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Observation of macular hole associated with retinoschisis in patients with high myopia

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To observe the characteristics of highly myopic macular holes (HMMHs) with macular retinoschisis (MRS) by optical coherence tomography (OCT) and explore the possible relationship between HMMHs and different types of MRS.

Methods

We consecutively reviewed the clinical data and OCT images of the patients with HMMHs from June 2015 to February 2021. Then we picked eyes with MRS from these HMMHs for analysis. The minimum linear diameter (MLD), basal diameter (BD), and height (H) of HMMHs were measured. HMMHs were grouped according to the extent or layer involvement of the concomitant MRS and the characteristics were compared among groups. The impact of MRS on the MLD of macular hole was analyzed with multivariable linear regression.

Results

We included 127 patients with MRS from 168 HMMHs (75.5%) for analysis.

According to the different classification systems, the most frequent type of MRS in HMMHs was S3 (foveal but not entire macular area MRS) (62.2%) and both inner- and outer- (I/O-MRS) involved types. In our study, HMMHs with more extensive MRS had larger MLD, larger BD, larger H, and poorer best-corrected visual acuity (BCVA). Meanwhile, HMMHs with outer layer-involved MRS (outer MRS and I/O-MRS) had larger BD than HMMH with only inner layer-involved MRS. (All P < 0.05) Multivariable linear regression further illustrated only the extent of MRS was significantly associated with the MLD of HMMH, while there was no significant correlation between the involved retinal layers and the MLD of HMMH.

Conclusion

HMMH with MRS presented as a predominant type in HMMHs. The MRS was always with a relatively large extent and involved both inner and outer layers. MLD of HMMH was mainly affected by the extent of MRS.

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References

  1. Wong YL, Saw SM (2016) Epidemiology of pathologic myopia in Asia and worldwide. Asia Pac J Ophthalmol (Phila) 5:394–402. https://doi.org/10.1097/APO.0000000000000234

    Article  Google Scholar 

  2. Ohno-Matsui K, Lai TY, Lai CC, Cheung CM (2016) Updates of pathologic myopia. Prog Retin Eye Res 52:156–187. https://doi.org/10.1016/j.preteyeres.2015.12.001

    Article  Google Scholar 

  3. Ruiz-Medrano J, Montero JA, Flores-Moreno I, Arias L, Garcia-Layana A, Ruiz-Moreno JM (2019) Myopic maculopathy: current status and proposal for a new classification and grading system (ATN). Prog Retin Eye Res 69:80–115. https://doi.org/10.1016/j.preteyeres.2018.10.005

    Article  Google Scholar 

  4. Cheng C, Teo K, Tan CS, Lee SY, Loh BK, Wong E, Wong D, Wong TY, Cheung CM (2016) Myopic retinoschisis in Asians: structural features and determinants of visual acuity and prognostic factors for progression. Retina 36:717–726. https://doi.org/10.1097/iae.0000000000000757

    Article  Google Scholar 

  5. Lin CW, Ho TC, Yang CM (2015) The development and evolution of full thickness macular hole in highly myopic eyes. Eye (Lond) 29:388–396. https://doi.org/10.1038/eye.2014.312

    Article  Google Scholar 

  6. Shimada N, Tanaka Y, Tokoro T, Ohno-Matsui K (2013) Natural course of myopic traction maculopathy and factors associated with progression or resolution. Am J Ophthalmol 156. https://doi.org/10.1016/j.ajo.2013.06.031

  7. Jo Y, Ikuno Y, Nishida K (2012) Retinoschisis: a predictive factor in vitrectomy for macular holes without retinal detachment in highly myopic eyes. Br J Ophthalmol 96:197–200. https://doi.org/10.1136/bjo.2011.203232

    Article  Google Scholar 

  8. Alkabes M, Pichi F, Nucci P, Massaro D, Dutra Medeiros M, Corcostegui B, Mateo C (2014) Anatomical and visual outcomes in high myopic macular hole (HM-MH) without retinal detachment: a review. Graefes Arch Clin Exp Ophthalmol 252:191–199. https://doi.org/10.1007/s00417-013-2555-5

    Article  Google Scholar 

  9. Panozzo GMA (2004) Optical coherence tomography findings in myopic traction maculopathy. Arch Ophthalmol 122:1455–1460. https://doi.org/10.1001/archopht.122.10.1455

    Article  Google Scholar 

  10. Sun CB, Liu Z, Xue AQ, Yao K (2010) Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes. Eye (Lond) 24:1787–1791. https://doi.org/10.1038/eye.2010.123

    Article  CAS  Google Scholar 

  11. Shimada N, Ohno-Matsui K, Yoshida T, Sugamoto Y, Tokoro T, Mochizuki M (2008) Progression from macular retinoschisis to retinal detachment in highly myopic eyes is associated with outer lamellar hole formation. Br J Ophthalmol 92:762–764. https://doi.org/10.1136/bjo.2007.131359

    Article  CAS  Google Scholar 

  12. Gaucher D, Haouchine B, Tadayoni R, Massin P, Erginay A, Benhamou N, Gaudric A (2007) Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome. Am J Ophthalmol 143:455–462. https://doi.org/10.1016/j.ajo.2006.10.053

