Visual prognosis and spectral-domain optical coherence tomography findings of myopic foveoschisis surgery using 25-gauge transconjunctival sutureless vitrectomy

摘要

Purpose: To identify spectral-domain optical coherence tomography findings related to visual outcome in myopic foveoschisis after 25-gauge transconjunctival sutureless vitrectomy. Methods: Thirty-eight eyes with myopic foveoschisis were prospectively followed-up to 6 months after vitrectomy. Best-corrected visual acuity (BCVA), axial length, and spectral-domain optical coherence tomography findings were analyzed for identification of factors affecting visual outcome. Results: Best-corrected visual acuity improved significantly (preoperative 0.841 ± 0.534 logarithm of minimal angle of resolution to postoperative 0.532 ± 0.536 logarithm of minimal angle of resolution, P = 0.001), and central retinal thickness showed significant reduction (preoperative 409 ± 143 μm to postoperative 259 ± 72 μm, P < 0.001) with surgery. Anatomical success was achieved in 34/38 eyes (89.5%). Photoreceptor layer disruption was found in 20 of 38 eyes (52.6%) preoperatively and persisted after surgery in 18 of 20 eyes (90.0%). Patients with preoperative photoreceptor layer defects had significantly more associated foveal detachments and irregular choroidal surfaces and worse preoperative and final best-corrected visual acuity. Preoperative best-corrected visual acuity showed significant correlation with final best-corrected visual acuity (Pearson correlation coefficient = 0.555, P = 0.001). Patients with irregular choroidal surfaces and photoreceptor layer disruption had significantly worse final best-corrected visual acuity (P = 0.035, 0.005). Conclusion: Twenty-five-gauge transconjunctival sutureless vitrectomy showed favorable results for the management of myopic foveoschisis. Photoreceptor layer defects and irregular choroidal surfaces on spectral-domain optical coherence tomography persist despite surgery, limiting visual outcome.