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Alexander R Bottini, Joseph J Tseng, Michael Rothschild, Kenneth J. Wald; Characteristics and outcomes of patients with myopic foveoschisis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5486.
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© ARVO (1962-2015); The Authors (2016-present)
Myopic foveoschisis (MF) in patients with myopic degeneration was not well appreciated prior to the advent of high resolution optical coherence tomography (OCT) imaging. Information is still limited on the clinical course of patients with MF. In our study we aim to provide additional data on the clinical outcomes of patients with MF.
We performed a retrospective review of patients with a diagnosis of myopic degeneration with posterior staphyloma from a New York City retinal subspecialty practice to identify patients with evidence of MF present on OCT. In cases of MF the demographic data, clinical course, and imaging, including OCT and fluorescein angiography, were evaluated.
196 patients with myopic degeneration and posterior staphyloma were identified: 9 eyes of 8 patients had MF on OCT. Age at incidence of MF ranged from 47 to 73 years old. Six were females, 2 were males. Mean follow up from incidence of MF was 47 months. Seven of the 8 patients had unilateral MF during the period of observation; one patient developed bilateral MF. Four of the 9 eyes underwent surgery. Of the 5 that did not receive surgery, 2 were noted to have anatomic improvement on OCT and maintained stable acuity and 3 demonstrated stable OCT findings but with a reduction in visual acuity. Of the 4 patients who underwent surgical intervention, 3 of the 4 had repair of macular hole, and one underwent repair of a subtotal retinal detachment. Time from development of MF to time of macular hole development was 4, 11, and 49 months in the 3 eyes. Two of the 3 eyes with macular holes had stable visual acuity following repair, one of the eyes showed improved visual acuity. The retinal detachment was repaired with anatomic improvement of the foveoschisis. Myopic choroidal neovascularization did not develop in any of the 9 eyes during the period of follow up.
Our data are consistent with prior studies indicating that the course of MF is highly variable, ranging from nonprogression (3/9), spontaneous resolution (2/9) or macular hole formation (3/9). Surgical outcomes can be favorable.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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