The aim of this study was to implore the classification of pathological myopia ocular shape in 3 dimensions magnetic resonance imaging (3D-MRI), the incidence rate of ocular morphology classification in different pathological myopia fundus lesion, and the relationship between ocular shape and age, axis oculi length, diopter, and fundus lesion types.

This observational study was divided 58 pathological myopia patients (104 eyes) into groups by age (<60 years and ≥60 years), axis oculi length (<29 mm and ≥29 mm), diopter (-6.00 to -12.00 D, -12.25 to -18.00 D, and ≥ -18.25 D), and fundus lesions (pathological myopia choroidal neovascularization, foveoschisis, macular hole retinal detachment, and chorioretinal atrophy). All the patients were examined for diopter, dilated pupil for fundus examination, fundus photography, optical coherence tomography angiography, magnetic resonance orbital scanning. The incidence rate of various ocular shape and compare the differences between different age groups, axis oculi length groups, diopter groups, and fundus lesion groups was observed.

Pathological myopia ocular shape was divided into ellipsoidal shape (10 cases, 14 eyes), conical shape (22 cases, 26 eyes), distorted shape (24 cases, 36 eyes), and barrel shape (20 cases, 28 eyes) according to clinical experiences and 3D-MRI results. Ten cases (10 eyes) for pathological myopia choroidal neovascularization contained 4 cases (4 eyes, accounting for 40.0% of the 10 eyes) for conical shape and distorted shape, respectively, and 2 cases (2 eyes, 20.0%) for ellipsoidal shape. Eight cases (8 eyes) for pathological myopia foveoschisis contained 4 cases (4 eyes, accounting for 50.0% of the 8 eyes) for distorted shape, and 4 cases (4 eyes, 50.0%) for barrel shape. Six cases (6 eyes) for pathological myopia macular hole retinal detachment contained 4 cases (4 eyes, 66.7%) for barrel shape, and 2 cases (2 eyes, 33.3%) for distorted shape. Fifty-four cases (80 eyes) for pathological myopia chorioretinal atrophy contained 18 cases (26 eyes, 32.5%) for distorted shape, 18 cases (22 eyes, 27.5%) for conical shape, 10 cases (20 eyes, 25.0%) for barrel shape, and 8 cases (12 eyes, 15.0%) for ellipsoidal shape. The distribution of the four types ocular shape had statistical significance between different age groups, axis oculi length groups, and diopter groups (χ²=10.43, 44.13, 48.93; P<0.05), but no in fundus lesion groups (χ²=15.59, P>0.05).

3D-MRI can directly and comprehensively show ocular shape. Pathological myopia ocular shape is related to age, axis oculi length, and diopter. Ocular shape of pathological myopia choroidal neovascularization, foveoschisis, chorioretinal atrophy tend to distorted shape and conical shape, while macular hole retinal detachment did to barrel shape.