A common surgery to an uncommon problem: Surgical management of Myopic Traction Maculopathy

Theme: Retina*
What: Retina
Part of: Retina III: A Passionate Potpourri for Pinching Out Pathology / Rétine III: Pot-pourri passionné pour éliminer les pathologies
When: 6/2/2024, 11:15 AM - 12:45 PM
Where: Room | Salle 713 AB

Abstract

Purpose:

To review outcome of vitrectomy with membrane peeling in patients with Myopic Traction Maculopathy(MTM)

 

Study design and Methods

Patients who met the inclusion criteria of MTM with vitrectomy and membrane peeling done between 2018-2022(5-years) in a tertiary centre were included. Baseline demographics, visual acuity(VA), lens status, axial length and OCT features were extracted. The primary outcome was to analyze factors associated with anatomical success. The secondary outcome was to analyze factors associated with VA improvement.

 

Results

80 eyes(from 71 patients) were included. 34 eyes had myopic foveoschisis-only, 31 had macular hole and 34 had macular detachment.

 

70.6% of myopic foveoschisis-only eyes showed post-op improvement in central retinal thickness(CRT). The median %CRT improvement was 25%. 52.9% had VA improvement(median 7.5-letter gain). Outer-schisis group had a median 61% CRT improvement, compared to no improvement in inner-schisis-only group(p=0.0047). Eyes without lamellar-hole had greater %CRT improvement, median 45% versus no improvement in lamellar-hole group (p=0.046) and VA improvement, median 15-letter gain versus no gain in lamellar-hole-group (p=0.0067)

 

42% of macular holes and 53% of macular detachments achieved primary anatomical success. For the latter, the presence of macula hole was associated with reduced chance of anatomical success(p=0.0006, odds-ratio=18.2). The final anatomical success rate was 51.7% for macula holes and 55.9% for macular detachment cases.

 

A better baseline VA was associated with VA improvement(median: pre-VA=1.0 logMAR, 7.5-letter-gain).

 

Conclusion

Vitrectomy with membrane peeling is effective in the management of MTM, especially those with myopic foveoschisis-only. Although macular detachment and macula hole are both poor prognostic factors, the final anatomic success is >50%.

 

 

Presenter(s)

Presenting Author: Wai Yan Lam

Additional Author(s):

Qing Li, Grantham Hospital, Hong Kong

Nicholas Fung, Department of Ophthalmology, University of Hong Kong

Wai Ching Lam, Department of Ophthalmology & Visual Sciences, University of British Columbia

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