Korean J Ophthalmol.  2019 Dec;33(6):539-546. 10.3341/kjo.2019.0045.

Long-term Outcomes of Macular Hole Retinal Detachment in Highly Myopic Eyes after Surgical Reattachment

• Kim HY
• Lee JJ
• Kwon HJ
• Park SW
• Lee JE

• KMID: 2465134
• DOI: http://doi.org/10.3341/kjo.2019.0045

Abstract

PURPOSE
To evaluate visual acuity changes over 3 years following surgical reattachment of macular hole retinal detachment (MHRD) developed in high myopia.
METHODS
A retrospective analysis was performed using the medical records of patients with highly myopic eyes who underwent pars plana vitrectomy with internal limiting membrane peeling or the internal limiting membrane flap technique for MHRD. Changes in best-corrected visual acuity (BCVA) were measured at baseline, 6 months, 1 year, 2 years, and 3 years.
RESULTS
Of the 22 eyes analyzed, macular hole was closed in 13 and unclosed in nine. BCVA significantly improved from 1.61 ± 0.39 logarithm of the minimum angle of resolution (logMAR) at baseline to 1.17 ± 0.43 logMAR at 6 months and 1.33 ± 0.48 logMAR at 2 years after MHRD surgery. At 3 years, BCVA significantly decreased compared with that at 6 months, and visual improvement from baseline was not significant. BCVA and proportion of vision loss ≥0.3 logMAR were not different between the closed and unclosed macular hole groups.
CONCLUSIONS
Visual improvement after surgical reattachment of MHRD in high myopia was not maintained, and favorable macular hole closure effects were not observed at 3-year follow-up.

Keyword

Degenerative myopia; Retinal detachment; Retinal perforations; Vitrectomy

MeSH Terms

Follow-Up Studies
Humans
Medical Records
Membranes
Myopia
Myopia, Degenerative
Retinal Detachment*
Retinal Perforations*
Retinaldehyde*
Retrospective Studies
Visual Acuity
Vitrectomy
Retinaldehyde

Figure

• 

  Fig. 1 Changes in visual acuity (VA) after vitrectomy for macular hole (MH) retinal detachment at postoperative 6 months and 1, 2, and 3 years. BCVA = best-corrected visual acuity; logMAR = logarithm of the minimum angle of resolution.

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  Fig. 2 Distribution of VA changes between postoperative 6 months and 1, 2, and 3 years for (A) closed and (B) unclosed MH groups. VA = visual acuity; MH = macular hole; logMAR = logarithm of the minimum angle of resolution.

• 

  Fig. 3 A 50-year-old woman presenting with macular hole (MH) retinal detachment. Fundus photos demonstrate progression of chorioretinal atrophy. (A) The retina was detached within the arcade. The initial best-corrected visual acuity (BCVA) was 1.4 logarithm of the minimum angle of resolution (logMAR). Primary pars plana vitrectomy with the internal limiting membrane peeling technique was performed. (B) Three months after surgery, the retina was reattached, but the MH was unclosed. Additional surgery to close the MH was conducted. The BCVA after secondary surgery was 1.4 logMAR. (C) Two years after primary surgery, the BCVA was 1.2 logMAR. (D) Three years after primary surgery, chorioretinal atrophy progressed, and the BCVA decreased to 1.7 logMAR. The retina remained attached, and the MH remained open.

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