Abstract

Volume.123 Number.9

Original article : Clinical science

Thirty-six-month Follow-up of Cases with Myopic Macular Schisis after Vitrectomy Combined with Temporal Scleral Imbrication
Takayuki Baba1, Sumiyoshi Tanaka2, Tomohiro Nizawa1, Shuichi Yamamoto1
1 Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine
2 Tanaka Sumiyoshi Eye Clinic

Purpose: To report outcomes at 36 months after vitrectomy and scleral imbrication for treating myopic macular schisis.
Subjects and methods: Eleven eyes (from 10 females and 1 male) with myopic macular schisis were included. All cases were treated by vitrectomy combined with temporal scleral imbrication at Chiba University Hospital between November 2013 and November 2015. The internal limiting membrane was not removed during surgery. Best-corrected visual acuity (BCVA), axial length (AL), amount of astigmatism, macular (central retinal) thickness measured using optical coherence tomography, detachment height and curvature of eye wall were evaluated at baseline and up to 36 months after the surgery.
Results: At 36 months after the surgery, the BCVA improved from 0.72±0.28log MAR units to 0.49±0.44log MAR units (p=0.092), and 7 of the 11 eyes (64%) showed improvement in visual acuity from the baseline value. The AL was 29.4±1.4 mm at the baseline and 28.5±2.0 mm at 36 months (p=0.003). The macular thickness and detachment height were significantly reduced after the surgery and remained that way for 36 months. In one eye, myopic choroidal neovascularization developed, which was treated using an anti-vascular endothelial growth factor drug.
Conclusions: Vitrectomy combined with temporal scleral imbrication was effective for treating myopic macular schisis. Schisis and retinal detachment in the macular area were improved in all cases without recurrence for up to 36 months after the surgery. Possible complications specific for high myopia require long-term follow-up.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 924-931, 2019.

Key words
Myopic macular schisis, Temporal scleral imbrication, Pars plana vitrectomy, Posterior staphyloma, Macular hole
Reprint requests to
Takayuki Baba, M.D. Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine. 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan