Postoperative anatomical and functional outcomes of different stages of high myopia macular hole

BMC Ophthalmology

Research Article

Yanling Ouyang¹  Xiaodong Sun²  Huijuan Xia²  Ying Fan²  Qing Shao³  Florian M. A. Heussen⁴ 

[1] Department of Ophthalmology, Charité-Universitätsmedizin, Berlin, Germany;Department of Ophthalmology, Shanghai First People’s Hospital, Haining Road 100, 200080, Shanghai, China;Department of Ophthalmology, Shanghai First People’s Hospital, Haining Road 100, 200080, Shanghai, China;Department of Ophthalmology, Charité-Universitätsmedizin, Berlin, Germany;Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, UK;

关键词: Retinal Detachment;    Macular Hole;    Internal Limit Membrane;    Spectral Domain Optical Coherence Tomography;    Subretinal Fluid;   

DOI  :  10.1186/s12886-015-0098-8

 received in 2015-01-14, accepted in 2015-07-31,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundRecently 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).MethodsPatients 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.Results43 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.ConclusionsPars 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.

【 授权许可】

CC BY   
© Shao et al. 2015