Abstract
To provide the surgical indication for patients with myopic traction maculopathy (MTM) by investigating the postoperative outcomes after vitrectomy among different types of morphological characteristic groups. This was a retrospective cohort study that included patients (37 eyes) diagnosed with MTM at a single institution. All 37 eyes from 37 patients with MTMs were classified into three groups: foveal retinoschisis (FS), lamellar macular hole (LMH), and foveal retinal detachment (FRD). The ratios of anatomic recovery, central retinal thickness (CRT), and best-corrected visual acuity (BCVA) were statistically analyzed among the three groups preoperatively and at 1, 3, 6, and 12 months after vitrectomy. Anatomical recovery could be found in all patients of the FS group at 6 months postoperatively and in the LMH group at 12 months postoperatively. Only 83.33% patients in the FRD group showed anatomic recovery until 12 months. The time taken for CRT to reduce to 200 µm was gradually increased between the FS, LMH, and FRD groups. Postoperative BCVA was better in the FS group than the LMH and FRD groups (P < .05), but the LMH and FDR groups had no difference (P ≥ .05) at any point. The visual acuity was significantly improved in the FS group (P < .01) and FRD group (P = .018), but not in the LMH group (P = .196) at 12 months postoperatively. The FS group achieved anatomical recovery in the shortest time and had the best postoperative BCVA. FRD patients could get visual gain but need too much time for the anatomical recovery. LMH patients experienced anatomic success with surgery, but not in BCVA. Early surgery might be considered for eyes at FS prior to the occurrence of LMH or FRD. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:574-582.].
Highlights
Myopic traction maculopathy (MTM) is one of the major causes of poor vision in eyes with pathological macular lesions associated with high myopia, which are caused by traction and are discovered in 9 to 34% of high myopia and posterior staphylomas [1,2,3,4]
Surgery should be considered for eyes at foveal retinoschisis (FS) and before lamellar macular hole (LMH) or foveal retinal detachment (FRD) occurs
We found that the visual acuity of the FS group was significantly better than LMH (P < 0.05) and FRD group (P < 0.01)
Summary
Myopic traction maculopathy (MTM) is one of the major causes of poor vision in eyes with pathological macular lesions associated with high myopia, which are caused by traction and are discovered in 9 to 34% of high myopia and posterior staphylomas [1,2,3,4]. The vision suffers damage when MTM present manifestation including thickening of the retina, macular retinoschisis-like structures, foveal retinal detachment and macular holes. Some studies have reported that it may be related to the adherent vitreous cortex, epiretinal membrane, internal limiting membrane (ILM), retinal blood vessels, axis lengthening, and formation of posterior staphyloma [7,8,9,10]. Some researchers preferred vitrectomy combined with fovea-sparing ILM peeling for reducing the occurrence of secondary macular holes [24, 25]. On the basis of the appeal study, we chose vitrectomy combined with ILM peeling and C3F8 tamponade, and foveasparing ILM peeling in patients with foveal detachment and thinned retina
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