title: Postoperative anatomical and functional outcomes of different stages of high myopia macular hole.
abstract: BACKGROUND
  Recently it was suggested that high myopia macular holes (HMMH) and macular holes accompanied by retinal detachment occur in the advanced stages of myopia traction maculopathy (MTM), while macular retinoschisis, shallow retinal detachment without holes, and lamellar macular holes occur in the early stages of MTM. Complete vitreous cortex removal associated with internal limiting membrane peeling is now widely used to treat HMMH. However, it remains uncertain at what HMMH stage patients would benefit most from surgical intervention. Our study was aimed to evaluate the postoperative anatomical changes and functional outcomes of high myopia macular holes (HMMH).
  
  
  METHODS
  Patients were retrospectively collected between March 2009 and August 2011. Before and 1st, 3rd, and 9th month after 23G pars plana vitrectomy, all patients underwent a complete ophthalmologic examination, spectral domain optical coherence tomography (SD-OCT) and MP-1. At each follow-up, best-corrected visual acuity (BCVA), photoreceptor inner and outer segments (IS/OS) defects, and retinal sensitivity (RS) were investigated. According to different preoperative macular hole morphologies, patients were divided into three groups: Group 1, macular hole with epiretinal membrane (ERM) traction and macular retinoschisis; Group 2, full-thickness macular hole (FTMH); Group 3, FTMH with subretinal fluid.
  
  
  RESULTS
  43 eyes from 43 patients met the inclusion criteria. The mean age was 60 years. BCVA and RS were significantly improved after vitrectomy; the mean IS/OS defect was significantly reduced. At 9 postoperative months, 11 of 43 (25.6 %) eyes achieved IS/OS junction integrity; 9 of these 11 (81.8 %) eyes belonged to Group 1, 2 (18.2 %) belonged to Group 2.
  
  
  CONCLUSIONS
  Pars plana vitrectomy combined with ILM peeling and gas tamponade results in limited functional outcomes in patients with HMMH. The appearance of subretinal fluid indicates a worse prognosis for surgical intervention.
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, Haining Road 100, 200080, Shanghai, China. qshao87@hotmail.com.|Department of Ophthalmology, Charité-Universitätsmedizin, Berlin, Germany. qshao87@hotmail.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Shao
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, Haining Road 100, 200080, Shanghai, China. huijuanxia2015@sina.com.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Xia
authors.affiliation: Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK. florian.heussen@gmail.com.
authors.forename: Florian M A
authors.initials: FM
authors.lastname: Heussen
authors.affiliation: Department of Ophthalmology, Charité-Universitätsmedizin, Berlin, Germany. yanlingyouyang@gmail.com.
authors.forename: Yanling
authors.initials: Y
authors.lastname: Ouyang
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, Haining Road 100, 200080, Shanghai, China. xdsun@sjtu.edu.cn.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Ophthalmology, Shanghai First People's Hospital, Haining Road 100, 200080, Shanghai, China. mdyingfan@gmail.com.
authors.forename: Ying
authors.initials: Y
authors.lastname: Fan
mesh_terms: D000368:Aged; D058450:Endotamponade; D019773:Epiretinal Membrane / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000503:physiopathology* / Q000601:surgery; D011184:Postoperative Period; D012160:Retina / Q000503:physiopathology*; D012167:Retinal Perforations / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology*; D058609:Visual Field Tests; D014821:Vitrectomy