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K. Bailey Freund, MD; Antonio P. Ciardella, MD; Lawrence A. Yannuzzi, MD; Alfredo Pece, MD; Mauro Goldbaum, MD; Gregg T. Kokame, MD; Dennis Orlock, CRA

Arch Ophthalmol. 2003;121:197-204.

Objective  To describe peripapillary detachment in pathologic myopia (PDPM), a newly recognized fundus lesion.

Design  Retrospective medical record review.

Methods  We evaluated a series of myopic eyes that had a yellow-orange elevation of the retina and retinal pigment epithelium at the inferior border of the myopic conus.

Results  Twenty eyes of 15 patients were identified during a 17-year period to have characteristic findings of PDPM. The mean age of the patients was 58 years. They were followed up for an average of 6 years. The mean spherical equivalent correction was -11.00 diopters (D) (range, -6.00 to -16.00 D). The mean axial length was 27.4 mm (range, 25.3-28.9 mm). In each case, ophthalmic coherence tomographic examination showed a localized detachment of the retinal pigment epithelium and retina corresponding to the PDPM lesion. During the follow-up period, the lesion remained stable in all cases except for 1. No apparent negative effect on visual function was noted.

Conclusions  Peripapillary detachment in pathologic myopia is an asymptomatic, yellow-orange peripapillary detachment of the retinal pigment epithelium and retina in pathologic myopia. Recognition of this lesion is important to distinguish it from other fundus pathologic conditions, such as tumors or choroidal neovascularization, which require further investigation and treatment.

From the Retinal Research Department, Manhattan Eye, Ear, and Throat Hospital, New York, NY (Drs Freund, Ciardella, Yannuzzi, Pece, and Goldbaum and Mr Orlock); and University of Hawaii School of Medicine, Honolulu (Dr Kokame).

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