title: Autofluorescence and axial length as prognostic factors for outcomes of macular hole retinal detachment surgery in high myopia.
abstract: OBJECTIVE
  To evaluate the results of fundus autofluorescence and axial length as prognostic factors for surgical outcome of macular hole retinal detachment in high myopic patients.
  
  
  METHODS
  This is a retrospective, interventional, nonrandomized study. Patients were treated with posterior vitrectomy, internal limiting membrane peeling, and silicone oil tamponade. Best-corrected visual acuity, axial length, fundus autofluorescence, and spectral domain optical coherence tomography images were obtained.
  
  
  RESULTS
  Fifteen eyes from 15 patients (mean age, 69.4 years) were evaluated. The mean refractive error was -19 diopters, and the mean axial length was 29.9 mm. The mean best-corrected visual acuity (logMAR) improved from 2.17 to 1.42 (P = 0.02) after a mean follow-up of 19.3 months. Spectral domain optical coherence tomography scans showed retinal detachment resolution in 13 eyes (86.6%) and macular hole closure in 9 eyes (60%). Fundus autofluorescence showed macular hypoautofluorescence with foveal involvement (mean area of 9.7 mm2) in 10 eyes (66.6%). Postoperative best-corrected visual acuity was significantly worse in these eyes (P = 0.009). Axial length >30 mm was found in the 2 cases with recurrent retinal detachment and in 4 of the 6 cases without macular hole closure (66.6%).
  
  
  CONCLUSIONS
  Macular hole retinal detachment in high myopic patients can be successfully treated with vitrectomy, internal limiting membrane peeling, and silicone oil. Axial length >30 mm and macular hypoautofluorescence with foveal involvement seem to be prognostic factors for a worse anatomical and visual outcome.
authors.affiliation: Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Arias
authors.forename: Jose M
authors.initials: JM
authors.lastname: Caminal
authors.forename: Marcos J
authors.initials: MJ
authors.lastname: Rubio
authors.forename: Estefania
authors.initials: E
authors.lastname: Cobos
authors.forename: Pere
authors.initials: P
authors.lastname: Garcia-Bru
authors.forename: Alejandro
authors.initials: A
authors.lastname: Filloy
authors.forename: Noel
authors.initials: N
authors.lastname: Padron
authors.forename: Karol
authors.initials: K
authors.lastname: Mejia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058452:Axial Length, Eye / Q000473:pathology*; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications* / Q000503:physiopathology; D011379:Prognosis; D012163:Retinal Detachment / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012167:Retinal Perforations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D012827:Silicone Oils