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Efficacy of non-fovea-sparing ILM peeling for symptomatic myopic foveoschisis with and without macular hole
  1. Amer Hamad Al-Badawi,
  2. Mohamad Amr Salah Eddin Abdelhakim,
  3. Tamer Ahmed Macky,
  4. Hassan Aly Mortada
  1. Department of Ophthalmology, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
  1. Correspondence to Dr Mohamad Amr Salah Eddin Abdelhakim, Department of Ophthalmology, Kasr Al Ainy Hospital, Cairo University, Cairo 11431, Egypt; m.amr.salah{at}kasralainy.edu.eg

Abstract

Aim To study anatomical and visual outcomes of pars plana vitrectomy (PPV) with non-fovea-sparing (entire) internal limiting membrane (ILM) peeling in eyes with myopic foveoschisis (MF).

Methods Prospective interventional case series of eyes undergoing PPV with entire ILM peeling for symptomatic MF.

Main outcome measures Preoperative spectral domain optical coherence tomography (SD-OCT) epiretinal membrane, anomalous posterior vitreous detachment, vitreoschisis and postoperative changes in SD-OCT central foveal thickness (CFT), ellipsoid zone defect, foveal detachment (FD), macular hole (MH) diameter (if present) and best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR).

Results This study included 21 eyes (21 patients) with mean age 60.4±13.1, 15 females (71.4%). All patients achieved complete postoperative reattachment by SD-OCT (no FD) 6 months post vitrectomy, with no iatrogenic intraoperative or postoperative MH, and with significant improvement in final BCVA from 1.6±0.30 to1.0±0.2 logMAR, and in CFT from 918.2±311.4 to182.3±33.1 µm. Patients were subdivided into subgroup A: 11 eyes without MH; and subgroup B: 10 eyes with MH, the latter had significant improvement in MH diameter (p=0.005). Preoperative BCVA was a significant risk factor for visual gain, while preoperative FD and CFT were significant for CFT change.

Conclusion Vitrectomy with non-fovea-sparing (entire) ILM peeling resulted in a significant functional and anatomical improvement in eyes with MF with/without MH with no reported complications. Results are comparable to fovea-sparing ILM peeling.

  • Myopic foveoschisis
  • non-fovea sparing ILM peeling
  • foveal detachment
  • myopic macular hole
  • SD-OCT

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Footnotes

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Ophthalmology ethical committee, Kasr Al-Ainy, Faculty of Medicine, Cairo University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent Obtained.

  • Contributors AHA-B: acquisition and interpretation of data and drafting the work. MASEA and TAM: acquisition, analysis and interpretation of data, drafting the work and revising it critically for important intellectual content, final approval of the version published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HAM: conception and design of the work, revising the work critically for important intellectual content, final approval of the version published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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