[Pathogenesis and treatment of myopic foveoschisis]

Myopic foveoschisis (MF) can now be recognized as the result of recent progress in imaging diagnostic technology such as optical coherence tomography (OCT). MF predominantly occurs in highly myopic eyes with posterior staphyloma, and often induces visual loss and/or metamorphopsia. In order to better understand the detailed pathogenesis of MF, we observed 21 myopic eyes after vitrectomy using OCT. Retinal microfolds along the retinal vessels were observed in over 60% of the patients 6 months after surgery. Relative inflexibility of retinal arterioles/venules may be one of the causes for MF. We performed a pilot study (6 eyes of 5 patients) to treat MF by vitrectomy including vitreous cortex removal, internal limiting membrane peeling, and gas tamponade. In all 6 eyes the fovea was reattached and vision improved by more than two lines. This pilot study indicates that vitrectomy is an effective and safe treatment for MF.