Abstract
Purpose: :
To analyze 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, 2002 - October 31, 2011 at the Bascom Palmer 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. To qualify, patients were required to have had surgical intervention and at least 6 months of post-operative follow-up.
Results: :
A total of 19 eyes of 16 patients were identified that met inclusion criteria. The average age at the time of surgery was 63.2 years. Of these patients, 7 had foveal retinal detachment and 6 had macular holes. Internal limiting membrane peeling was performed in 17 eyes. Re-operation was required in 7 eyes, 1 within 6 months of initial surgery. Foveal retinal detachment was the cause of re-operation in three patients, and macular hole was the cause of re-operation in 3 patients. C3F8 gas was used in 14 of the eyes, and SF6 gas was used in 2 eyes.Mean visual acuity at presentation was 20/162, median 20/200 (range 20/30-4/200). At 6 months, mean visual acuity at 6 months was 20/85, median 20/55 (range 20/30-20/400). Central foveal thickness as measured by OCT was available for 17 patients at baseline, with mean 540 micrometers (range 342-723). Central foveal thickness for 12 patients was available at 6 months with mean 285 micrometers (range 146-442).
Conclusions: :
In this study, visual acuity and central foveal thickness were stabilized or improved after surgery for myopic macular retinoschisis with or without macular hole or foveal detachment. A percentage of patients required re-operation during follow-up.
Keywords: vitreoretinal surgery • myopia • macula/fovea