title: Risk factors for development of full-thickness macular holes after pars plana vitrectomy for myopic foveoschisis.
abstract: OBJECTIVE
  To identify risk factors for development of secondary full-thickness macular holes after pars plana vitrectomy with internal limiting membrane (ILM) peeling for myopic foveoschisis.
  
  
  METHODS
  Retrospective, interventional case series.
  
  
  METHODS
  We retrospectively reviewed the records of 42 eyes (42 patients) treated with pars plana vitrectomy (vitreous separation, internal limiting membrane peeling, and gas tamponade) for myopic foveoschisis with and without a retinal detachment but without a macular hole from January 2002 through June 2012. Cataract surgery was performed in all phakic eyes. Patients were followed up for 6 months after the initial surgery, and optical coherence tomography images were obtained at every visit. The factors associated with development of postoperative full-thickness macular holes were investigated.
  
  
  RESULTS
  A postoperative macular hole developed in 8 (19.0%) eyes. No significant correlations of age (P = .369), axial length (P = .113), visual acuity (P = .859), foveal status (P = .331), posterior staphyloma (P = 1.000), or chorioretinal atrophy (P = .837) were found between patients with and without secondary macular holes. Among the characteristics seen on the optical coherence tomography images, the percentage of eyes with an inner segment/outer segment junction defect was significantly (P = .013, Fisher exact test) higher in patients with a macular hole than in those without a macular hole. Logistic regression analysis showed that only an inner segment/outer segment junction defect (P = .018) was a significant risk factor for development of secondary macular holes.
  
  
  CONCLUSIONS
  Secondary macular holes can develop in myopic foveoschisis after pars plana vitrectomy with internal limiting membrane peeling. A preoperative inner segment/outer segment junction defect can be a risk factor for development of a macular hole.
authors.affiliation: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Xinxiao
authors.initials: X
authors.lastname: Gao
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ikuno
authors.forename: Satoko
authors.initials: S
authors.lastname: Fujimoto
authors.forename: Kohji
authors.initials: K
authors.lastname: Nishida
mesh_terms: D000368:Aged; D001485:Basement Membrane / Q000601:surgery; D058450:Endotamponade; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D016684:Prone Position; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology; D055214:Retinal Photoreceptor Cell Outer Segment / Q000473:pathology; D041441:Retinoschisis / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D013459:Sulfur Hexafluoride