Pathological myopic tractional maculopathy (MTM), as an important type of macular lesions associated with high myopia, play a significant role in the prevention and treatment of myopic macular diseases. With the rapid development of retinal imaging technologies, especially the widespread application of optical coherence tomography, new technical support has been provided for the accurate diagnosis, clinical staging, treatment decision-making, and long-term follow-up of MTM. However, in clinical practice in China, there are still issues such as unclear definitions, inconsistent staging criteria, and significant differences in treatment strategies. To address these challenges, Fundus Diseases Group in Ophthalmology Branch of Chinese Medical Association and Professional Committee of Fundus Diseases in Ophthalmology Branch of Chinese Medical Doctor Association for Ophthalmologists jointly drafted the Expert consensus on management of pathologic myopic tractional maculopathy in China, based on a systematic literature review and the latest clinical evidence. The consensus was revised multiple times by the core expert group and finally finalized. This consensus systematically establishes a standardized diagnostic and therapeutic system for MTM, covering disease definition and staging, diagnostic pathways and follow-up protocols, treatment strategies based on staging, and surgical intervention plans. It aims to provide ophthalmologists at all levels with a scientifically sound and practically applicable clinical guidance. The development of the consensus strictly adheres to the principles of evidence-based medicine, fully considering the actual clinical conditions of medical institutions at different levels in China. It provides principled recommendations with broad guiding significance for the clinical practice of MTM. It is particularly emphasized that when applying this consensus, clinicians should comprehensively consider the patient’s clinical characteristics, treatment accessibility, and socioeconomic factors, and implement personalized and precise treatment strategies to meet the diverse clinical needs of patients with pathological myopia.
PURPOSE:Understanding the characteristics of color vision defects in patients with maculopathy. METHODS:Applying Panel D-15 test and FM 100-hue test to evaluate the color vision of 78 patients (122 eyes) with maculopathy and analyzing the types of color vision defects and the relationship between the color discrimination and the visual acuity. RESULTS:All eyes of the wetform AMT(14 eyes),Stargardt's disease(10 eyes),macular hole (6 eyes)and central exudative retinochoroidopathy(3 eyes)showed color vision defects and high average roots of total error scores of FM 1000-hue test.The abnormal rates of color vision and the average roots of tota error scores in patients with epiretinal membrane (18 eyes)and dry-form AMD(71 eyes)were low.The roots of total error scores in FM 100-hue test was negatively relative with the visual acuity（r-0.8944）. CNCLUSION:The types and severities of color vision defects vary in different maculopathy.The color discrimination was negatively relative with the visual acuity. （Chin J Ocul Fundus Dis,1996,12: 80-82）
ObjectiveTo summarize the clinical features in idiopathic hypotony maculopathy.MethodsA retrospective case series study. Eighteen eyes of 18 patients who were diagnosed with idiopathic hypotony maculopathy were enrolled in the Second Affiliated Hospital of Wenzhou Medical University from August 2012 to December 2017. There were 8 males (8 eyes) and 10 females (10 eyes). All patients underwent examinations including BCVA, optometry, slit lamp microscope, fundus color photography, UBM, B-mode ultrasound, OCT, FFA and axial length (AL). BCVA was recorded with logMAR acuity. The results of affected eyes and contralateral healthy eyes were compared. Paired t test was performed to compare the intraocular pressure (IOP), diopter and AL of the affected eyes and contralateral healthy eyes.ResultsAmong 18 eyes, there were 6 eyes with logMAR BCVA＜1.0, 10 eyes with logMAR BCVA 1.0−2.0, 2 eyes with light perception. The average diopter was +2.32±1.78 D. The average IOP was 5.18±1.38 mmHg (1 mmHg=0.133 kPa). The average AL was 20.92±1.61 mm. The differences of IOP (t=21.6, P＜0.000), diopter (t=5.9, P=0.002) and AL (t=9.13, P＜0.000) between the affected eyes and contralateral healthy eyes were significant. The inflammatory reaction in the anterior segment was observed in 13 eyes (72.22%). In the posterior segment, all the eyes were documented with chorioretinal folds, optic disc swelling and retinal phlebectasia were also demonstrated in 14 eyes, while with macular uplift in 7 eyes. In the UBM and gonioscope examination, the angle chamber was open in all patients with ciliary body cyst in 6 eyes, while no ciliary body detachment was detected. All eyes had been examined with B-scan ultrasound and found the increasing thickness of eye ball in all eyes, and nodular changes in the optic papilla in 5 eyes. The chorioretinal folds were further confirmed by OCT with the appearance of the gear shape, much more obviously in the choroid than that in retina. In the FFA, fluorescein leakage was found around the optic disc in 13 eyes at the late stage, while there was no obvious abnormal leakage in the macular or poster part of retina.ConclusionsIdiopathic hypotony maculopathy could present with various clinical manifestations. The choroiretinal folds is typical clinical sign.
ObjectiveTo observe the interobserver agreement of classification of macular degeneration in severe pathological myopia (PM) by ophthalmologists with different clinical experience. MethodsA retrospective study. From January 2019 to December 2021, 171 eyes of 102 patients with severe PM macular degeneration who were examined at Eye Center of Beijing Tongren Hospital of Capital Medical University were included in the study. The clinical data such as age, gender, axial length, spherical equivalent power, fundus color photography, and optical coherence tomography (OCT) were collected in detail. Six independent ophthalmologists (A, B, C, D, E, F) classified each fundus photography based on META-PM and ATN classification of atrophy (A) system and interobserver agreement was assessed by Kappa statistics. According to the classification standard of traction (T) in the ATN classification, the OCT images were interpreted and classified, in which T0 was subdivided into retinal pigment epithelium (RPE) and choroidal thinning, choroidal neovascularization (CNV) with partial RPE and choroidal atrophy, RPE, and choroidal atrophy. Lamellar macular hole can't be classified by ATN system, which was defined as TX. Kappa (κ) test was used to analyze the consistency of classification results between physicians A, B, C, D, E and F. κ value ≤0.4 indicates low consistency, 0.4＜κ value ≤ 0.6 indicates moderate consistency, and κ value ＞0.6 indicates strong consistency. ResultsAmong the 171 eyes of 102 cases, there were 20 males with 37 eyes (19.6%, 20/102), and 82 females with 134 eyes (80.4%, 82/102); age was 61.97±8.78 years; axial length was (30.87±1.93) mm; equivalent spherical power was (－16.56±7.00) D. Atrophy (A) classification results in META-PM classification and ATN classification, the consistency of physician A, B, C, D, E and physician F were 73.01%, 77.19%, 81.28%, 81.28%, 88.89%; κ value were 0.472, 0.538, 0.608, 0.610, 0.753, respectively. In the ATN classification, the T0, T1, T2, T3, T4, and T5 were in 109, 18, 11, 12, 9, and 8 eyes, respectively; TX was in 4 eyes. ConclusionsThere are differences in the consistency of classification of severe PM macular lesions among physicians with different clinical experience, and the consistency will gradually improve with the accumulation of clinical experience.