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Un-Chul Park, Dae Joong Ma, Baek-Lok Oh, Sung Wook Park, Bo Hee Kim, Hyeong Gon Yu; Influence of the foveal curvature on myopic traction maculopathy and its surgical outcome. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4746. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the influence of foveal curvature on the myopic traction maculopathy (MTM) and its relevance to surgical outcome after pars plana vitrectomy.
High myopes (axial length ≥ 26.5 mm, myopic refractive error ≥ -6 D) with posterior staphyloma were recruited. Three different parameters of foveal curvature were calculated based on the retinal pigment epithelium (RPE) hyperreflective line using spectral domain optical coherence tomography. The mean values of the curvature parameters in patients with MTM were compared with the patients with myopic choroidal neovascularization (mCNV) or those without MTM and mCNV. For the patients who underwent pars plana vitrectomy for the treatment of MTM, surgical outcome and its association with foveal curvature were assessed.
A total of 85 high myopic eyes with MTM were included. The axial length, refractive error, and distribution of the staphyloma types were comparable to mCNV group or controls. The means of all three curvature parameters were significantly higher in the MTM group than in the mCNV and control groups (all P’s < 0.001). In MTM patients, foveal curvature parameters had significant correlation with axial length, but not with foveoschisis height (FSH). In 55 eyes which underwent pars plana vitrectomy, FSH decreased from 548.5 ± 201.9 μm at baseline to 278.0 ± 106.8 μm at 1 month, 245.7 ± 93.7 μm at 3 months, 222.6 ± 146.2 μm at 6 months, 185.2 ± 59.4 μm at 12 months. Complete resolution of foveoschisis and foveal reattachment was achieved in 87.3% at 12 months after surgery, and was associated with complete removal of tractional elements at vitreoretinal interface rather than with foveal curvature.
The results suggested that a steeper change of foveal curvature plays a role in the development of MTM in high myopic patients, but foveal curvature itself is not the determinant of surgical success after vitrectomy. The evaluation of foveal curvature might be useful in predicting the development of MTM.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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