title: Radius of curvature changes in spontaneous improvement of foveoschisis in highly myopic eyes.
abstract: BACKGROUND
  Myopic foveoschisis is the splitting of retinal layers overlying staphyloma in highly myopic patients that can lead to vision loss. We assess possible contributing mechanisms to the formation of foveoschisis by examining two cases of spontaneous improvement of myopic foveoschisis and employ a radius of curvature (ROC) measure to track posterior scleral curvature over time.
  
  
  METHODS
  A retrospective, non-comparative case series was performed and optical coherence tomography images were analysed. Retinal pigment epithelial layer ROC was calculated from manually segmented images through the posterior scleral curvature apex.
  
  
  RESULTS
  Two cases of myopic foveoschisis with foveal detachments in the left eye (OS) were studied. Both patients had high myopia (either <-10 D or >30 mm in axial length). One case occurred in a treatment-naive patient who improved after 4 months of observation. On initial presentation, OS posterior scleral ROC was 12.35 mm and decreased to 12.15 mm at the time of resolution. The other case occurred in a patient who was followed for 7 years, had previously underwent pars plana vitrectomy and removal of epiretinal membrane, experienced recurrence of foveoschisis and then spontaneously improved without further posterior segment surgery. There was an uncomplicated cataract extraction in the interim. Posterior scleral ROC was 4.05 mm on presentation, 4.10 during recurrence, 3.55 mm after cataract extraction and 3.75 mm at resolution.
  
  
  CONCLUSIONS
  Spontaneous improvement of myopic foveoschisis may be due to changes in tractional forces from the internal limiting membrane, cortical vitreous or staphyloma or, alternatively, from a delayed or fluctuant recovery course after intervention.
authors.affiliation: Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Quan V
authors.initials: QV
authors.lastname: Hoang
authors.affiliation: Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Garcia-Arumi
authors.affiliation: Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Sherwood
authors.affiliation: Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Stanley
authors.initials: S
authors.lastname: Chang
mesh_terms: D000368:Aged; D003452:Cryosurgery; D004108:Dilatation, Pathologic; D005260:Female; D005584:Fovea Centralis / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012075:Remission, Spontaneous; D012163:Retinal Detachment / Q000601:surgery; D041441:Retinoschisis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012590:Sclera / Q000473:pathology*; D012591:Scleral Buckling; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
keywords: Macula; Retina; Treatment Surgery