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. 2005 Sep;89(9):1180-3.
doi: 10.1136/bjo.2005.069427.

Vitrectomy and gas tamponade without internal limiting membrane peeling for myopic foveoschisis

A K H Kwok  1 , T Y Y Lai, W W K Yip
Affiliations

Vitrectomy and gas tamponade without internal limiting membrane peeling for myopic foveoschisis

A K H Kwok et al. Br J Ophthalmol. 2005 Sep.

Abstract

Aim: To evaluate the clinical and anatomical outcomes of pars plana vitrectomy and gas tamponade without internal limiting membrane (ILM) peeling in symptomatic patients caused by myopic foveoschisis.

Methods: Nine eyes in eight highly myopic patients who had myopic foveoschisis with foveal detachment underwent vitrectomy without ILM peeling followed by gas tamponade. Main outcome measures include change in best corrected visual acuity (BCVA) and changes in height of the foveal detachment and resolution of the myopic foveoschisis measured by optical coherence tomography (OCT).

Results: After surgery, BCVA improved in eight eyes with the median BCVA improved from 20/80 to 20/50 (p=0.012). The mean line of visual improvement was 3.6 lines. OCT showed complete resolution of myopic foveoschisis with complete foveal reattachment in seven (77.8%) eyes with partial resolution in two (22.2%) eyes. The mean height of foveal detachment decreased from 505 mum preoperatively to 21 mum postoperatively (p<0.001).

Conclusions: Vitrectomy without ILM peeling followed by gas tamponade appeared to result in favourable visual and anatomical outcomes for treating myopic foveoschisis in highly myopic eyes. The results are comparable with studies in which ILM removal was performed. Further controlled study will be useful to determine the role of ILM peeling in these patients.

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Figures

Figure 1
Figure 1
Optical coherence tomography of case 2. (A) Preoperative horizontal OCT scan of the macula revealed extensive retinoschisis with foveal detachment. (B) Six months after vitrectomy, there was complete reattachment of the fovea and resolution of the macular retinoschisis.
Figure 2
Figure 2
Optical coherence tomography of case 6. (A) Preoperative horizontal OCT scan of the macula revealed foveal detachment without the presence of a macular hole. (B) Six months after surgery, there was complete foveal attachment with resolution of the macular retinoschisis.
Figure 3
Figure 3
Optical coherence tomography of case 7. (A) Preoperative horizontal OCT scan of the macula demonstrated extensive macular retinoschisis with foveal retinal detachment. Incomplete partial PVD can also be seen in the parafoveal region (arrow). (B) Six months after surgery, there was partial resolution of the macular retinoschisis with reduction in the height of the foveal detachment.
See this image and copyright information in PMC

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