Punctate Inner Choroidopathy (PIC) and Its Role in Progression of Pathological Myopia
试验速览
- 阶段
- 不适用
- 入组人数
- 39
- 试验地点
- 1
- 主要终点
- Calculate the progression rate of PIC related lesion.
研究概览
简要总结
Aim of the work PIC in pathological myopia has not been well documented due to difficult in diagnosis we conducted this retrospective study to characterize the clinical features of PIC in high myopic eye.
- To show the diagnostic criteria of PIC lesions in high myopic patients.
- Find out the prevalence of PIC related 'patchy atrophy'
- To determine risk factor for developed PIC in a series of highly myopic patients.
- Role of PIC in progression of high myopia.
- Calculate the progression rate of PIC related lesion, by the size change during follow-up.
- Search about complication of PIC in myopia. Patient and Methods This retrospective observational case series study included patients with high myopia who had been examined and followed-up in the High Myopia Clinic of the Tokyo Medical and Dental University. Approval from Ethics Committee of Tokyo Medical and Dental University was obtained, adhering to the tenets of Declaration of Helsinki. Signed informed consent documentation was obtained from all participants.
All study participants underwent a detailed ophthalmologic examination at baseline and at each follow-up visit. The examinations included measurements of best-corrected visual acuity (BCVA) using a Landolt C chart, refraction, slit lamp biomicroscopy, biometry for determination of axial length, (IOL Master; Carl Zeiss Meditec Co, Jena, Germany), fundus examination in medical mydriasis, fluorescein angiography, was performed with and colour fundus photography , and assessment of fundus autofluorescence (TRC-50DX; Topcon, Tokyo, Japan) a or the Heidelberg Spectralis HRA system. Swept source Optical coherence tomography (OCT) used in assessment of the RPE and photoreceptors using a (DRI-OCT;Topcon, Tokyo, Japan). As scanning protocols, 9 mm or 6 mm radial with 12 equal meridian scans were performed. The swept-source OCT device has an A-scan repetition rate of 100 000 Hz, and its light source operates in the wavelength range of 1 μm.
详细描述
Myopia The frequency of myopia and high myopia are growing on a worldwide for causes that not cleared. Myopia is vision challenges due to rises the risk of pathologic ophthalmic changes such as cataract, glaucoma, retinal detachment, and myopic macular degeneration, all of which can cause permanent vision loss.
High myopia was defined as an error of refractive above 8.0 diopters (D) or an axial length of 26.5 mm or more. Younger persons than 5 years, high myopia was defined by a refractive error of below- 4.0 D, and in children between 5 to 8 years, high myopia was defined by error of refraction below -6.0 D.
The term of pathologic myopia," "high myopia," and "axial myopia" have been used as a same in the literature. Pathologic myopia was defined as chorioretinal atrophy (by META-PM study group classification) with/or the existence of posterior staphylomas. Pathologic myopia is an significant origin of vision loss global, affecting up to 3% of the people. The effect of myopic maculopathy on impairment of vision is critical because the maculopathy is often affect both eye , permanent, and usually affects individuals in productive years.
Punctate inner choroidopathy Definition Punctate inner choroidopathy (PIC), classically bilateral and is considers one of "white dot syndromes" which usually presents with distinct ,multiple white-yellow lesions at posterior pole in the level of inner choroid and outer retina with a preference for young myopic female , without sign of old or recent anterior chamber or vitreous inflammation , with an increase the incidence of macular neovascularization (MNV).
ETIOLOGY The underlying pathophysiology are not completely understood. Multiple evanescent white dot syndrome( MEWDS)-like findings have been presented after traumatic subretinal bleeding, choroidal rupture, and penetrating injury or with angioid streaks, ensuring antigen exposure is likely causative factor. The present of acute retinopathy in Pseudoxanthoma elasticum (PXE) is marked along angioid streaks (breaks in the Bruch membrane), in which contact of retinal, RPE, and the Bruch membrane antigens to the immune system which stimulate an autoimmune system.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Highly myopic patients.
- •Men and women aged over 18 years
- •Fundus changes typical of pathological myopia
- •Minimum follow up period of 2 years
排除标准
- •Another choroidal lesion other than MFC.
- •Media opacity interfere with quality of image taking.
- •Alternative diagnosis (especially other white dot syndromes or when it was unclear whether the lesions were due to pathologic myopia)
- •If they had an underlying systemic condition that could mimic PIC (e.g., sarcoidosis, TB,)
- •If they had history of travel to Histoplasma-endemic regions
结局指标
主要结局
Calculate the progression rate of PIC related lesion.
时间窗: about 7 mounth
By measure the size of patchy atrophy changes during follow-up.
Development of complication as inflammatory choroidal neovascularization.
时间窗: about 7 mounth
Pick up the occurrence of inflammatory CNV during follow up period on fundus picture OCT images ,FA , and OCTA
Diagnostic criteria of PIC in high or pathological myopic.
时间窗: about 7 mounth
Pick up the characteristic fundus feature and OCT finding of inflammatory lesion in pathological myopia cases
次要结局
- Prevalence of PIC in pathological myopia.(about 7 mounth)
- Final visual acuity.(about 7 mounth)
研究者
shymaa kamel Ibrahim Hady
Assistant Lecture
Assiut University