Optical coherence tomographic characteristics and surgical outcome of eyes with myopic foveoschisis

Eye (Lond). 2009 Jun;23(6):1336-42. doi: 10.1038/eye.2008.291. Epub 2008 Oct 3.

Abstract

Aim: To describe the optical coherence topographic (OCT) characteristics and outcome of vitrectomy with triamcinolone acetonide (TA)-assisted epiretinal tissue removal and gas tamponade in eyes with myopic foveoschisis (MF).

Methods: We examined 101 myopic eyes, and the OCT characteristics of 18 eyes (18%) with an MF were studied. Six eyes underwent vitrectomy with TA-assisted epiretinal tissue removal and gas tamponade. The postoperative outcome measures were best-corrected visual acuity (BCVA), resolution of the MF as determined by OCT, and complications.

Results: OCT scans showed an isolated MF in three (17%) eyes, and the MF were associated with two or more macular anomalies in 15 (83%) eyes. A foveal detachment was found in 13 (72%), lamellar macular hole in 4 (22%), and a tractional epimacular membrane in 11 (61%) of the 18 eyes. Six eyes underwent surgery, in which the epiretinal tissue was made visible by intravitreal TA and completely removed. The median BCVA significantly improved from 20/400 preoperatively (range, 20/1000-20/160) to 20/160 postoperatively (range, 20/200-20/40; P=0.03, Wilcoxon signed-rank test). The mean VA improved by 5.6 lines. OCT showed a complete reattachment of the fovea in four (67%) eyes and a small subfoveal or parafoveal detachment in two (33%) eyes.

Conclusions: MF is commonly observed in highly myopic eyes and most are associated with one or more macular anomalies. Vitrectomy with TA-assisted complete removal of all tractional premacular structures followed by gas tamponade resulted in good visual and anatomical outcomes for treating MF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Epiretinal Membrane / surgery
  • Female
  • Fovea Centralis / pathology
  • Fovea Centralis / surgery*
  • Humans
  • Male
  • Middle Aged
  • Myopia / physiopathology
  • Myopia / surgery*
  • Prospective Studies
  • Retinoschisis / physiopathology
  • Retinoschisis / surgery*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy / methods