic young patients showed macular elevations all of which ran only in the horizontal direction across the vertical optical coherence tomographic section fulfilled the definition of a ridge and did not show any staphylomas or any macular Bruch membrane defects. By contrast, in the older patients with DSMs, the DSMs were significantly higher and had a narrower base than the ridges in the young patients, and showed macular Bruch membrane defects in their vicinity, with the axial length being significantly longer, the myopic maculopathy more severe, and the subfoveal choroid thinner.

Conclusion: Macular elevations detected in children and adolescents are usually ridge-shaped maculas and do not have the characteristics of DSMs. In comparison with DSMs, ridge-shaped maculas do not show a spatial association with macular Bruch membrane defects or posterior staphylomas and have a wider basis and smoother elevation slope. As a hypothesis, ridge-shaped maculas may be due to a folding of Bruch membrane at the posterior pole, potentially caused by an asymmetrical enlargement of Bruch membrane in the equatorial region.

Macular elevations detected in children and adolescents are usually a ridge-shaped macula. Ridge-shaped maculas may be due to a folding of Bruch membrane at the posterior pole, potentially caused by an asymmetrical enlargement of Bruch membrane in the equatorial region.

*Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan;

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China; and

Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.

Reprint requests: Kyoko Ohno-Matsui, MD, PhD, Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 1138510, Japan; e-mail: k.ohno.oph@tmd.ac.jp

Supported by grants from the Japanese Society for Promotion of Science (number; 15H04993 and 15K15629).

J. B. Jonas: Patent holder with Biocompatibles UK Ltd (Franham, Surrey, United Kingdom) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; Patent number: 20120263794), and patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4). The remaining authors have no any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.