Fundus Curvature as a Clinical Marker for Posterior Staphyloma Based on Widefield Optical Coherence Tomography

Nan Luo; Bingqian Liu; Lu Wang; Zhi Yang; Peiyuan Wang; Mary Ho; Andrew Chun Yue Mak; Yunyi Liu; Yunhe Song; Yingfeng Zheng; Shaolin Du; Xiaoyan Ding; Lin Lu; Jingjing Huang; Wei Wang; Li Huo; Kyoko Ohno-Matsui; Shida Chen

doi:10.1016/j.ajo.2024.12.020

Fundus Curvature as a Clinical Marker for Posterior Staphyloma Based on Widefield Optical Coherence Tomography

Am J Ophthalmol. 2024 Dec 27:S0002-9394(24)00586-5. doi: 10.1016/j.ajo.2024.12.020. Online ahead of print.

Authors

Nan Luo¹, Bingqian Liu¹, Lu Wang², Zhi Yang³, Peiyuan Wang¹, Mary Ho⁴, Andrew Chun Yue Mak⁴, Yunyi Liu¹, Yunhe Song¹, Yingfeng Zheng¹, Shaolin Du⁵, Xiaoyan Ding¹, Lin Lu¹, Jingjing Huang¹, Wei Wang¹, Li Huo⁶, Kyoko Ohno-Matsui⁷, Shida Chen⁸

Affiliations

¹ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
² The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ TowardPi Medical Technology, Beijing, China.
⁴ Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hongkong SAR, China; Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hongkong SAR, China.
⁵ Dongguan Tungwah Hospital, Dongguan, China.
⁶ Department of Electronic Engineering, Tsinghua University, Beijing, China.
⁷ Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: k.ohno.oph@tmd.ac.jp.
⁸ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China. Electronic address: chenshd3@mail.sysu.edu.cn.

PMID: 39733785
DOI: 10.1016/j.ajo.2024.12.020

Abstract

Purpose: To investigate the ability to quantify fundus curvature and detect posterior staphyloma using widefield optical coherence tomography (OCT).

Design: Cross-sectional diagnostic evaluation.

Subjects and participants: 205 highly myopic eyes of 205 participants.

Methods: The Gaussian curvature map of the fundus was automatically calculated from two million scan points over an area of 24mm × 20mm, visualizing localized deformations in the posterior region. Two fovea-centered areas were designated as follows: the 6mm × 6mm was the macular region, and the 8mm × 16mm area was the posterior region. Macular mean curvature (MMC) and curvature deviation (MCD), posterior mean curvature (PMC) and curvature deviation (PCD), and maximum posterior curvature (MPC) were calculated. The relationship between curvature indices, ocular parameters, and myopic complications was investigated. The diagnostic ability of curvature indices for posterior staphyloma was evaluated.7 RESULTS: The mean (SD) age of 205 participants was 34.06 (12.74) years, with 107 being female (52.2%). Posterior staphyloma was found in 33 of 205 (16.1%) eyes. The curvature value map and curvature deviation map revealed detailed morphologic patterns of posterior staphyloma. Eyes with staphyloma had a steeper and more irregular fundus than eyes without staphyloma, with a larger MPC (20.420 × 10-3 mm-2 vs. 10.925 × 10-3 mm-2, P<0.001), PMC (6.754 × 10-3 mm-2 vs. 5.352 × 10-3 mm-2, P=0.002), MCD (1.889 × 10-3 mm-2 vs. 1.078 × 10-3 mm-2, P<0.001), and PCD (3.894 × 10-3 mm-2 vs. 1.683 × 10-3 mm-2, P<0.001). However, no difference in MMC was found between eyes with and without posterior staphyloma. Larger MPC, MCD, and PCD were associated with greater degrees of myopia, more severe myopic maculopathy, and worse best-corrected visual acuity (all P<0.05). PCD demonstrated the ability to discriminate the presence of posterior staphyloma (area under the curve: 0.909 [95% CI, 0.854-0.963; P<0.001]). The optimal cutoff value of PCD was 3.060 × 10-3 mm-2 (Youden's index = 0.725), with a specificity of 90.7% and a sensitivity of 81.8%.

Conclusions: Widefield OCT-based analysis of fundus curvature enhances detection and quantitative assessment of posterior staphyloma in high myopia.

Keywords: fundus curvature; high myopia; myopic maculopathy; optical coherence tomography; pathologic myopia; posterior staphyloma.