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Eye (2010) 24, 17871791& 2010 Macmillan Publishers Limited All rights reserved 0950-222X/10 $32.00
http://www.nature.com/eye
Web End =www.nature.com/eye
Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes
CB Sun1, Z Liu2, AQ Xue3 and K Yao1
CLINICALSTUDY
Abstract
Purpose To evaluate the morphological changes that occurred during the development of a full-thickness macular hole (FTMH) from macular retinoschisis (MRS) in highly myopic eyes by optical coherence tomography (OCT).
Patients and methods The clinical characteristics and OCT images of ve eyes of ve patients with myopic MRS who developed FTMH during the follow-up period were evaluated.
Results The natural evolution from MRS to FTMH was classied into two patterns by OCT ndings. In FTMH formation pattern 1, a focal area of the external retinal layer was elevated and followed by the development of a small outer lamellar macular hole (OLMH) and retinal detachment (RD). The OLMH and RD were then enlarged horizontally and elevated vertically until the OLMH was attached to the overlying retinal layer. A FTMH nally developed when the roof of RD opened. In FTMH formation pattern 2, the opening of the roof of MRS or cystoid space caused an inner lamellar macular hole (ILMH). The MRS was then gradually resolved except the residual MRS beneath the ILMH, the ILMH would nally proceed into a FTMH as long as the remained external retinal layer beneath the ILMH continued splitting posteriorly until it reached retinal epithelium pigment. Conclusion Our longitudinal study revealed two patterns of FTMH formation in highly myopic eyes with MRS. This nding might be useful in further understanding the pathogenesis of macular hole formation in high myopia.
Eye (2010) 24, 17871791; doi:http://dx.doi.org/10.1038/eye.2010.123
Web End =10.1038/eye.2010.123 ; published online 10 September 2010
Keywords: macular hole; macular retinoschisis; optical coherence tomography; high myopia
Introduction
Macular retinoschisis (MRS) is one of the main complications leading to visual loss in highly myopic eyes.15 Studies have revealed that MRS could keep stable for years in some cases, however, the progression to a full-thickness macular hole (FTMH) from MRS has been frequently reported.13 Once a FTMH develops, the prognosis will be quite poor, for the surgical outcome of macular holes in high myopia is not satisfying.6 Unfortunately, the pathogenesis of FTMH formation from MRS is...