Abstract
Objectives
To investigate the correlation between the AI-measured area of the lacquer cracks (LC) at their first detection and the occurrence of a choroidal neovascularization (CNV) during the follow-up in patients affected by pathologic myopia. Secondary outcome was the detection of a correlation between the time to onset of CNV with both baseline LC area and LC area increase during follow-up.
Methods
Optical coherence tomography (OCT) acquisitions of patients diagnosed with LC were retrospectively analysed. The study population was divided in a CNV group (showing the documented onset of a CNV) and a n-CNV group (no CNV development during follow-up). LC area was measured using MatLab software after the application of a customized method for LC segmentation on infrared (IR) enface images.
Results
Forty-five (45) patients with a mean follow-up of 4.9 ± 1.5 years were included. LC area at baseline was 2.82 ± 0.54 mm2 and 1.70 ± 0.49 mm2 in CNV (20 patients) and n-CNV group (25 patients) group respectively (p < 0.001). LC area increase was significantly higher in CNV group (p < 0.001). Time to onset of CNV was linearly correlated with both LC area at baseline (p = 0.006) and LC area increase (p < 0.001).
Conclusions
Myopic CNV development is associated with lager LC areas and higher LC area increase during time. Earlier CNV onset is inversely correlated with LC area and LC area increase.
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Data availability
Data supporting the results reported in the article are available upon reasonable request to the Corresponding author.
References
Ruiz-Medrano J, Montero JA, Flores-Moreno I, Arias L, García-Layana A, Ruiz-Moreno JM. Myopic maculopathy: Current status and proposal for a new classification and grading system (ATN). Prog Retinal Eye Res. 2019;69:80–115.
Ikuno Y, Jo Y, Hamasaki T, Tano Y. Ocular risk factors for choroidal neovascularization in pathologic myopia. Investig Ophthalmol Vis Sci. 2010;51:3721–5.
Noble KG, Carr RE. Pathologic myopia. Ophthalmology 1982;89:1099–100.
Klein RM, Green S. The development of lacquer cracks in pathologic myopia. Am J Ophthalmol. 1988;106:282–5.
Xu X, Fang Y, Uramoto K, Nagaoka N, Shinohara K, Yokoi T, et al. Clinical features of lacquer cracks in eyes with pathologic myopia. Retina 2019;39:1265–77.
Neelam K, Cheung CMG, Ohno-Matsui K, Lai TYY, Wong TY. Choroidal neovascularization in pathological myopia. Prog Retinal Eye Res. 2012;31:495–525.
Ohno-Matsui K, Yoshida T, Futagami S, Yasuzumi K, Shimada N, Kojima A, et al. Patchy atrophy and lacquer cracks predispose to the development of choroidal neovascularisation in pathological myopia. Br J Ophthalmol. 2003;87:570–3.
Crincoli E, Zhao Z, Querques G, Sacconi R, Carlà MM, Giannuzzi F, et al. Deep learning to distinguish Best vitelliform macular dystrophy (BVMD) from adult-onset vitelliform macular degeneration (AVMD). Sci Rep. 2022;12:12745.
Catania F, Allegrini D, Nembri A, Confalonieri F, Zollet P, Crincoli E, et al. Macular microvascular modifications in progressive lamellar macular holes. Diagnostics 2021;11:1717.
Ohno-Matsui K, Lai TYY, Lai CC, Cheung CMG. Updates of pathologic myopia. Prog Retinal Eye Res. 2016;52:156–87.
Querques G, Corvi F, Querques L, Souied EH, Bandello F. Optical coherence tomography angiography of choroidal neovascularization secondary to pathologic myopia. OCT Angiogr Retinal Macular Dis 2016;56:101–6.
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 2016;123:1036–42.
Brancato R, Trabucchi G, Introini U, Avanza P, Pece A. Indocyanine Green Angiography (Icga) in pathological myopia. Eur J Ophthalmol. 1996;6:39–43.
Liu CF, Liu L, Lai CC, Chou JC, Yeh LK, Chen KJ, et al. Multimodal imaging including spectral-domain optical coherence tomography and confocal near-infrared reflectance for characterization of lacquer cracks in highly myopic eyes. Eye. 2014;28:1437–45.
Axer -Siegel R, Cotlear D, Priel E, Rosenblatt I, Snir M, Weinberger D. Indocyanine green angiography in high myopia. Ophthalmic Surg, Lasers Imaging Retin 2004;35:139–45.
Sayanagi K, Ikuno Y, Uematsu S, Nishida K. Features of the choriocapillaris in myopic maculopathy identified by optical coherence tomography angiography. Br J Ophthalmol. 2017;101:1524–9.
Young TL. Dissecting the genetics of human high myopia: a molecular biologic approach. Trans Am Ophthalmol Soc. 2004;102:423–46.
Cedrone C, Nucci C, Scuderi G, Ricci F, Cerulli A, Culasso F. Prevalence of blindness and low vision in an Italian population: a comparison with other European studies. Eye. 2006;20:661–7.
Chiang PPC, Fenwick E, Cheung CMG, Lamoureux EL. Public health impact of pathologic myopia. In: Spaide RF, Ohno-Matsui K, Yannuzzi LA, editors. Pathologic Myopia [Internet]. New York, NY: Springer; 2014 [cited 2022 Aug 19]. 75–81. Available from: https://doi.org/10.1007/978-1-4614-8338-0_6
Ikuno Y, Sayanagi K, Soga K, Sawa M, Gomi F, Tsujikawa M, et al. Lacquer crack formation and choroidal neovascularization in pathologic myopia. Retina 2008;28:1124–31.
Hung KC, Chen MS, Yang CM, Wang SW, Ho TC. Multimodal imaging of linear lesions in the fundus of pathologic myopic eyes with macular lesions. Graefes Arch Clin Exp Ophthalmol. 2018;256:71–81.
Bontzos G, Xirou T, Gkiala A, Smoustopoulos G, Gkizis I, Kontou E, et al. Long-term progression of myopic maculopathy in degenerative myopia as imaged by SD-OCT and IR imaging. Clin Exp Optom. 2022;105:26–31.
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Conceptualization, EC; Methodology, EC, FC; Software, EC, FC; Validation, GQ, EHS; Formal analysis, EC; Investigation, AM, MB, RS, SF; Resources, GQ, RS; Data curation, AM, MB, RS, SF; Writing—original draft preparation, EC, SF; Writing—review and editing, GQ, RS; Supervision, GQ; Project administration, GQ. All authors have read and agreed to the published version of the manuscript.
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Crincoli, E., Ferrara, S., Miere, A. et al. Correlation between AI-measured lacquer cracks extension and development of myopic choroidal neovascularization. Eye 37, 2963–2968 (2023). https://doi.org/10.1038/s41433-023-02451-w
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DOI: https://doi.org/10.1038/s41433-023-02451-w
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