Long-term Follow-up of High Myopic Foveoschisis: Natural Course and Surgical Outcome

To determine the natural evolution and surgical indications of myopic foveoschisis (MF), which are still poorly documented, and the factors that predict poor prognosis. Retrospective observational case series. Twenty-nine operated and nonoperated cases of MF (29 eyes of 23 patients) were studied. Al...

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Bibliographic Details
Published in:American journal of ophthalmology Vol. 143; no. 3; pp. 455 - 462.e1
Main Authors: Gaucher, David, Haouchine, Belkacem, Tadayoni, Ramin, Massin, Pascale, Erginay, Ali, Benhamou, Nathanael, Gaudric, Alain
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01.03.2007
Elsevier
Elsevier Limited
Subjects:
Adult
Aged
Biological and medical sciences
Epiretinal Membrane - etiology
Epiretinal Membrane - surgery
Female
Follow-Up Studies
Fovea Centralis - pathology
Fovea Centralis - surgery
Humans
Male
Medical research
Medical sciences
Middle Aged
Miscellaneous
Myopia, Degenerative - complications
Ophthalmology
Refraction, Ocular
Retina
Retinal Perforations - etiology
Retinal Perforations - surgery
Retinoschisis - diagnosis
Retinoschisis - etiology
Retinoschisis - surgery
Retrospective Studies
Surgery
Tomography, Optical Coherence
Treatment Outcome
Vision disorders
Visual Acuity
Vitrectomy
High
Eye disease
Prognosis
Treatment
Vision disorder
Surgery
Refractive error
Myopia
Evolution
Ophthalmology
Long term
ISSN:0002-9394, 1879-1891
Online Access:Get full text
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Summary:To determine the natural evolution and surgical indications of myopic foveoschisis (MF), which are still poorly documented, and the factors that predict poor prognosis. Retrospective observational case series. Twenty-nine operated and nonoperated cases of MF (29 eyes of 23 patients) were studied. All eyes underwent repeated examinations, including optical coherence tomographic (OCT) recordings, during a mean follow-up of 31.2 months. Special attention was paid to the evolution of visual acuity (VA) and to the thickness of foveoschisis. Mean refraction was −14.4 diopters, and mean axial length was 29.1 mm. OCT scans revealed that the foveoschisis was associated with macular anomalies: a premacular structure in 13 (44.8%) of 29 eyes, a foveal detachment in 10 (34.5%) of 29 eyes, and a lamellar macular hole in six (20.7%) of 29 eyes. Isolated foveoschisis was found in four eyes (13.8%). During follow-up, foveoschisis and VA worsened in 20 eyes and remained stable in nine. Ten of the 20 eyes that worsened had a premacular structure. A macular hole occurred in nine eyes, six of which had previously exhibited foveal detachment. Eleven eyes with foveoschisis underwent surgery, which improved VA significantly ( P = .04, Wilcoxon test), but three eyes developed a macular hole. MF may remain stable for many years without affecting VA. However, when it is combined with the presence of a premacular structure, the risk of a decrease in VA increases. When it is combined with foveal detachment, a macular hole seems to develop frequently, whether or not surgery is performed.
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ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2006.10.053