Supra choroidal buckling in managing myopic vitreoretinal interface disorders: 1-year data

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Disorders

Background:

• Myopic vitreomacular interface disorders, such as myopic foveoschisis and macular hole retinal detachment, pose significant challenges in treatment, particularly in eyes with posterior staphyloma.
• Conventional treatments may have limited success in complex or recurrent cases, necessitating novel approaches.

Purpose of the Study:

• To evaluate the efficacy of a novel supra choroidal buckling procedure using a supra choroidal catheter for treating myopic vitreomacular interface disorders.
• To assess the outcomes in challenging cases of myopic traction maculopathy, including those with macular hole retinal detachment and posterior staphyloma.

Main Methods:

• A supra choroidal catheter delivered hyaluronic acid into the supra choroidal space, creating an indentation effect.
• Pars plana vitrectomy was performed without internal limiting membrane peeling in 23 patients (11 with myopic foveoschisis, 12 with myopic macular hole retinal detachment).
• Patients were followed for 1 year with clinical and optical coherence tomographic evaluations.

Main Results:

• Complete retinal layer restoration was observed in all 11 eyes with myopic foveoschisis within 2-6 weeks, with no recurrence.
• Visual acuity improved by at least one line in 81.8% of foveoschisis cases.
• Macular holes closed in 83% of the 12 macular hole detachment cases, with 66.6% showing visual acuity improvement and no recurrence over 12 months.

Conclusions:

• Supra choroidal indentation is an effective method for managing myopic foveoschisis and myopic macular hole with detachment, even in eyes with failed primary vitrectomy.
• This technique effectively counteracts the effects of posterior staphyloma in these conditions.
• The indentation effect proved sufficient and stable throughout the 1-year follow-up period.