Intravitreal gas injection for macular hole with localized retinal detachment in highly myopic patients.
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.
Chen
Fang-Ting
FT
Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
Yeh
Po-Ting
PT
Lin
Chang-Ping
CP
Chen
Muh-Shy
MS
Yang
Chang-Hao
CH
Yang
Chung-May
CM
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
D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren