Foveal anatomical status and surgical results in vitrectomy for myopic foveoschisis

Abstract

Myopic foveoschisis (MF), a major cause of visual loss in highly myopic patients, shows varied foveal anatomic characteristics. We determined how the foveal status is related to surgical results in MF. Forty-four eyes underwent vitrectomy for MF, including internal limiting membrane (ILM) peeling and gas tamponade. The eyes were divided into three groups depending on the preoperative foveal anatomy: foveal detachment (FD, n = 17), retinoschisis (RS, n = 16), and macular hole (MH, n = 11). Best-corrected visual acuity (BCVA) and optical coherence tomographic findings preoperatively and 3, 6, and 12 months postoperatively were obtained and compared. BCVA improved two lines or more in 81% of the FD group, 50% of the RS group, and 45% of the MH group 12 months postoperatively. The FD group had significantly improved vision (P < 0.01). Visual improvement was borderline in the RS group (P = 0.057) and not significant in the MH group. Visual improvement was significantly better in FD eyes than in RS (P < 0.05) or MH (P < 0.01) eyes. In FD and RS eyes, the postoperative BCVA was significantly correlated with age (P < 0.05) and preoperative BCVA (P < 0.01), whereas visual improvement was correlated with symptom duration (P < 0.05) and preoperative BCVA (P < 0.01). Vitrectomy including ILM peeling and gas tamponade is safe and effective for MF. Patients with FD showed the most visual improvement postoperatively and therefore can obtain the most benefit from the surgery. Surgery also benefits RS and MH patients by preserving vision. The foveal status, age, duration of symptoms, and preoperative BCVA are key factors determining postoperative visual outcome in MF.