Macular vitreoretinal interface abnormalities in highly myopic eyes with posterior staphyloma: 5-year follow-up

Retina. 2012 Sep;32(8):1531-8. doi: 10.1097/IAE.0b013e318255062c.


Purpose: To review prevalence, long-term progression, and prognosis of vitreoretinal interface modifications in pathologic myopia with posterior staphyloma and investigate foveal sensitivity and fixation stability.

Methods: Retrospective single-institution series of 214 eyes (116 patients) with pathologic myopia, axial length >30 mm, and posterior staphyloma. Exclusion criteria included follow-up less than five years, incomplete records, and/or less than three optical coherence tomography or microperimetry. Patients were divided into 5 groups according to optical coherence tomography: 1) epiretinal membrane without schisis (ERM); 2) macular retinal schisis (Schisis); 3) partial thickness macular hole (PTMH); 4) full-thickness macular hole (FTMH); and 5) posterior retinal detachment (PRD) with or without macular hole. Disease progression was defined as a visual acuity decrease of two or more lines associated to objective worsening of the optical coherence tomography and/or microperimetry.

Results: Vitreoretinal abnormalities at baseline were present in 116 of 204 patients (56.8%) and 214 of 408 eyes (52.4%); 98 of 116 patients (84.4%) showed bilateral involvement. Baseline visual acuity and foveal sensitivity varied significantly with ERM performing better and PRD worse than others; PTMH and FTMH did not differ. During the 66 months of average follow-up, 33 of 214 eyes (15.4%) required surgery and 13 of 33 eyes (39.3%) needed reintervention. Surgery rate significantly differed among groups: 2% for ERM, 20% to 25% for Schisis, PTMH, and FTMH, and up to 50% for PRD. Progression rate of Schisis and FTMH was the same, regardless of symptoms, while macula-off PRD always required surgery. Decrease of fixation stability and foveal sensitivity correlated to need for surgery, while baseline foveal sensitivity and fixation did not.

Conclusion: Vitreoretinal interface pathology in pathologic myopia with posterior staphyloma encompasses a spectrum of conditions whose baseline functionality, prognosis, rate, and amount of progression vary significantly. Customized treatment for each different condition should be considered.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dilatation, Pathologic
  • Disease Progression
  • Epiretinal Membrane / diagnosis
  • Epiretinal Membrane / physiopathology*
  • Female
  • Fixation, Ocular / physiology
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myopia, Degenerative / physiopathology*
  • Posterior Eye Segment / pathology
  • Prevalence
  • Prognosis
  • Retinal Detachment / diagnosis
  • Retinal Detachment / physiopathology*
  • Retinal Perforations / diagnosis
  • Retinal Perforations / physiopathology*
  • Retinoschisis / diagnosis
  • Retinoschisis / physiopathology*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Visual Field Tests
  • Vitreous Body / pathology*