Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun 18;15(6):975-982.
doi: 10.18240/ijo.2022.06.16. eCollection 2022.

Long-term outcome of pathologic myopic foveoschisis treated with posterior scleral reinforcement followed by vitrectomy

Yao Huang  1 , Yue Qi  1 , Wen-Bin Wei  1 , An-Li Duan  1
Affiliations

Long-term outcome of pathologic myopic foveoschisis treated with posterior scleral reinforcement followed by vitrectomy

Yao Huang et al. Int J Ophthalmol. .

Abstract

Aim: To report the long-term outcome of posterior scleral reinforcement (PSR) followed by vitrectomy for pathologic myopic foveoschisis (MF).

Methods: The records of 27 patients (44 eyes) treated with posterior scleral reinforcement (PSR) followed by vitrectomy for pathologic MF were retrospectively reviewed. The best-corrected visual acuity (BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings and complications were analyzed.

Results: Forty-four eyes of 27 patients were included in this study. The follow-up period was 47.98±18.23mo (24-83mo). The mean preoperative BCVA (logMAR) was 1.13±0.63, and the mean postoperative BCVA was 0.30±0.33 at the last visit. There showed a significant improvement in BCVA postoperatively (P<0.001). Postoperative BCVA in 41 eyes (93%) was improved compared with the preoperative one. Forty-two eyes (95.45%) got total resolution of the MF after surgery. The remaining two eyes (4.55%) got partial resolution of foveoschisis. The preoperative foveal thickness was 610.45±217.11 µm and the postoperative foveal thickness at the last visit was significantly reduced to 177.64±55.40 µm (P<0.001). The preoperative axial length was 29.60±1.71 mm, and the postoperative axial length was 29.74±1.81 mm at the last visit. There was no significant increase in axial length within 47.98±18.23mo of follow-up (P=0.562). There was no recurrence of foveoschisis or occurrence of full-thickness macular hole during the whole follow-up period.

Conclusion: For pathologic MF, PSR followed by vitrectomy is an effective procedure to improve the visual acuity and the anatomical structure of macula. It can also stabilize the axial length for a long time.

Keywords: myopic foveoschisis; posterior scleral reinforcement; vitrectomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Representative OCT findings before and after PSR followed by vitrectomy
A: Preoperative OCT showed MF with significant FD; B: OCT showed complete resolution of MF and FD 26mo postoperatively. Arrow indicated posterior scleral buckle with flattening of the scleral staphyloma and foveoschisis. OCT: Optical coherence tomography; PSR: Posterior scleral reinforcement; FD: Foveal detachment; MF: Myopic foveoschisis.
Figure 2
Figure 2. Comparison of BCVA at the last visit and baseline BCVA
A: At the last visit, the Snellen BCVA was improved in 41 eyes (93%), had no change in 1 eye (2%), and decreased in 2 eyes (5%); B: Among the improved eyes, 36 eyes (82%) showed more than 3-line improvement in BCVA. BCVA: Best-corrected visual acuity.
Figure 3
Figure 3. Representative OCT findings of case 1
A: Preoperative OCT of the macula showed MF with VMT. The central foveal thickness was 550 µm. B: The foveoschisis partially resolved one month after surgery, with residual retinoschisis in the inner retina. C: The MF got complete resolution 3mo postoperatively and maintained to 5y postoperatively. The central foveal thickness decreased to 264 µm at the last visit. VMT: Vitreomacular traction; OCT: Optical coherence tomography; MF: Myopic foveoschisis.
Figure 4
Figure 4. Representative OCT findings of case 2
A: Preoperative OCT of the macula showed myopic foveoschisis with FD. The preoperative central foveal thickness was 675 µm. B: After posterior scleral reinforcement combined with vitrectomy, OCT of the macula showed complete resolution of myopic foveoschisis and FD at the last visit. The central foveal thickness was decreased to 140 µm. FD: Foveal detachment; OCT: Optical coherence tomography.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Duan TQ, Tan W, Yang J, Li FL, Xiong SQ, Wang XG, Xu HZ. Morphological characteristics predict postoperative outcomes after vitrectomy in myopic traction maculopathy patients. Ophthalmic Surg Lasers Imaging Retina. 2020;51(10):574–582. - PubMed
    1. Meng B, Zhao L, Yin Y, Li HY, Wang XL, Yang XF, You R, Wang JL, Zhang YJ, Wang H, Du R, Wang NL, Zhan SY, Wang YL. Internal limiting membrane peeling and gas tamponade for myopic foveoschisis: a systematic review and meta-analysis. BMC Ophthalmol. 2017;17(1):166. - PMC - PubMed
    1. Wang LF, Wang YH, Li YL, Yan ZY, Li YH, Lu L, Lu TX, Wang X, Zhang SJ, Shang YX. Comparison of effectiveness between complete internal limiting membrane peeling and internal limiting membrane peeling with preservation of the central fovea in combination with 25G vitrectomy for the treatment of high myopic foveoschisis. Medicine. 2019;98(9):e14710. - PMC - PubMed
    1. Iwasaki M, Miyamoto H, Okushiba U, Imaizumi H. Fovea-sparing internal limiting membrane peeling versus complete internal limiting membrane peeling for myopic traction maculopathy. Jpn J Ophthalmol. 2020;64(1):13–21. - PubMed
    1. Lee DH, Moon I, Kang HG, Choi EY, Kim SS, Byeon SH, Koh HJ, Lee SC, Kim M. Surgical outcome and prognostic factors influencing visual acuity in myopic foveoschisis patients. Eye (Lond) 2019;33(10):1642–1648. - PMC - PubMed

LinkOut - more resources