Posterior staphyloma and long-term structural and visual trajectories in high myopia

Area of Science:

• Ophthalmology
• Retinal Diseases
• Myopia Research

Background:

• High myopia is a leading cause of visual impairment globally.
• Posterior staphyloma (PS) is a common structural abnormality in high myopia.
• The long-term impact of PS on ocular health and visual outcomes requires further investigation.

Purpose of the Study:

• To investigate the association between posterior staphyloma (PS) and long-term ocular structural changes.
• To assess the relationship between PS and myopia-related complications, including myopic macular degeneration (MMD) and myopic traction maculopathy (MTM).
• To determine the impact of PS on visual outcomes, specifically moderate-to-severe visual impairment (MSVI).

Main Methods:

• A prospective longitudinal cohort study involving 614 highly myopic eyes over 12 years.
• Eyes were categorized into three groups: baseline PS, new-onset PS, and no PS.
• Statistical analyses assessed the association of PS with MMD progression, MTM, plus lesions, axial elongation, and incident MSVI.

Main Results:

• Posterior staphyloma (PS) was independently linked to increased risks of MMD progression, MTM, and incident plus lesions.
• Eyes with PS exhibited significantly faster axial elongation compared to those without PS.
• PS was associated with a fivefold higher risk of developing moderate-to-severe visual impairment (MSVI).

Conclusions:

• Posterior staphyloma (PS) represents a critical structural change in high myopia, signaling accelerated progression.
• PS is associated with a heightened risk of ocular complications and poorer visual outcomes.
• PS may serve as a valuable biomarker for risk stratification and a target for early therapeutic interventions in high myopia.