Myopic traction maculopathies and their treatments

Abstract

ABSTRACTIntroduction: Pathologic myopia is associated with structural and physiological posterior segment changes, including myopic tractional maculopathies, which can be associated with sight threatening complications. With higher resolution ophthalmic imaging techniques and access to more advanced surgical treatment options, myopic tractional maculopathies are better understood and effective management strategies are being developed.Areas covered: In this review we will examine the clinical characteristics and the current management, of myopic traction maculopathies. An extensive literature search was made using the following key words: pathologic myopia, high myopia, dome shaped maculopathy, posterior staphyloma, myopic foveoschisis, myopic maculoschisis, myopic tractional maculopathy, myopic macular hole, myopia macular hole retinal detachment, scleral buckling, macular buckling, and imbrication. This review used Medline, PubMed, and The Cochrane Library databases.Expert commentary: Rapid advances in retinal and ocular imaging have been accompanied by rapid technical improvements in vitreoretinal surgery. In cases with an axial length greater than 30mm, a marked staphyloma, foveoschisis and macula hole (with or without retinal detachment) vitrectomy surgery alone becomes less effective. It is becoming clear that some form of intervention, such as macular buckling, in terms of limiting the staphyloma or axial length may be required.