June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Parafoveal atrophy after human amniotic membrane graft for macular hole in patients with high myopia
Author Affiliations & Notes
  • Der-Chong Tsai
    Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan
  • Yu-Hsuan Huang
    Ophthalmology, Asia University Hospital, Taiwan
  • Shih Jen Chen
    Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
  • Footnotes
    Commercial Relationships   Der-Chong Tsai, None; Yu-Hsuan Huang, None; Shih Jen Chen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4242. doi:
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      Der-Chong Tsai, Yu-Hsuan Huang, Shih Jen Chen; Parafoveal atrophy after human amniotic membrane graft for macular hole in patients with high myopia. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4242.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : To report the surgical outcome and postoperative hypopigmented change around fovea among high myopia patients with macular hole (MH) after human amniotic membrane (hAM) transplantation.

Methods : This retrospective, interventional case series included ten eyes of ten consecutive patients (5 [50%] male) with high myopia (axial length over 26.5 mm) who received hAM graft to treat persisted or chronic macular hole with or without RD in two hospitals. Postoperative parafoveal atrophy was identified with color fundus picture and structure optical coherent tomography. Baseline characteristics and short-term visual outcome were analyzed.

Results : The preoperative mean (± standard deviation) axial length and macular hole diameter were 29.9 (± 1.8) mm and 881.8 (± 438.5) μm, respectively. After hAM transplantation, seven (70%) eyes had complete MH closure and the mean best-corrected visual acuity (BCVA) improved from 1.26 (± 0.48) logMAR before operation to 1.11 (± 0.44) logMAR on the last visit (p=0.074). Patchy atrophy-like depigmentation developed around the MH lesion in four (40.0%) eyes as early as in the first month after surgery. None of them had visual worsening. In terms of demographics, axial length, MH size, ocular history, preoperative and postoperative BCVA, there was no significant difference between those with and without the parafoveal atrophy. No graft rejection and inflammation happened during the follow-up.

Conclusions : Parafovea atrophy, a rare complication in the conventional macular hole surgery, was observed in 40% of eyes with highly myopic MH after hAM graft transplantation. The pathogenesis and long-term consequence need further investigations.

This is a 2020 ARVO Annual Meeting abstract.



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