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Radius of curvature changes in spontaneous improvement of foveoschisis in highly myopic eyes
  1. Quan V Hoang1,
  2. Ching-Lung Chen1,2,
  3. Jose Garcia-Arumi3,
  4. Pamela R Sherwood1,
  5. Stanley Chang1,4
  1. 1Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York, USA
  2. 2Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan
  3. 3Department of Ophthalmology, Hospital Universitario Vall d'Hebrón, Barcelona, Spain
  1. Correspondence to Sr Stanley Chang, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, 635 West 165th Street, New York, NY 10032, USA; sc434{at}columbia.edu

Abstract

Background Myopic foveoschisis is the splitting of retinal layers overlying staphyloma in highly myopic patients that can lead to vision loss. We assess possible contributing mechanisms to the formation of foveoschisis by examining two cases of spontaneous improvement of myopic foveoschisis and employ a radius of curvature (ROC) measure to track posterior scleral curvature over time.

Methods A retrospective, non-comparative case series was performed and optical coherence tomography images were analysed. Retinal pigment epithelial layer ROC was calculated from manually segmented images through the posterior scleral curvature apex.

Results Two cases of myopic foveoschisis with foveal detachments in the left eye (OS) were studied. Both patients had high myopia (either <−10 D or >30 mm in axial length). One case occurred in a treatment-naive patient who improved after 4 months of observation. On initial presentation, OS posterior scleral ROC was 12.35 mm and decreased to 12.15 mm at the time of resolution. The other case occurred in a patient who was followed for 7 years, had previously underwent pars plana vitrectomy and removal of epiretinal membrane, experienced recurrence of foveoschisis and then spontaneously improved without further posterior segment surgery. There was an uncomplicated cataract extraction in the interim. Posterior scleral ROC was 4.05 mm on presentation, 4.10 during recurrence, 3.55 mm after cataract extraction and 3.75 mm at resolution.

Conclusions Spontaneous improvement of myopic foveoschisis may be due to changes in tractional forces from the internal limiting membrane, cortical vitreous or staphyloma or, alternatively, from a delayed or fluctuant recovery course after intervention.

  • Retina
  • Macula
  • Treatment Surgery

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