Myopia Research Today is a free monthly online journal that collates and summarizes the latest research about Myopia, including details on treatment, prevention, causes, correction. | ||||||||
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Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome.Gaucher D, Haouchine B, Tadayoni R, Massin P, Erginay A, Benhamou N, Gaudric A Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Service d'Ophtalmologie; Université Paris, France. david.gaucher@lrb.aphp.fr 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. Published 23 February 2007 in Am J Ophthalmol, 143(3): 455-62.
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