Myopic Macular Retinoschisis in Teenagers: Clinical Characteristics and Spectral Domain Optical Coherence Tomography Findings

Abstract

To investigate the morphological characteristics of myopic macular retinoschisis (MRS) in teenagers with high myopia, six male (9 eyes) and 3 female (4 eyes) teenagers with typical MRS identified from chart review were evaluated. All cases underwent complete ophthalmic examinations including best corrected visual acuity (BCVA), indirect ophthalmoscopy, colour fundus photography, B-type ultrasonography, axial length measurement, and spectral-domain optical coherence tomography (SD-OCT). The average age was 17.8 ± 1.5 years, average refractive error was −17.04 ± 3.04D, average BCVA was 0.43 ± 0.61, and average axial length was 30.42 ± 1.71 mm. Myopic macular degenerative changes (MDC) by colour fundus photographs revealed Ohno-Matsui Category 1 in 4 eyes, and Category 2 in 9 eyes. Posterior staphyloma was found in 9 eyes. SD-OCT showed outer MRS in all 13 eyes, internal limiting membrane detachment in 7 eyes, vascular microfolds in 2 eyes, and inner MRS in 1 eye. No premacular structures such as macular epiretinal membrane or partially detached posterior hyaloids were found. Our results showed that MRS rarely occurred in highly myopic teenagers, and was not accompanied by premacular structures, severe MDC, or even obvious posterior staphyloma. This finding indicates that posterior scleral expansion is probably the main cause of MRS.

Association Between the Types of Posterior Staphyloma and Their Risk Factors in Pathological Myopia

“…Moreover, we found that some eyes (12/60) had vitreous traction. However, among them, four eyes from two male patients presented with MRS, but not PS, a finding similar to the study findings of Sun et al 34 Thus, MRS may also appear to be associated with vitreous traction, similar to the conclusions by Shinohara et al 35 and Ikuno et al 36 Thus, the occurrence of MRS is due to the combined action result of the vitreous-retinal interface and PS. 37 According to the theoretical causes of MRS, surgeons should consider the operation plan to treat MRS; the results of OCT and 3D-MRI are suggested to be analyzed, and PSR or pars plana vitrectomy (PPV) should be chosen cautiously to ensure that patients obtain admirable surgical benefits.…”

Progression and new onset of macular retinoschisis in myopic choroidal neovascularization eyes after Conbercept therapy: a post-hoc analysis

“…Second, posterior staphyloma was rarely recorded in the primary RCT study. Sun et al [29] suggested that posterior scleral expansion, progressively inducing an outward expansion of choroid, may be the initial pathological trigger of MRS in pathologic myopic eyes. It should be noted that few evidences indicate the disturbance of the scleral collagen array or posterior scleral expansion after anti-VEGF treatment.…”

Wide-Field En Face Swept-Source Optical Coherence Tomography Features of Extrafoveal Retinoschisis in Highly Myopic Eyes

“…Myopic macular retinoschisis is generally classified as inner limiting membrane (ILM) detachment and inner and outer schisis. 13,14 However, there was no study investigating the classification of EFRS. Therefore our study also sought to classify myopic EFRS and to link this classification with pathological changes such as staphyloma.…”