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Y. Ikuno, C. Mizuno, H. Sakaguchi, Y. Oshima, M. Kamei, Y. Tano, M. Ohji; Preoperative Optical Coherence Tomographic Findings and Surgical Outcome in Vitrectomy for Highly Myopic Macular Holes. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1177. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Macular hole (MH) closure rate in highly myopic eyes with retinal detachment (RD) believed to be poor but not in those without RD. However, there have been no comparative studies. We investigated the preoperative optical coherence tomographic (OCT) findings and the visual/anatomic outcomes after vitrectomy.Patients and
We retrospectively reviewed the medial records of patients who underwent vitrectomy for highly myopic MH (axial length ≥26 mm or refractive error ≤-8 D) between 2001 and 2007, and divided into groups: eyes with no RD on OCT (group 1), eyes with localized RD with surrounding retinoschisis (group 2), and eyes with RD within the area of posterior staphyloma and no retinoschisis (group 3). Eyes with extensive RD or follow-up <6 months were excluded. Surgical outcome was determined by best-corrected visual acuity (BCVA) and MH closure confirmed with OCT.
Group 1 included 10 eyes (33%), group 2 nine eyes (30%), group 3 11 eyes (37%).The average preoperative logMAR values were 0.34, 0.91, and 1.05, respectively (P<0.01, one-way ANOVA) and the average preoperative logMAR values after 6 months were 0.21, 0.84, and 1.00 (P<0.01), respectively; the rates of significant BCVA improvement (≥3 Snellen lines) were 30%, 22%, and 36%, and the rates of MH closure were 80%, 33%, and 18%.
Only group1, in which the inner retina supposed to have the highest redundancy, presented the favorable MH closure rate. BCVA was poor in group 2 and 3, however visual improvement did not differ significantly, despite different MH closure rates. These facts indicate that not only MH closure but also other factors such as retinal damage from RD and/or myopic chorioretinal atrophy may influence on the visual outcome.
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