Table 3.

Perspectives on Posterior Staphyloma from Some Recent Human Publications

Author Year (Ref)	Clues – Current Data	Hypotheses	Potential Exploration Tracks	Perspectives
Numa 201821	Greater curvature irregularities in female, elderly, and eyes with longer axial length documented using SD-OCT	Posterior staphyloma severity can be measured quantitatively through its curvature irregularity	To develop quantitative and standardized methodologies to measure the curvature irregularity of posterior staphyloma	Achieve quantitative standardized methods to assess the severity of posterior staphyloma for randomized studies.
Mori 202195	Randomized study shows promise for violet-light glasses to slow myopia progression in pre-adolescent children.	Glasses transmitting violet sunlight slow the progression of myopia	Confirmatory studies	Achieve practical terms of use in combination to outdoor activities
Hoang 202177	Gaze down movement increases the vitreous chamber axial volume while other eye gazes do not.	Increase in vitreous chamber axial volume, induced by gaze down movement may be relevant for the role of near and reading activities in myopia.	Confirmatory studies. Exploratory studies to analyze eyeball changes related to eye movements	Analysis of the intraocular and ocular changes during near work and their relationship with myopia development and progression.
Liu 202257	Scleral collagen birefringence is related to myopia status and progression as detected using triple-input polarization-sensitive-OCT technique	In-vivo monitoring of early scleral changes toward pathologic myopia is possible with this technology	Studies for improving this technology	Perform early in-vivo detection of posterior scleral signs indicating pathological changes in myopia
Ehongo 202213	Characteristics of peripapillary staphyloma (PPS) analyzed using SD-OCT suggest that PPS is promoted by ON sheaths traction force	ON sheaths traction forces lead to PPS in susceptible individuals	Exploratory studies to confirm the hypothesis. Exploratory studies to find the risk factors to develop PPS.	Achieve an understanding of scleral and ON sheaths factors contributing to PPS and how to counteract them
Nakao 202246	Posterior staphyloma deepens more than it enlarges with age. Posterior staphyloma type II depth is related to axial length as documented using UWF-OCT	Posterior staphyloma severity can be measured quantitatively through its depth-to-diameter ratio	To standardize methodologies to measure depth-to-diameter ratio of posterior staphyloma	Achieve quantitative standardized methods to assess the severity of posterior staphyloma for randomized studies
Luo 202347	Equatorial and anterior eyeball irregularities documented in myopic subjects using 3D-MRI	Rectus muscles forces might deform the eyeball	Confirmatory studies for the anterior eye-shape irregularities. Exploratory studies for the rectus muscles potential implication.	Achieve an understanding of the scleral and rectus muscles factors favoring the susceptibility for these irregularities
Ehongo 2023 (This article)	Widefield OCT, 3D-MRI, and widefield fundus co-analysis suggests, a correspondence between the edges of the posterior staphyloma and the landmarks of the ON sheaths. It seems the case for oblique muscles, suggesting new insights into the pathogenesis of posterior staphyloma.	ON sheaths and oblique muscles traction forces might lead to posterior staphyloma in susceptible individuals	Exploratory studies to analyze this hypothesis. Exploratory studies to find the determinant factors	Understanding the scleral, ON sheaths and oblique muscles factors favoring the occurrence of posterior staphyloma and how to counteract them

Abbreviations: SD-OCT, spectral domain optical coherence tomography; OCT, optical coherence tomography; ON, optic nerve; PPS, peripapillary staphyloma; UWF, ultra-widefield optical coherence tomography; 3D-MRI, Three-dimensional magnetic resonance imaging.