    Article  Google Scholar 

  13. Ceklic L, Munk MR, Wolf-Schnurrbusch U, Gekkieva M, Wolf S (2017) Visual acuity outcomes of ranibizumab treatment in pathologic myopic eyes with macular retinoschisis and choroidal neovascularization. Retina 37:687–693. https://doi.org/10.1097/iae.0000000000001236

    Article  CAS  Google Scholar 

  14. Li J, Liu B, Li Y, Zhao X, Chen S, Huang X, Lian P, Li T, Jin C, Liang X, Lu L (2021) Clinical characteristics of eyes with different grades of myopic traction maculopathy: based on the new classification system. Retina 41:1496–1501. https://doi.org/10.1097/IAE.0000000000003043

    Article  CAS  Google Scholar 

  15. Yu Y, Liang X, Wang Z, Wang J, Liu W (2018) Clinical and morphological comparisons of idiopathic macular holes between stage 3 and stage 4. Graefes Arch Clin Exp Ophthalmol 256:2327–2333. https://doi.org/10.1007/s00417-018-4158-7

    Article  CAS  Google Scholar 

  16. Hogan MJ, Alvarado JA, Weddell JE (1971) Histology of the Human Eye. In: The macular region. W.B.Saunders, Philadelphia, pp 491–497

  17. Wu PC, Chen YJ, Chen YH, Chen CH, Shin SJ, Tsai CL, Kuo HK (2009) Factors associated with foveoschisis and foveal detachment without macular hole in high myopia. Eye (Lond) 23:356–361. https://doi.org/10.1038/sj.eye.6703038

    Article  Google Scholar 

  18. Baumann C, Almarzooqi A, Blobner K, Zapp D, Kirchmair K, Schwer LS, Lohmann CP, Kaye SB (2021) Repeatability and reproducibility of macular hole size measurements using optical coherence tomography. J Clin Med 10. https://doi.org/10.3390/jcm10132899

  19. Takahashi H, Tanaka N, Shinohara K, Uramoto K, Yokoi T, Yoshida T, Ohno-Matsui K (2021) Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT. Ophthalmology 128:256–265. https://doi.org/10.1016/j.ophtha.2020.06.063

    Article  Google Scholar 

  20. Takahashi H, Tanaka N, Shinohara K, Yokoi T, Yoshida T, Uramoto K, Ohno-Matsui K (2019) Ultra-widefield optical coherence tomographic imaging of posterior vitreous in eyes with high myopia. Am J Ophthalmol 206:102–112. https://doi.org/10.1016/j.ajo.2019.03.011

    Article  Google Scholar 

  21. Hsieh YT, Yang CM (2019) Retinal detachment due to paravascular abnormalities-associated breaks in highly myopic eyes. Eye (Lond) 33:572–579. https://doi.org/10.1038/s41433-018-0255-4

    Article  Google Scholar 

  22. Schneider EW, Jaffe GJ (2020) Baseline characteristics of vitreomacular traction progressing to full-thickness macular or lamellar holes in the phase III trials of enzymatic vitreolysis. Retina 40:1579–1584. https://doi.org/10.1097/IAE.0000000000002634

    Article  CAS  Google Scholar 

  23. Ohno-Matsui K, Jonas JB (2018) Posterior staphyloma in pathologic myopia. Prog Retin Eye Res 70. https://doi.org/10.1016/j.preteyeres.2018.12.001

  24. Zheng F, Wong C-W, Sabanayagam C, Cheung Y-B, Matsumura S, Chua J, Man REK, Ohno-Matsui K, Wong T-Y, Cheng C-Y, Tai ES, Lamoureux ELED, Schmetterer L, Kuo A, Hoang QV, Saw S-M (2020) Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide-field optical coherence tomography in Singapore adults with high myopia. Acta Ophthalmol 99:e144–e153. https://doi.org/10.1111/aos.14527

    Article  Google Scholar 

  25. VanderBeek BL, Johnson MW (2012) The diversity of traction mechanisms in myopic traction maculopathy. Am J Ophthalmol 153. https://doi.org/10.1016/j.ajo.2011.06.016

  26. Fujimoto M, Hangai M, Suda K, Yoshimura N (2010) Features associated with foveal retinal detachment in myopic macular retinoschisis. Am J Ophthalmol 150:863–870. https://doi.org/10.1016/j.ajo.2010.06.023

    Article  Google Scholar 

  27. Shih YF, Fitzgerald ME, Norton TT, Gamlin PD, Hodos W, Reiner A (1993) Reduction in choroidal blood flow occurs in chicks wearing goggles that induce eye growth toward myopia. Curr Eye Res 12:219–227. https://doi.org/10.3109/02713689308999467

    Article  CAS  Google Scholar 

  28. Akyol N, Kükner AS, Ozdemir T, Esmerligil S (1996) Choroidal and retinal blood flow changes in degenerative myopia. Can J Ophthalmol 31:113–119

    CAS  Google Scholar 

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Correspondence to Wu Liu.

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All procedures performed in studies involving human participants were adhered to the Helsinki Declaration and its lateral amendments. Approval was granted by the ethical review committee of Beijing Tongren Hospital, Capital Medical University.

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Zhang, K., Yang, X., Wang, Z. et al. Observation of macular hole associated with retinoschisis in patients with high myopia. Graefes Arch Clin Exp Ophthalmol 261, 57–65 (2023). https://doi.org/10.1007/s00417-022-05766-8

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  • DOI: https://doi.org/10.1007/s00417-022-05766-8

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