Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome

Am J Ophthalmol. 2007 Mar;143(3):455-62. doi: 10.1016/j.ajo.2006.10.053. Epub 2006 Dec 8.


Purpose: To determine the natural evolution and surgical indications of myopic foveoschisis (MF), which are still poorly documented, and the factors that predict poor prognosis.

Design: Retrospective observational case series.

Methods: Twenty-nine operated and nonoperated cases of MF (29 eyes of 23 patients) were studied. All eyes underwent repeated examinations, including optical coherence tomographic (OCT) recordings, during a mean follow-up of 31.2 months. Special attention was paid to the evolution of visual acuity (VA) and to the thickness of foveoschisis.

Results: Mean refraction was -14.4 diopters, and mean axial length was 29.1 mm. OCT scans revealed that the foveoschisis was associated with macular anomalies: a premacular structure in 13 (44.8%) of 29 eyes, a foveal detachment in 10 (34.5%) of 29 eyes, and a lamellar macular hole in six (20.7%) of 29 eyes. Isolated foveoschisis was found in four eyes (13.8%). During follow-up, foveoschisis and VA worsened in 20 eyes and remained stable in nine. Ten of the 20 eyes that worsened had a premacular structure. A macular hole occurred in nine eyes, six of which had previously exhibited foveal detachment. Eleven eyes with foveoschisis underwent surgery, which improved VA significantly (P = .04, Wilcoxon test), but three eyes developed a macular hole.

Conclusions: MF may remain stable for many years without affecting VA. However, when it is combined with the presence of a premacular structure, the risk of a decrease in VA increases. When it is combined with foveal detachment, a macular hole seems to develop frequently, whether or not surgery is performed.

MeSH terms

  • Adult
  • Aged
  • Epiretinal Membrane / etiology
  • Epiretinal Membrane / surgery
  • Female
  • Follow-Up Studies
  • Fovea Centralis / pathology*
  • Fovea Centralis / surgery
  • Humans
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications*
  • Refraction, Ocular
  • Retinal Perforations / etiology
  • Retinal Perforations / surgery
  • Retinoschisis / diagnosis*
  • Retinoschisis / etiology
  • Retinoschisis / surgery*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy*