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  • Surgical outcomes of centripetal non-fovea-sparing internal limiting membrane peeling for myopic foveoschisis with and without foveal detachment: a follow-up of at least 3 years

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Clinical science
Surgical outcomes of centripetal non-fovea-sparing internal limiting membrane peeling for myopic foveoschisis with and without foveal detachment: a follow-up of at least 3 years
  1. Kai-Ling Peng,
  2. Ya-Hsin Kung,
  3. Chia-Ming Hsu,
  4. Shu-Ping Chang,
  5. Pei-Lin Tseng,
  6. Tsung-Tien Wu
  1. Correspondence to Dr Tsung-Tien Wu, Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ttwu{at}vghks.gov.tw

Abstract

Background We evaluated the surgical outcomes of vitrectomy with non-fovea-sparing internal limiting membrane (ILM) peeling for myopic foveoschisis with a follow-up of at least 3 years.

Methods In this retrospective study, 32 consecutive eyes with high myopia with or without foveal detachment underwent vitrectomy and centripetal, non-fovea-sparing ILM peeling with gas tamponade for myopic foveoschisis. Outcome measures were visual acuity (VA) and optical coherence tomography findings.

Results Mean axial length was 29.39±1.92 mm; mean follow-up was 42.66 (±8.29) months. Foveoschisis and foveal detachment completely resolved in all eyes postoperatively. Mean central foveal thickness (CFT) improved significantly from 631.88±191.72 to 232.65±69.67 µm, and mean best-corrected visual acuity improved significantly from 0.90 (Snellen equivalent (SE), 20/160)±0.43 logarithm of minimum angle of resolution (logMAR) to 0.43 (SE, 20/54)±0.29 logMAR (both p<0.001; two-tailed, paired t-test). Eyes with foveal detachment (n=10) at baseline had thicker preoperative CFT (737.8±239.83 vs 583.73±147.78 µm; p=0.033) but thinner postoperative CFT (188.20±31.52 vs 252.86±73.29 µm; p=0.012). Eyes without foveal detachment at baseline had significantly better postoperative VA (0.33 (SE, 20/43)±0.18 vs 0.65 (SE, 20/86)±0.37 logMAR; p=0.002). No macular hole or other complications occurred during follow-up.

Conclusion Centripetal, non-fovea-sparing ILM peeling with gas tamponade may achieve myopic foveoschisis resolution and vision improvement without macular hole formation during at least 3-year follow-up.

  • macula
  • retina
  • treatment surgery
  • vitreous

https://doi.org/10.1136/bjophthalmol-2019-314972

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    Footnotes

    • Partial results of the article have been presented as a poster previously at the 17th EURETINA congress on 7–10 September 2017.

    • Contributors S-P C and P-L T did colour fundal pictures and OCT exams of the whole study. K-L P and C-M H collected clinical data and images and edited images. K-L P and Y-H K wrote the statistical analysis plan, cleaned and analysed the data, and drafted and revised the paper. T-T W was responsible for clinical treatment of the patients, initiated this study, designed data collection tools, implemented the study and revised the draft paper. All authors read and approved the final manuscript.

    • Funding This study was supported by the Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (grant VGHKS107-067). None of the authors have any proprietary interest in any device or drug mentioned in the article.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the hospital Institutional Review Board.

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

    • Data availability statement Data are available upon request. No data are available. All data relevant to the study are included in the article or uploaded as supplementary information.