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  • Title: Risk factors for development of full-thickness macular holes after pars plana vitrectomy for myopic foveoschisis.
    Author: Gao X, Ikuno Y, Fujimoto S, Nishida K.
    Journal: Am J Ophthalmol; 2013 Jun; 155(6):1021-1027.e1. PubMed ID: 23522356.
    Abstract:
    PURPOSE: To identify risk factors for development of secondary full-thickness macular holes after pars plana vitrectomy with internal limiting membrane (ILM) peeling for myopic foveoschisis. DESIGN: Retrospective, interventional case series. METHODS: We retrospectively reviewed the records of 42 eyes (42 patients) treated with pars plana vitrectomy (vitreous separation, internal limiting membrane peeling, and gas tamponade) for myopic foveoschisis with and without a retinal detachment but without a macular hole from January 2002 through June 2012. Cataract surgery was performed in all phakic eyes. Patients were followed up for 6 months after the initial surgery, and optical coherence tomography images were obtained at every visit. The factors associated with development of postoperative full-thickness macular holes were investigated. RESULTS: A postoperative macular hole developed in 8 (19.0%) eyes. No significant correlations of age (P = .369), axial length (P = .113), visual acuity (P = .859), foveal status (P = .331), posterior staphyloma (P = 1.000), or chorioretinal atrophy (P = .837) were found between patients with and without secondary macular holes. Among the characteristics seen on the optical coherence tomography images, the percentage of eyes with an inner segment/outer segment junction defect was significantly (P = .013, Fisher exact test) higher in patients with a macular hole than in those without a macular hole. Logistic regression analysis showed that only an inner segment/outer segment junction defect (P = .018) was a significant risk factor for development of secondary macular holes. CONCLUSIONS: Secondary macular holes can develop in myopic foveoschisis after pars plana vitrectomy with internal limiting membrane peeling. A preoperative inner segment/outer segment junction defect can be a risk factor for development of a macular hole.
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