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A variation of foveal morphology in a group of children with hypermetropia

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Abstract

Purpose

During routine eye examinations, we noticed widened and flattened foveal pits with loss of normal V-shaped foveal profile and a pseudohole-like appearance in some otherwise healthy hypermetropic children. Our purpose was to describe clinical significance and multimodal imaging features of this incidental finding.

Methods

Prospectively, 25 eyes of 13 hypermetropic children with these foveal changes and 36 eyes of 19 hypermetropic children with normal foveal appearance were enrolled. The macular thickness measurements and foveal parameters including pit diameter, depth, base, and area obtained by optical coherence tomography (OCT) (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany), macular superficial and deep vessel density (VD) and foveal avascular zone values obtained by optical coherence tomography angiography (Avanti RTVue‑XR; Optovue, Fremont, CA, USA) were noted. The correlations of these parameters with visual function were evaluated.

Results

In the study group, significantly widened and flattened pit contours with decreased central foveal thickness (p = 0.01), and increased distance between foveal edges (p < 0.001) were observed. While the whole image superficial macular VD was similar between the groups (p = 0.74), a significant decrease in deep macular VD was observed in the study group (p = 0.01). None of these changes were correlated with visual acuity.

Conclusion

Wider and flattened foveal pits described here represent a newly defined variation in healthy hypermetropic children. Although a correlation with visual acuity was not evident, these changes in foveal profile are shown to be related with macular microvascular changes in deep capillary plexus. Awareness of these morphologic changes will help clinicians in the differential diagnosis of macular pseudohole.

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Acknowledgements

We would like to thank Proofed for English editing.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Baskent University, Mareşal Fevzi Çakmak Caddesi 53. Sokak, No: 48, 06490, Çankaya, Ankara, Turkey

    Almila Sarıgül Sezenöz, Sibel Oto, Sezin Akça Bayar, İmren Akkoyun & Gürsel Yılmaz

  2. Department of Biostatistics, Baskent University, Ankara, Turkey

    Meriç Yavuz Çolak

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  1. Almila Sarıgül Sezenöz
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  2. Sibel Oto
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  3. Sezin Akça Bayar
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  5. Gürsel Yılmaz
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Contributions

ASS, SO, SAB, İA, GY and MYÇ all contributed to the conception and design of the work; the acquisition, analysis, and interpretation of data; and drafting and revising the manuscript critically for important intellectual content; and final approval of the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Almila Sarıgül Sezenöz.

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The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Başkent University (Date: 07.09.2021 / No: KA21/376).

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Written informed consent was obtained from the participants’ legal guardians to participate in the study.

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Sarıgül Sezenöz, A., Oto, S., Akça Bayar, S. et al. A variation of foveal morphology in a group of children with hypermetropia. Int Ophthalmol 43, 2947–2956 (2023). https://doi.org/10.1007/s10792-023-02701-6

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