Due to different directions of tractional forces, subtypes of VMIAs may have clinical implications on the anatomical configuration of MF. It is reported that MF with FD presented poorer visual acuity and foveal sensitivity ( 6). Myopic foveoschisis may exhibit different anatomical configurations, including foveal detachment (FD), outer lamellar macular hole (OLMH), and inner lamellar macular hole (ILMH). On the other hand, ERM, presented as a thin and highly reflective epiretinal material in optical coherence tomography (OCT), is proposed to generate tangential forces on the retinal surface ( 5). In the eyes with VMT, contraction of the preretinal vitreous could lead to a trampoline-like shallow vitreous detachment, which generates anterior traction on the fovea ( 4). Different subtypes of VMIAs, with different tomographic presentations, could lead to different tractional forces on retina. Among them, VMIAs including epiretinal membrane (ERM) and vitreomacular traction (VMT) are among the independent factors associated with MF ( 3). It is reported that 9.3–31.3% of the highly myopic eyes with posterior staphyloma (PS) have foveal retinoschisis, which is believed to be one of the main causes of full-thickness macular holes (MHs) in highly myopic eyes, along with obvious vision impairment ( 1, 2).Īlthough the exact pathogenesis of MF has not been clarified, several factors have been found to play a role in the occurrence of MF, including vitreomacular interface abnormalities (VMIA), retinal arteriolar stiffness, globe ectasia and staphyloma. Myopic foveoschisis (MF) is a common sight-threatening complication in patients with high myopia, which is characterized by intraretinal splitting in the macula region. Tangential force generated by ERM may act as a causative factor for the inner retinal lesions in MF, and inward-directed force resulting from VMT may act as a causative factor for outer retinal lesions in MF. The VMT group was associated with a higher proportion of eyes with visual acuity improvement postoperatively ( p = 0.02) and had more a decrease of CFT ( P = 0.007) compared with the ERM group.Ĭonclusion: In the eyes with MF, outer retinal lesions occurred more frequently in the eyes with VMT, whereas inner retinal lesions occurred more frequently in the eyes with ERM. At the final visit, the mean central foveal thickness (CFT) decreased significantly from 547.83 to 118.74 μm, and the mean LogMAR BCVA improved significantly from 0.92 to 0.57. After surgery, anatomical resolution was achieved in 51 eyes (83.6%). PPV was performed in 61 eyes with a mean follow-up time of 23.55 ± 19.92 months. The disruption of the external limiting membrane (ELM) was more common in the eyes with VMT than in those with ERM (45.8 vs. 60.0% p = 0.001) was detected in the eyes with VMT compared with those with ERM. In contrast, a lower rate of inner lamellar macular hole (28.9 vs. 21.3% p = 0.001) were detected in the eyes with VMT compared with those with ERM. 26.7% p < 0.001) and a higher rate of outer lamellar macular hole (45.8 vs. A higher rate of foveal detachment (61.4 vs. Outcome: ERM and VMT were found in 47.47 and 52.53% of the cases, respectively. The morphologic characteristics based on OCT and the surgical outcome were evaluated. Sixty-one eyes underwent pars plana vitrectomy (PPV) and were followed up for at least 6 months. All the eyes were divided into two groups by the pattern of VMIAs: ERM and VMT group. Methods: In this observational case series, 158 eyes of 121 MF patients with epiretinal membrane (ERM) or vitreomacular traction (VMT) based on optical coherence tomography (OCT) were enrolled. Purpose: To compare the morphologic characteristics and response to surgery of myopic foveoschisis (MF) with different patterns of vitreomacular interface abnormalities (VMIAs).
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