Morphologic and functional outcomes of different optical coherence tomography patterns of myopic foveoschisis after vitrectomy and inner limiting membrane peeling

Eye (Lond). 2019 Nov;33(11):1768-1775. doi: 10.1038/s41433-019-0490-3. Epub 2019 Jun 17.

Abstract

Objective: To evaluate the morphologic and functional outcomes of different optical coherence tomography (OCT) patterns of myopic foveoschisis after vitrectomy with Inner Limiting Membrane (ILM) peeling.

Methods: In this prospective non-randomised study, 62 consecutive eyes with Myopic Foveoschisis were categorised into three groups according to OCT pattern: retinoschisis type (Rt) Group (23/62), foveal detachment type (FDt) Group (20/62) and macular hole type (MHt) Group (19/62). All patients underwent 25-Gauge vitrectomy and ILM peeling. Air or gas tamponade was used. All patients were observed at month 1, 2, 4 and 6 after surgery.

Main outcomes measures: surgical success as resolution of myopic foveoschisis, central retinal thickness (CRT), IS/OS junction recovery and best-corrected visual acuity (BCVA) measurement. Any complication was reported.

Results: In all eyes OCT showed a resolution of the retinoschisis, foveal detachment and macular hole pattern, respectively. CRT significantly decreased in all Groups (p < .001), mainly in MHt. IS/OS junction recovery was mainly observed in MHt. BCVA significantly increased in all Groups (p < .01). A functional gain ≥2 Snellen lines occurred in 70, 85 and 68% in the Rt, FDt and MHt Group, respectively. Final BCVA was correlated with preoperative BCVA (R 0.74, p < 0.0001), postoperative CRT (R -0.49, p < 0.0001), and the recovery of IS/OS junction at 6 months (R 0.76, p < 0.0001). Few postoperative complications occurred.

Conclusions: Vitrectomy with ILM peeling results in favourable anatomic and functional outcomes for different patterns of myopic foveoschisis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Basement Membrane / surgery*
  • Cataract Extraction
  • Endotamponade / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myopia / diagnostic imaging
  • Myopia / physiopathology*
  • Myopia / surgery
  • Prospective Studies
  • Pseudophakia / physiopathology
  • Refraction, Ocular / physiology
  • Retinal Detachment / diagnostic imaging
  • Retinal Detachment / physiopathology*
  • Retinal Detachment / surgery
  • Retinoschisis / diagnostic imaging
  • Retinoschisis / physiopathology*
  • Retinoschisis / surgery
  • Sulfur Hexafluoride / administration & dosage
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity / physiology*
  • Vitrectomy*

Substances

  • Sulfur Hexafluoride