Vitrectomy and internal limiting membrane peeling for myopic foveoschisis.
OBJECTIVE
Myopic foveoschisis is common in high myopia. We report results of a pilot study of vitrectomy for patients with myopic foveoschisis.


METHODS
Interventional case series.


METHODS
In an institutional setting five patients with high myopia (six eyes), and who had progressive visual impairment presumably due to myopic foveoschisis were studied. No eyes had a macular hole preoperatively based on optical coherence tomography (OCT). We performed vitrectomy including vitreous cortex removal, internal limiting membrane (ILM) peeling, and gas tamponade. Patients were followed for at least 6 months. Best-corrected visual acuity (BCVA), OCT. Scanning laser ophthalmoscope (SLO) microperimetry was examined in three eyes.


RESULTS
The foveal detachment resolved completely in five eyes and partially in one eye. No serious complications developed including macular hole formation or retinal detachment; BCVA improved more than two lines in all eyes (100%) 6 months postoperatively (P <.01); SLO microperimetry showed smaller scotoma compared with preoperatively and stabilized fixation.


CONCLUSIONS
Vitrectomy with vitreous cortex removal, ILM peeling, and gas tamponade could be useful to treat myopic foveoschisis in highly myopic eyes. Because the natural course of the disease is not well-understood, further study should establish indications for this surgery.
Ikuno
Yasushi
Y
Department of Ophthalmology, Osaka University Medical School, Suita, Japan. ikuno@opthal.med.osaka-u.ac.jp
Sayanagi
Kaori
K
Ohji
Masahito
M
Kamei
Motohiro
M
Gomi
Fumi
F
Harino
Seiyo
S
Fujikado
Takashi
T
Tano
Yasuo
Y
D001485:Basement Membrane / Q000601:surgery; D004396:Coloring Agents; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005584:Fovea Centralis / Q000601:surgery*; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D009887:Ophthalmoscopy; D010865:Pilot Projects; D012163:Retinal Detachment / Q000601:surgery; D041441:Retinoschisis / Q000601:surgery*; D013194:Staining and Labeling / Q000379:methods; D041623:Tomography, Optical Coherence; D014221:Triamcinolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014792:Visual Acuity; D058609:Visual Field Tests; D014821:Vitrectomy / Q000379:methods*
D004396:Coloring Agents; D004791:Enzyme Inhibitors; D005466:Fluorocarbons; D014221:Triamcinolone; C030262:triamcinolone diacetate; C042852:perflutren; D007208:Indocyanine Green