Fig 1.
Images of highly myopic eyes without an evident staphyloma.
(A)-(C) Left eye of a 16-year-old young man with an axial length of 27.6 mm. (A) Left fundus photograph showing an almost normal fundus. (B) Horizontal widefield optical coherence tomographic (WF-OCT) image showing a uniform thickness of the choroid. The inner scleral surface shows a smooth arc. (C) Vertical WF-OCT section showing a smooth arc of the inner scleral surface. Choroid appears to be thinner toward the periphery, however the transition of the choroidal thickness is gradual and smooth. (D)-(F) Images of the left eye of an 8-year-old boy with an axial length of 26.0 mm. (D) Fundus photograph shows slight tessellation only temporal to the optic disc. (E) Horizontal WF-OCT image showing a uniform thickness of the choroid although the inner scleral surface has an asymmetric arc. Inner scleral surface has a smooth arc. (F) Vertical WF-OCT section showing a smooth arc of the inner scleral surface. Choroid appears to be thinner toward the periphery, however the transition of choroidal thickness is gradual and smooth.
Fig 2.
Images of highly myopic eyes with peripapillary diffuse atrophy but without a posterior staphyloma.
(A) Fundus photograph of the left eye of a 9-year-old boy with an axial length of 28.4 mm showing marked tessellation as well as peripapillary diffuse chorioretinal atrophy (PDCA) temporal to the optic disc. (B) Horizontal WF-OCT image shows a marked thinning of the choroid (arrowheads) in the area of the PDCA. The transition of surrounding choroid to almost absent choroid in the area of the PDCA is sudden. However, the inner scleral curvature is smooth and no posterior dislocation is seen. (C) Right fundus photograph of an 8-year-old boy with an axial length of 26.0 mm showing peripapillary diffuse atrophy temporal to the optic disc. (D) Horizontal WF-OCT image showing a marked thinning of the choroid (arrowhead) in the area of the PDCA. The transition of the surrounding choroid to almost absent choroid in the area of the PDCA is sudden. However, the inner scleral curvature is a smooth arc and no posterior dislocation is seen.
Fig 3.
WF-OCT images of highly myopic eyes with peripapillary staphyloma without a scleral inward protrusion.
(A) Fundus photograph of the left eye of an 11-year-old girl with an axial length of 27.1 mm showing peripapillary diffuse atrophy. (B) Horizontal WF-OCT image shows that the nasal choroid gradually thins toward the staphyloma edge (arrow) and gradually re-thickens toward the posterior pole (arrowheads). Inner scleral surface is posteriorly displaced in the area between the edge of the staphyloma (arrow) and nasal edge of the optic disc, compared to the curvature more nasal to the staphyloma edge. However, the scleral inward protrusion at staphyloma edge is not obvious. (C) Right fundus photograph of a 17-year-old young man with an axial length of 28.1 mm showing peripapillary diffuse chorioretinal atrophy (PDCA). (D) Horizontal WF-OCT image showing that the inner scleral surface is slightly displaced posteriorly nasal to the optic nerve. The choroid gradually thins toward the edge of the staphyloma (arrow) and re-thickens toward the posterior pole (yellow arrowheads). However, scleral inward protrusion at the staphyloma edge is not obvious. Choroidal thickening closer to the optic nerve appears to be similar to peripapillary intrachoroidal cavitation. In the area of the PDCA (blue arrowheads), the scleral curvature is also displaced posteriorly.
Fig 4.
WF-OCT image of a highly myopic eye with peripapillary staphyloma and a scleral inward protrusion.
(A) Fundus photograph of the right eye of an 11-year-old girl with an axial length of 26.8 mm showing peripapillary diffuse chorioretinal atrophy (PDCA). (B) Horizontal WF-OCT image showing a posterior displacement of the inner scleral surface nasal to the optic disc compared to the surrounding curve. The choroid at the edge of the staphyloma gradually thins toward the staphyloma edge (arrow) and gradually re-thickening toward the posterior pole (arrowheads). Scleral inward protrusion is also seen at the staphyloma edge (arrow).
Fig 5.
Images of highly myopic eyes with macular staphyloma.
(A) Fundus photograph of the left eye of an 18-year-old young woman with an axial length of 27.0 mm showing peripapillary diffuse chorioretinal atrophy (PDCA). (B) Vertical WF-OCT section across the fovea shows a slight elevation of the inner scleral curvature indicating the edge of the staphyloma (arrow). The sclera is posteriorly dislocated more central from the staphyloma edge. The choroid gradually thins toward the edge of the staphyloma and gradually re-thickens toward the posterior pole. The inner sclera is slightly displaced posteriorly (arrowheads) in the area with re-thickening of choroid. (C) In the adjacent OCT section, the same features of the staphyloma edge (scleral inward protrusion and choroidal thinning and re-thickening) are seen. The inner sclera is slightly dislocated posteriorly (arrowheads) in the area with re-thickening of choroid. (D) Fundus photograph of the right eye of an 18-year-old young man with an axial length of 30.8 mm showing diffuse chorioretinal atrophy and multiple lacquer cracks. (E) Nasal choroid gradually thins toward the staphyloma edge and gradually re-thickens toward the optic nerve. Inward scleral protrusion at the edge of the staphyloma is not obvious. However, the sclera is posteriorly displaced in the area between staphyloma edge and the nasal edge of optic nerve. The macular sclera is also dislocated posteriorly, however no obvious OCT features of a staphyloma edge is seen temporal to the fovea.
Table 1.
Clinical characteristics of the eyes with or without a staphyloma in children.
Table 2.
Retinal and choroidal thickness of eyes with and without staphyloma in children.