Gas tamponade for myopic foveoschisis with foveal detachment

Abstract

To evaluate the effects of gas tamponade without vitrectomy in patients with myopic foveoschisis and foveal detachment. We examined 10 eyes of 10 patients with myopic foveoschisis and foveal detachment. All patients received an intravitreal injection of 0.2-0.4mL C3F8 and remained in the prone position for 5 to 7days. The patients were followed up for at least 6months after the procedure. The refractive status, best-corrected visual acuity (BCVA), fundus changes, premacular disorders, and anatomical results before and after the treatment were assessed and recorded. All participants underwent serial optical coherence tomography (OCT). All patients had myopia of more than -7 diopters in the lesion eye. Staphyloma with chorioretinal atrophy was noted in all 10 eyes. The best-corrected visual acuity (BCVA) ranged from logMAR 0.52-2.0 before treatment. After initial gas tamponade, foveal detachment had resolved completely in four eyes and partially in four eyes at the 1-month follow-up visit, and two of the partially resolved cases achieved anatomical success after repeated treatment. Another eye achieved reattachment 15months later and the other had a persistent but decreased level of detachment. Vitrectomy was subsequently performed in the one eye that showed increased detachment, and complete resolution of the schisis-detachment was achieved. The final BCVA improved in seven eyes and none of the study subjects showed decreased visual acuity. Gas tamponade is an alternative treatment for myopic foveoschisis with foveal detachment. More than 50% cases showed a positive response with increased visual acuity. Further, the procedure did not appear to interfere with subsequent vitrectomy, if this procedure must be performed.