DEVELOPMENT OF MACULAR ATROPHY AFTER PARS PLANA VITRECTOMY FOR MYOPIC TRACTION MACULOPATHY AND MACULAR HOLE RETINAL DETACHMENT IN PATHOLOGIC MYOPIA

Retina. 2020 Oct;40(10):1881-1893. doi: 10.1097/IAE.0000000000002709.

Abstract

Purpose: To determine the incidence and long-term outcome of macular atrophy (MA) after pars plana vitrectomy (PPV) in pathologic myopia.

Methods: Highly myopic patients who underwent PPV for myopic traction maculopathy and macular hole retinal detachment at Tokyo Medical and Dental University between 2012 and 2016 were studied. Fundus photographs and/or optical coherence tomography were examined before and after PPV at every visit.

Results: A total of 133 eyes were followed for 39 months with the mean age of 62.8 years and the mean axial length of 30.0 mm. Postoperatively, 14 eyes (10.5%) developed fovea-centered MA, observed initially as a small, isolated, whitish lesion at the center of fovea at 3.5 months after PPV. The appearance of the MA was distinctly different from the choroidal neovascularization-related MA or patchy atrophy-related MA. With time, the lesions enlarged circumferentially. In these 14 eyes, the final best-corrected visual acuity was worse than the baseline, although the difference was not significant. The occurrence of MA was significantly associated with the preoperative foveal status.

Conclusion: The development of MA can occur in 11% of highly myopic eyes after PPV for myopic traction maculopathy and macular hole retinal detachment. This postoperative MA might be a new complication of pathologic myopia.

MeSH terms

  • Aged
  • Atrophy
  • Endotamponade
  • Female
  • Follow-Up Studies
  • Humans
  • Macula Lutea / pathology*
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Postoperative Complications*
  • Retinal Detachment / diagnostic imaging
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery*
  • Retinal Diseases / diagnostic imaging
  • Retinal Diseases / etiology
  • Retinal Diseases / surgery*
  • Retinal Perforations / diagnostic imaging
  • Retinal Perforations / etiology
  • Retinal Perforations / surgery*
  • Retrospective Studies
  • Tissue Adhesions
  • Tomography, Optical Coherence
  • Visual Acuity
  • Vitrectomy / adverse effects*