A 23-year-old healthy woman with a history of pathologic myopia presented for evaluation of retinal aneurysms. Her visual acuity was 20/30 OD and 20/40 OS, and her refractive error was −14 diopters and −15 diopters in the right and left eyes, respectively. Fundus examination revealed clusters of aneurysmal lesions and telangiectasias along the inferior and temporal midperiphery of both eyes (Figure, A), which demonstrated late leakage on ultra–widefield fluorescein angiography (Figure, B). Optical coherence tomography showed myopic traction maculopathy and aneurysmal lesions located within areas of retinal nerve fiber layer schisis (arrowhead, Figure, A, inset). Retinal vascular abnormalities including telangiectatic vessels, aneurysms, and arteriolar sheathing have been reported in high myopia, but the underlying etiology is unclear.1- 3 In this patient, the locations of the aneurysms correspond to areas of inner retinal schisis, suggesting that these vascular changes may result from direct mechanical traction of retinal vessels within the nerve fiber layer.
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Corresponding Author: Glenn Yiu, MD, PhD, Department of Ophthalmology and Vision Science, University of California, Davis, Tschannen Eye Institute, 4860 Y St, Sacramento, CA 95817 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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