Grading of posterior staphyloma with spectral-domain optical coherence tomography and correlation with macular disease

Objective: To develop a novel grading system for posterior staphyloma imaged by spectral-domain optical coherence tomography (SD-OCT) and to correlate the incidence of macular disease (vitreomacular traction, epiretinal membrane, macular schisis, lamellar macular hole, and full-thickness macular hole) with each grade. Design: Retrospective chart review. Participants: A total of 150 eyes from 89 patients with posterior staphylomas were examined at Jules Stein Eye Institute, University of California Los Angeles. Methods: Retrospective analysis of the Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, Calif.) database at a large institution (Jules Stein Eye Institute) was performed and eyes with a posterior staphyloma involving the macula were evaluated for the presence of macular pathology. The radius of each circle was measured and graded, and the incidence of macular pathology was correlated with each staphyloma grade. Statistical analysis was done using Fisher exact and Kruskal-Wallis tests. Results: The overall incidence rate of macular disease was 50.6% (76/150 eyes). The incidence rate of macular schisis was 17.3% (26/150) and was significantly greater with steeper (grade 3 [25.0%] and grade 4 [30.3%] staphyloma) versus shallower grade (grade 1 [5.6%]) staphyloma (p = 0.016). Conclusions: Imaging of staphyloma via SD-OCT is a valuable tool for determining the severity of posterior staphyloma and for determining risk stratification for various macular diseases.