Introduction:

Posterior staphyloma occurs in the setting of high myopia (axial length >26 mm) as a result of progressive anteroposterior elongation of the globe over time with scleral thinning in the posterior pole.

Clinical Features:

Externally, the globe itself may appear elongated, which is consistent with high myopia. On fundoscopy, there are associated atrophic changes of the retina, retinal pigment epithelium, and choroid in the posterior pole (Fig. 9.1.1). A teacup-like deformity is present, typically within the macula, but can also involve the optic nerve. The deformity can be difficult to appreciate clinically and requires stereopsis to appreciate.

OCT Features:

The appearance of a posterior staphyloma on OCT is rather striking compared to the more subtle clinical appearance. OCT reveals significant posterior bowing and curvature of the posterior eye wall, including the sclera and overlying choroid and retinal layers (Fig. 9.1.2). The choroid is typically almost imperceptible due to significant thinning.

Ancillary Testing:

Ultrasonography can be used to document progressive enlargement of the globe as well as to reveal the posterior out-pouching of the posterior wall of the eye.

Treatment:

Treatment of any associated pathology may be required, but no primary therapy for the progressive globe enlargement has been proven to work.

Introduction:

Posterior staphyloma occurs in the setting of high myopia (axial length >26 mm) as a result of progressive anteroposterior elongation of the globe over time with scleral thinning in the posterior pole.

Clinical Features:

Externally, the globe itself may appear elongated, which is consistent with high myopia. On fundoscopy, there are associated atrophic changes of the retina, retinal pigment epithelium, and choroid in the posterior pole (Fig. 9.1.1). A teacup-like deformity is present, typically within the macula, but can also involve the optic nerve. The deformity can be difficult to appreciate clinically and requires stereopsis to appreciate.

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