Foveal anatomical status and surgical results in vitrectomy for myopic foveoschisis.
OBJECTIVE
Myopic foveoschisis (MF), a major cause of visual loss in highly myopic patients, shows varied foveal anatomic characteristics. We determined how the foveal status is related to surgical results in MF.


METHODS
Forty-four eyes underwent vitrectomy for MF, including internal limiting membrane (ILM) peeling and gas tamponade. The eyes were divided into three groups depending on the preoperative foveal anatomy: foveal detachment (FD, n = 17), retinoschisis (RS, n = 16), and macular hole (MH, n = 11). Best-corrected visual acuity (BCVA) and optical coherence tomographic findings preoperatively and 3, 6, and 12 months postoperatively were obtained and compared.


RESULTS
BCVA improved two lines or more in 81% of the FD group, 50% of the RS group, and 45% of the MH group 12 months postoperatively. The FD group had significantly improved vision (P < 0.01). Visual improvement was borderline in the RS group (P = 0.057) and not significant in the MH group. Visual improvement was significantly better in FD eyes than in RS (P < 0.05) or MH (P < 0.01) eyes. In FD and RS eyes, the postoperative BCVA was significantly correlated with age (P < 0.05) and preoperative BCVA (P < 0.01), whereas visual improvement was correlated with symptom duration (P < 0.05) and preoperative BCVA (P < 0.01).


CONCLUSIONS
Vitrectomy including ILM peeling and gas tamponade is safe and effective for MF. Patients with FD showed the most visual improvement postoperatively and therefore can obtain the most benefit from the surgery. Surgery also benefits RS and MH patients by preserving vision. The foveal status, age, duration of symptoms, and preoperative BCVA are key factors determining postoperative visual outcome in MF.
Ikuno
Yasushi
Y
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan. ikuno@ophthal.med.osaka-u.ac.jp.
Sayanagi
Kaori
K
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
Soga
Kaori
K
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
Oshima
Yusuke
Y
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
Ohji
Masahito
M
Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan.
Tano
Yasuo
Y
Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D012163:Retinal Detachment / Q000601:surgery; D041441:Retinoschisis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; C042852:perflutren
Am J Ophthalmol. 2002 Jun;133(6):794-800
12036671
Am J Ophthalmol. 2003 Sep;136(3):477-81
12967801
Jpn J Ophthalmol. 2006 Jan-Feb;50(1):53-61
16453188
Am J Ophthalmol. 2004 Apr;137(4):719-24
15059711
Br J Ophthalmol. 1958 Dec;42(12):749-53
13607958
Am J Ophthalmol. 2003 Apr;135(4):547-9
12654379
Retina. 2005 Apr-May;25(3):290-5
15805905
Am J Ophthalmol. 2005 Mar;139(3):462-7
15767054
Am J Ophthalmol. 2005 Jan;139(1):197-9
15652854
Invest Ophthalmol Vis Sci. 2003 Jan;44(1):316-23
12506091
Am J Ophthalmol. 2005 Apr;139(4):658-63
15808161
Am J Ophthalmol. 1999 Oct;128(4):472-6
10577588
Ophthalmology. 2003 Sep;110(9):1702-7
13129865
Br J Ophthalmol. 2005 Sep;89(9):1180-3
16113377
Am J Ophthalmol. 2003 Apr;135(4):546-7
12654378
Am J Ophthalmol. 2004 Jan;137(1):172-3
14700661
Am J Ophthalmol. 2006 Nov;142(5):850-2
17056366
Am J Ophthalmol. 2006 Apr;141(4):774-6
16564831
Am J Ophthalmol. 2003 Mar;135(3):338-42
12614751
Arch Ophthalmol. 2004 Oct;122(10):1455-60
15477456
Am J Ophthalmol. 2003 Jul;136(1):177-80
12834688
Am J Ophthalmol. 2001 Sep;132(3):433-5
11530072