title: Intravitreal gas injection for macular hole with localized retinal detachment in highly myopic patients.
abstract: OBJECTIVE
  This study aimed to evaluate treatment effects of intravitreal gas for macular hole with localized retinal detachment (RD) in highly myopic eyes and to examine how the vitreomacular relationship and other factors may influence treatment outcomes.
  
  
  METHODS
  Twenty highly myopic patients with macular holes and localized posterior RD, treated initially with intravitreal injection of C(3) F(8) , were prospectively studied. Recurrent disease was treated with repeated gas injection or vitrectomy according to the extent of detachment. Length of follow-up was ≥ 12 months. Vitreomacular conditions were determined before and within 2 months after gas injection by standard optical coherence tomography. Demographics, refractive errors, axial length, the extent of chorioretinal (CR) atrophy and visual acuity were recorded.
  
  
  RESULTS
  The success rate after primary gas injection was 70%. The remaining 30% of patients achieved anatomic success after further treatment, including vitrectomy with gas or silicone oil tamponade and/or scleral buckling. All cases achieved anatomic success after a mean of 1.4 surgeries. Univariate analysis showed that the patterns of the posterior vitreoretinal relationship did not differ significantly between those successfully treated with gas only (group 1) and those requiring vitrectomy (group 2) (p = 1.000). Logistic regression showed no statistically significant differences in any characteristics between groups 1 and 2.
  
  
  CONCLUSIONS
  Intravitreal gas tamponade alone may achieve anatomic success in more than two-thirds of highly myopic patients with macular holes and localized RD. Patients with different clinical characteristics and vitreoretinal relationships seem to have similar opportunities to achieve reattachment through this relatively non-invasive surgery.
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Fang-Ting
authors.initials: FT
authors.lastname: Chen
authors.forename: Po-Ting
authors.initials: PT
authors.lastname: Yeh
authors.forename: Chang-Ping
authors.initials: CP
authors.lastname: Lin
authors.forename: Muh-Shy
authors.initials: MS
authors.lastname: Chen
authors.forename: Chang-Hao
authors.initials: CH
authors.lastname: Yang
authors.forename: Chung-May
authors.initials: CM
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D058452:Axial Length, Eye; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012030:Refractive Errors / Q000503:physiopathology; D012163:Retinal Detachment / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D019233:Retreatment; D012827:Silicone Oils / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren