Purchase this article with an account.
K. Suda, M. Hangai, H. Nakanishi, M. Kita, N. Yoshimura; The Closure Rate and Spectral-Domain Opitical Coherence Tomography Findings of Macular Hole in Moderate to High Myopia. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2271.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
We aimed to study the relationship between the axial length and the closure rate of the macular hole (MH) and to use spectral-domain optical coherence tomography (SD-OCT) imaging to reveal the characteristic tomographic features of the eyes in which MH closure was not achieved in the first operation.
We conducted an interventional case-control, comparative study on 50 eyes (48 subjects). All the eyes had undergone internal limiting membrane (ILM) peeling and pars plana vitrectomy with SF6 gas tamponade. The medical records were retrospectively reviewed and the eyes were divided into 2 groups, namely, eyes with moderate to high myopia (axial length, 25.0 mm or longer) and eyes with mild myopia or emmetropia (axial length shorter than 25.0 mm). The closure rate and the tomographic features of SD-OCT images were compared using univariate analysis.
Moderate to high myopia and mild myopia or emmetropia were diagnosed in 16 and 34 eyes, respectively. The mean age in the moderate to high myopia group was lower than that in the mild myopia or emmetropia group (57.4 ± 8.7 y vs. 66.8 ± 6.5 y; P < 0.01, unpaired t test). The initial closure rates in the moderate to high myopia and the mild myopia or emmetropia groups were 68.7% and 94.1%, respectively (P = 0.03, Fisher’s exact test). The preoperative SD-OCT images revealed the presence of a retinoschisis-like feature in the outer retina of 4 (80%) of the 5 eyes with moderate to high myopia in which MH closure was not achieved initially; the condition recurred in 4 (80%) eyes within 1-4 months after the surgery. However, this feature was observed in only 1 (9.1%) of the eyes with initial success (P = 0.01). The retinoschisis-like feature was not observed in the mild myopia or emmetropia group.
The initial closure rate of the macular hole in the eyes with moderate to high myopia was lower than that of the other group. The retinoschisis-like feature in the eyes with moderate to high myopia was significantly associated with failure, indicating a residual traction to the outer retina in these eyes even after surgery.
This PDF is available to Subscribers Only