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

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.

Keywords: macula; retina; treatment surgery; vitreous.