Abstract
Objective. To observe the fellow eye in patients undergoing surgery on one eye for treating myopic traction maculopathy. Methods. 99 fellow eyes of consecutive patients who underwent unilateral surgery to treat MTM were retrospectively evaluated. All patients underwent thorough ophthalmologic examinations, including age, gender, duration of follow-up, refraction, axial length, intraocular pressure, lens status, presence/absence of a staphyloma, and best-corrected visual acuity (BCVA). Fundus photographs and SD-OCT images were obtained. When feasible, MP-1 microperimetry was performed to evaluate macular sensitivity and fixation stability. Results. At an average follow-up time of 24.7 months, 7% fellow eyes exhibited partial or complete MTM resolution, 68% stabilized, and 25% exhibited progression of MTM. Of the 38 eyes with “normal” macular structure on initial examination, 11% exhibited disease progression. The difference in progression rates in Groups 2, 3, and 4 was statistically significant. Refraction, axial length, the frequency of a posterior staphyloma, chorioretinal atrophy, initial BCVA, final BCVA, and retinal sensitivity all differed significantly among Groups 1–4. Conclusions. Long axial length, chorioretinal atrophy, a posterior staphyloma, and anterior traction contribute to MTM development. Patients with high myopia and unilateral MTM require regular OCT monitoring of the fellow eye to assess progression to myopic pre-MTM. For cases exhibiting one or more potential risk factors, early surgical intervention may maximize the visual outcomes.
Highlights
High myopia is associated with a lens diopter ≤ −6 D and an axial length ≥ 26 mm
myopic traction maculopathy” (MTM) can present with vitreoretinal traction, schisis-like thickening, a lamellar or full-thickness macular hole, foveal detachment, or a macular hole associated with retinal detachment [5]
Tsujikawa et al observed that high myopic patients, in whom one eye develops a macular hole with retinal detachment, would be expected to be at an increased risk of retinal detachment in the fellow eye [9]
Summary
High myopia is associated with a lens diopter ≤ −6 D and an axial length ≥ 26 mm. Such a condition is termed malignant or pathologic myopia when accompanied by choroid retinal degeneration and a series of pathological changes in the macular region [1]. Panozzo and Mercanti [3] proposed unifying all pathological features generated by traction in the context of myopia under a condition termed “myopic traction maculopathy” (MTM). This is a form of degenerative disease reported in 9–34% of highly myopic eyes with posterior staphylomas [3, 4]. The various clinical manifestations impact patient vision and function, eventually affecting the quality of life
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