Long-term surgical outcomes of multiple parfoveolar curvilinear internal limiting membrane peeling for myopic foveoschisis

Tian, Tian; Jin, Haiying; Zhou, Qi Tony; Zhang, Xiang; Zhang, Hongtao; Zhao, Ping

doi:10.1038/s41433-018-0178-0

Cited by 28 publications

(46 citation statements)

References 20 publications

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“…In addition, postoperative VA was superior in eyes with fovea-sparing ILM peeling. Similar results have been reported in two other studies (24,25), however, a recent study has argued that there was no difference in the postoperative VA between fovea-sparing and complete ILM peeling groups and that the rate of postoperative MH development was not significant (2/20 vs. 0/13; p = 0.508) (26). The potential benefit of fovea-sparing ILM peeling compared to complete ILM peeling has not been established yet and this needs to be addressed in the future.…”

Section: Myopic Choroidal Neovascularization (Cnv)supporting

confidence: 93%

Pathologic myopia: an overview of the current understanding and interventions

Ueta

Makino

Yamamoto

et al. 2020

GHM

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Pathologic myopia is a major cause of low vision and blindness worldwide. Its social and economic burden has been demonstrated by epidemiological studies. There have been recent advances in the classification system for myopic maculopathy that enables clinicians to describe different types of lesions, including tessellated fundus, diffuse/patchy chorioretinal atrophy, macular atrophy, lacquer cracks, choroidal neovascularization (CNV), and Fuchs' spot, in a standardized format. From a therapeutic point of view, anti-vascular endothelial growth factor therapy has been established as first-line choice for myopic CNV. For myopic retinoschisis and macular holes with/without retinal detachment, pars plana vitrectomy has been generally accepted as an efficient strategy. Studies are being conducted to determine how to avoid the development of a postoperative macular hole and to improve the quality of vision after surgery. In recent years, studies have revealed preventive measures that can be taken against myopia progression, including low-dose atropine eyedrops and contact lens wearing with peripheral myopic defocusing.

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Section: Myopic Choroidal Neovascularization (Cnv)supporting

confidence: 93%

Pathologic myopia: an overview of the current understanding and interventions

Ueta

Makino

Yamamoto

et al. 2020

GHM

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“…Although these techniques have showed a better success rate and visual outcome when compared to the classic ILM peeling, no consensus regarding the ILM area to be preserve was developed. A range from 300 to 1000 μ m diameter was reported in different studies [77]. Anatomical results showed the primary success rate limited to 50–73.3% with vitrectomy, ILM peeling, and gas tamponade in high myopic eyes [80].…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Due to thin central foveal tissue, an iatrogenic full-thickness MH could develop during ILM removal. The risk of this complication ranges from 16.7 to 20.8% [ 76 ] and significantly increases in case of outer lamellar macular hole [ 77 ]. To reduce the risk of this complication and to preserve the epifoveal ILM, foveal-sparing ILM peeling procedures were introduced [ 76 – 79 ].…”

Section: Surgical Techniquesmentioning

confidence: 99%

Macular Hole in Myopic Eyes: A Narrative Review of the Current Surgical Techniques

Giacinto

Pastore

Cirigliano

et al. 2019

Journal of Ophthalmology

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Macular hole (MH) in myopic eyes is a disease arising from complex tractional forces exerted by vitreomacular interface, epiretinal tissue, and progressive scleral ectasia of the posterior ocular globe wall. This retinal disease requires vitreoretinal treatment for its repair, and the surgical intervention remains a challenge also for experienced surgeons. The aim of this review is to describe the current knowledge regarding the pathogenesis of MH in myopic eyes and to detail novel surgical techniques and technological advancements in its surgical management.

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“…Such adverse events may be even more common in pathological myopia, characterized by long axial length and diffuse chorioretinal atrophy. To prevent postoperative macular hole formation and possible damage to the fovea, a fovea-sparing ILMP technique has been advocated [8,19,20], but some studies have shown that there is no difference in postoperative visual acuity between fovea-sparing ILMP and complete ILMP [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Many subsequent studies have demonstrated that vitrectomy with internal limiting membrane peeling (ILMP) can be effective in producing both anatomical and functional improvement in MF [3][4][5][6][7]. In order to reduce postoperative macular hole (MH) formation and foveal damage, a partial ILMP technique with foveal sparing was proposed [8], but there is little evidence that this technique has better outcomes than complete ILMP [9,10] Furthermore, more recent studies have shown similar anatomical and functional improvements can be achieved without any form of IMLP [4,11], casting doubt on the benefits of ILMP.…”

Section: Introductionmentioning

confidence: 99%

Vitrectomy with or without internal limiting membrane peeling for myopic foveoschisis

Gui¹,

Ai²,

Huang³

2020

BMC Ophthalmol

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Background: The aim of this study was to compare the anatomical and visual outcomes of vitrectomy with or without internal limiting membrane (ILM) peeling for symptomatic myopic foveoschisis (MF). Methods: A retrospective cohort study of patients who had undergone vitrectomy for symptomatic MF at our specialist ophthalmology department in China. Cases were retrospectively categorized into one of two cohorts, depending on whether or not they had undergone ILM peeling (ILMP) during their surgery. Over a mean follow-up period of 18 months, all eyes underwent repeated examinations, including best-corrected visual acuity (BCVA) and optical coherence tomographic (OCT) recordings, particularly focusing on central foveal thickness (CFT), macular hole (MH) formation and/or foveal detachment (FD). Results: We included 32 eyes (32 patients) with mean age of 62.2 ± 7.4 years. 31 patients (96.8%) were female. There were 21 eyes in the ILMP cohort and 11 eyes in the non-ILMP cohort. There were no significant preoperative differences in age, axial length, symptom duration or postoperative follow-up period between the two cohorts. MF was resolved completely in all of the eyes except one eye in the ILMP cohort. The postoperative CFT was significantly reduced compared to the preoperative baseline in both cohorts (469 ± 203 μm to 253 ± 56 μm; p = 0.003 in no-ILMP; 495 ± 178 μm to 244 ± 63 μm; p < 0.001 in ILMP, respectively). The final BCVA improved significantly in non-ILMP (1.27 ± 0.63 logMAR to 0.73 ± 0.55 logMAR; p = 0.021); but not significantly in ILMP cohort (1.25 ± 0.51 to 0.98 ± 0.57 logMAR; p = 0.143). Conclusion: Vitrectomy, either with or without ILM peeling, results in a significant anatomical improvement in eyes with MF. Eyes treated by vitrectomy may have a better visual improvement when ILM was not peeled.

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Long-term surgical outcomes of multiple parfoveolar curvilinear internal limiting membrane peeling for myopic foveoschisis

Abstract: Fovea-sparing ILM peeling achieves a higher rate of macular schisis resolution over total peeling. A preoperative outer lamellar macular hole can be a risk factor for the development of a macular hole.

Cited by 28 publications

References 20 publications

Pathologic myopia: an overview of the current understanding and interventions

Pathologic myopia: an overview of the current understanding and interventions

Macular Hole in Myopic Eyes: A Narrative Review of the Current Surgical Techniques

Vitrectomy with or without internal limiting membrane peeling for myopic foveoschisis

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