EXTREME MACULAR SCHISIS-SIMULATING RETINAL DETACHMENT IN EYES WITH PATHOLOGIC MYOPIA

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• Pathologic myopia can lead to complex macular pathologies.
• Myopic traction maculopathy is a common complication in highly myopic eyes.
• Distinguishing simulated retinal detachment from true detachment is crucial for treatment.

Purpose of the Study:

• To characterize extreme macular schisis simulating retinal detachment (EMSSRD) in pathologic myopia.
• To investigate the natural course and surgical outcomes of EMSSRD.
• To differentiate EMSSRD from other myopic macular pathologies.

Main Methods:

• Retrospective analysis of 617 highly myopic eyes with myopic traction maculopathy.
• Diagnosis of EMSSRD based on optical coherence tomography (OCT) findings: high retinal elevation (>500 µm), indistinct columnar structures, and residual outer retinal tissue.
• Comparison of clinical and imaging features, natural progression, and surgical outcomes.

Main Results:

• EMSSRD was identified in 25 out of 617 highly myopic eyes.
• All EMSSRD cases were associated with macular atrophy secondary to myopic macular neovascularization.
• Surgical intervention in 10 eyes showed no significant difference in visual acuity outcomes between EMSSRD and myopic hole-related detachment (MHRD) progression.

Conclusions:

• EMSSRD is a distinct clinical entity in severely myopic eyes with macular atrophy.
• OCT findings are key to differentiating EMSSRD from MHRD, particularly the presence of thin retinal remnants.
• Surgical management of EMSSRD yields comparable visual outcomes to MHRD, suggesting similar therapeutic potential.