Staphyloma Severe Atrophy
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53-year-old man is a very high myope.
He had cataract surgery done sometime ago. He is aphakic. His left eye also had a retinal detachment repair and unfortunately the left eye does not see well. He is on Timolol in both eyes for glaucoma. He noticed his vision in the right eye a little bit worse, but some of that may have to do with the new prescription that he feels may not be correct.
VISUAL ACUITY: OD 20/50, OS: Faint light perception. IOP: 14 OU. Both eyes are aphakic.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. The nerve is pink, but embedded in an area of concentric atrophy around the optic nerve. There is also patchy geographic atrophy superior and inferior to the fovea, consistent with his high myopia. There are lacquer cracks through the fovea. There is a patch of pigmented lattice degeneration very posterior. Temporally between about 7 o’clock and 11 o’clock. There is also a posterior staphyloma, the edges of which can be seen just outside the arcades and it looks to be a fairly deep staphyloma, when looking in within the direct ophthalmoscope.
OS: Vertical C/D ratio is 0.6. The nerve is pale. There are patches of atrophy throughout the macula around the arcades and also into the fovea. The retina is attached on a moderate buckle. Photos confirm clinical findings.
IMPRESSION:
1. MYOPIC MACULAR DEGENERATION – BOTH EYES
2. POSTERIOR STAPHYLOMA – BOTH EYES
3. HISTORY OF RETINAL DETACHMENT REPAIR – LEFT EYE
4. LATTICE DEGENERATION – RIGHT EYE
DISCUSSION: I explained to the patient that he does have extensive areas of thinning in the maculae, because of his myopia, but I do not see anything there that looks new or sinister.
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Myopic Degeneration - Staphyloma - Atrophy820 views53-year-old man was a -15.00 myope. He is aphakic. His left eye also had a retinal detachment repair and unfortunately the left eye does not see well. He is on Timolol in both eyes for glaucoma. VISUAL ACUITY: OD 20/50, OS: Faint light perception. 
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Myopic Degeneration - Staphyloma - Atrophy891 views53-year-old man was a -15.00 myope. He is aphakic. His left eye also had a retinal detachment repair and unfortunately the left eye does not see well. He is on Timolol in both eyes for glaucoma. VISUAL ACUITY: OD 20/50, OS: Faint light perception.
(0 votes)
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Myopic Degeneration - Staphyloma - Atrophy771 views53-year-old man was a -15.00 myope. He is aphakic. His left eye also had a retinal detachment repair and unfortunately the left eye does not see well. He is on Timolol in both eyes for glaucoma. VISUAL ACUITY: OD 20/50, OS: Faint light perception.
(0 votes)
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53-year-old man is a very high myope.
He had cataract surgery done sometime ago. He is aphakic. His left eye also had a retinal detachment repair and unfortunately the left eye does not see well. He is on Timolol in both eyes for glaucoma. He noticed his vision in the right eye a little bit worse, but some of that may have to do with the new prescription that he feels may not be correct.
VISUAL ACUITY: OD 20/50, OS: Faint light perception. IOP: 14 OU. Both eyes are aphakic.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.0. The nerve is pink, but embedded in an area of concentric atrophy around the optic nerve. There is also patchy geographic atrophy superior and inferior to the fovea, consistent with his high myopia. There are lacquer cracks through the fovea. There is a patch of pigmented lattice degeneration very posterior. Temporally between about 7 o’clock and 11 o’clock. There is also a posterior staphyloma, the edges of which can be seen just outside the arcades and it looks to be a fairly deep staphyloma, when looking in within the direct ophthalmoscope.
OS: Vertical C/D ratio is 0.6. The nerve is pale. There are patches of atrophy throughout the macula around the arcades and also into the fovea. The retina is attached on a moderate buckle. Photos confirm clinical findings.
IMPRESSION:
1. MYOPIC MACULAR DEGENERATION – BOTH EYES
2. POSTERIOR STAPHYLOMA – BOTH EYES
3. HISTORY OF RETINAL DETACHMENT REPAIR – LEFT EYE
4. LATTICE DEGENERATION – RIGHT EYE
DISCUSSION: I explained to the patient that he does have extensive areas of thinning in the maculae, because of his myopia, but I do not see anything there that looks new or sinister.
