Myopic Chorioretinal Atrophy

Fundus photo and red-free image (right eye)

Fundus photographs showed a yellowish white appearance of the posterior fundus, starting at the optic disc and macula and involving the entire staphyloma. Also present are lacquer cracks (for more information on lacquer cracks, please refer to the appropriate section of this atlas).

Optomap and fundus autofluorescence images (right eye)

Optomap imaging shows the extent of the diffuse atrophy around the optic nerve more clearly. Fundus autofluorescence revealed mottled areas of hypo-autofluorescence at the macula, and inferotemporal to the macula.

Spectralis OCT line scan (right macula)

OCT showed marked thinning of the choroid. Due to their thin nature and overlap with the hyperreflective RPE, lacquer cracks are not typically visible on OCT scans

Fundus photo and red-free image (right eye)

Retinal photos show diffuse chorioretinal atrophy at the posterior pole with a small region of patchy chorioretinal atrophy and hyper-pigmentation superior to the macula.

Spectralis OCT line scans (right eye)

OCT images show a posterior staphyloma and foveoschisis. Image 1 is taken through the area of patchy chorioretinal atrophy which presents as a loss of the outer retinal layers and hyper-transmission of the signal through to the choroid. Note the marked thinning of the choroid and choriocapillaris throughout the posterior pole.

Spectralis OCT volume scan (right eye macula)

The OCT volume scan shows a posterior staphyloma and foveoschisis as well as paravascular cysts and schisis, vascular mircofolds and inner limiting membrane detachment.

Fundus photo and red-free image (right eye)

Retinal photos reveal large areas of patchy chorioretinal atrophy centrally.

Optomap and fundus autofluroescence imaging (right eye)

FAF revealed multiple zones of hypofluorescence, including around and inferior to the optic disc, inferior to the macula corresponding to the areas of patchy atrophy,

Fundus photo and red-free image (left eye)

Retinal photos show discrete spots of chorioretinal atrophy in the inferior posterior pole. The optic nerves are atypical in shape due to the patient's high myopia. There is a large area of peripapillary atrophy also present.

Optomap and green separation images (left eye)

Optomap images show the discrete spots of chorioretinal atrophy but also highlight the posterior staphyloma.

Spectralis OCT line scans through areas of patchy chorioretinal atrophy

The areas of patchy chorioretinal atrophy seen on retinal imaging show loss of the outer retinal layers on OCT with hyper-transmission of the signal through to the choroid in these areas.

Spectralis OCT volume scan (left eye)

The areas of patchy chorioretinal atrophy seen on retinal imaging show loss of the outer retinal layers on OCT with hyper-transmission of the signal through to the choroid in these areas.

Fundus photo and red-free image (left eye)

Fundus photos show large areas of foveal-sparring chorioretinal atrophy at the posterior pole, more extensive in this eye than in the right. Patches of hyper-pigmentation are also present within the atrophic areas.

Optomap and fundus autofluorescence imaging

Optomap shows the extent of the posterior staphyloma more clearly. The areas of chorioretinal atrophy present as hypo-autofluorescent on FAF.

Spectralis OCT line scans - Right (1) and Left (2) macula

OCT line scans through the areas of chorioretinal atrophy show a loss of the outer retinal layers, choriocapillaris and choroid in these areas.

Fundus photography and red-free image (left eye)

Retinal images show a large area of parapapillary atrophy around the optic disc. Through the macula region there is generalized patchy chorioretinal atrophy enabling better visualization of underlying choroidal vessels. There are two focal areas of chorioretinal atrophy inferior to the macula.

Optomap widefield and fundus autofluorescence images

Optomap images show a large area of parapapillary atrophy around the optic disc. Through the macula region and extending beyond the vascular arcardes there is generalized patchy chorioretinal atrophy enabling better visualization of underlying choroidal vessels. There are two focal areas of chorioretinal atrophy inferior to the macula.

Fundus autofluorescence shows discrete hypoFAF signal around the disc and in the round areas inferior to the macula. There is also a more mottled relative hypofluorescent signal through the macula and surrounds.

Cirrus OCT macular line scans (left eye)

An OCT line scan through the fovea shows a lamellar hole with cystic spaces temporally (1). The RPE is present but irregular outside of the PPA zone where it is absent.

OCT scans through the focal chorioretinal atrophy zones show absence of the RPE and outer retina and subsidence of the overlying inner retina. There is associated signal hypertransmission through the choroid (which is very thin) and sclera. An epiretinal membrane is also partially visible.