Gas tamponade for myopic foveoschisis with foveal detachment

Graefes Arch Clin Exp Ophthalmol. 2013 May;251(5):1319-24. doi: 10.1007/s00417-012-2192-4. Epub 2012 Nov 10.

Abstract

Purpose: To evaluate the effects of gas tamponade without vitrectomy in patients with myopic foveoschisis and foveal detachment.

Methods: We examined 10 eyes of 10 patients with myopic foveoschisis and foveal detachment. All patients received an intravitreal injection of 0.2-0.4 mL C3F8 and remained in the prone position for 5 to 7 days. The patients were followed up for at least 6 months after the procedure. The refractive status, best-corrected visual acuity (BCVA), fundus changes, premacular disorders, and anatomical results before and after the treatment were assessed and recorded. All participants underwent serial optical coherence tomography (OCT).

Results: All patients had myopia of more than -7 diopters in the lesion eye. Staphyloma with chorioretinal atrophy was noted in all 10 eyes. The best-corrected visual acuity (BCVA) ranged from logMAR 0.52-2.0 before treatment. After initial gas tamponade, foveal detachment had resolved completely in four eyes and partially in four eyes at the 1-month follow-up visit, and two of the partially resolved cases achieved anatomical success after repeated treatment. Another eye achieved reattachment 15 months later and the other had a persistent but decreased level of detachment. Vitrectomy was subsequently performed in the one eye that showed increased detachment, and complete resolution of the schisis-detachment was achieved. The final BCVA improved in seven eyes and none of the study subjects showed decreased visual acuity.

Conclusion: Gas tamponade is an alternative treatment for myopic foveoschisis with foveal detachment. More than 50 % cases showed a positive response with increased visual acuity. Further, the procedure did not appear to interfere with subsequent vitrectomy, if this procedure must be performed.

MeSH terms

  • Aged
  • Dilatation, Pathologic
  • Endotamponade*
  • Female
  • Fluorocarbons / administration & dosage*
  • Fovea Centralis
  • Humans
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Retinal Detachment / diagnosis
  • Retinal Detachment / etiology
  • Retinal Detachment / therapy*
  • Retinoschisis / diagnosis
  • Retinoschisis / etiology
  • Retinoschisis / therapy*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity / physiology

Substances

  • Fluorocarbons
  • perflutren