Natural course of myopic traction maculopathy and factors associated with progression or resolution

Abstract

Purpose: To investigate the natural course of myopic traction maculopathy and to identify the factors associated with its progression or resolution in 207 highly myopic eyes.

Design: Retrospective, consecutive case series.

Methods: We investigated 207 highly myopic eyes with myopic traction maculopathy by optical coherence tomography (OCT) and followed the patients for at least 24 months. The size of the macular retinoschisis was categorized according to its extent and location relative to the fovea. The clinical data, status of the myopic traction maculopathy, and changes in the posterior vitreous and inner limiting membrane (ILM) were analyzed during the natural course of the disease process.

Results: During a mean follow-up of 36.2 ± 6.2 months, 8 of 207 eyes (3.9%) showed a decrease or complete resolution of the macular retinoschisis. Of these 8 eyes, 6 had release of retinal traction in the OCT images, and 4 of the 6 eyes developed posterior vitreous detachment. A spontaneous disruption of the ILM occurred in 2 eyes before the improvement of the myopic traction maculopathy. Of the 207 eyes, 24 (11.6%) experienced progression of the myopic traction maculopathy. The eyes with more extensive macular retinoschisis showed progression significantly more commonly (42.9%) than the eyes having less extensive macular retinoschisis areas (6.7%).

Conclusions: The natural course of myopic traction maculopathy varies, and eyes with more extensive macular retinoschisis tend to progress more commonly. A complete resolution of macular retinoschisis can occur after a release of traction on the retina. These findings can be used to determine whether surgery should be performed.