Chorioretinal folds in eyes with myopic staphyloma

To determine the frequency and clinical characteristics of chorioretinal folds emanating from the edge of a staphyloma in highly myopic patients.

Observational case series.

Eight hundred and eighty-three eyes of 463 patients with an axial length ≥26.5 mm in at least 1 eye were studied. The fellow eyes of patients with unilateral high myopia were also included. Wide-field fundus images and fundus autofluorescence images were used to detect chorioretinal folds emanating from the staphyloma edge. In 100 patients, the eye shape was analyzed by 3-dimensional magnetic resonance imaging (3D MRI).

A posterior staphyloma was found in 459 of the 883 eyes (52.0%). Choroidal folds radiating from the staphyloma edge were found in 6 of the 459 eyes (1.3%) with a posterior staphyloma in wide-field autofluorescent images. The axial length varied greatly from 24.3 mm to 32.5 mm. Regardless of the axial length, all of the 6 eyes had a wide, macular type of staphyloma. Chorioretinal folds emanated from the upper or upper-temporal staphyloma edge. 3D MRI images showed the presence of a notch along the upper or temporal edge of the outpouching, and the eye curvature became flatter toward the steep edge of the outpouching.

Chorioretinal folds can emanate from the staphyloma edge in highly myopic patients even though the edge was away from the macula. Some directional force toward the steeper edge of the staphyloma might be related to the development of chorioretinal folds.