Abstract
Purpose:
To review anatomical and functional outcomes of surgical treatment for myopic macular retinoschisis with vitrectomy, membrane peeling and gas tamponade.
Methods:
Non-randomized consecutive case series of patients from January 1, 1998 - September 2012 at the Bascom Palmer Eye Institute and Edward Harkness Eye Institute. All patients had fundus changes of high myopia and optical coherence tomography (OCT) findings of intraretinal schisis, with or without foveal detachment or macular hole. In the current study of surgical outcomes, patients were required to have at least 6 months of post-operative follow-up.
Results:
A total of 41 eyes of 38 patients were identified. The average age at the time of surgery was 61.2 years. Macular hole was present in 11 eyes and foveal retinal detachment present in 16 eyes. Internal limiting membrane peeling was performed in 35 eyes. Mean visual acuity at presentation was 20/130, (range 20/30-4/200). At 6 months, mean visual acuity was 20/70, (range 20/20-count fingers). Visual acuity improved in 29/41 (70.7%) patients and was stable in 4 patients. In 14/41 (34.1%) patients, visual acuity was 20/40 or better following surgery. In 12 patients vision was 20/200 or worse following surgery. Central foveal thickness as measured by OCT was available for 34 patients at baseline, with mean 558 micrometers (range 227-848). Central foveal thickness for 20 patients was available at 6 months with mean 265 micrometers (range 138-459). Re-operation was performed in 11 eyes. Indications for re-operation included foveal retinal detachment, macular hole, rhegmatogenous retinal detachment, elevated intraocular pressure, vitreous hemorrhage and cataract.
Conclusions:
Visual acuity and anatomic outcomes were generally improved or stabilized surgery for myopic macular retinoschisis.
Keywords: 605 myopia •
762 vitreoretinal surgery •
585 macula/fovea