Postoperative large intraretinal cavity and schisis with paravascular inner break in high myopia

To report distinct structural changes following surgery for myopic traction maculopathy (MTM).

A single-center, retrospective case series.

Patients with MTM who underwent vitrectomy and had persistent large intraretinal cavities and schisis were reviewed. The pre- and postoperative clinical findings and optical coherence tomography characteristics are described.

Five eyes of five patients were included in the study. Three patients had prominent schisis, and four had retinal/foveal detachment before surgery. All patients underwent fovea-sparing internal limiting membrane peeling during vitrectomy and had improved vision at 3 months after surgery. Large intraretinal cavities were noted on optical coherence tomography at the first postoperative exam in three patients and 12 to 18 months postoperation in the other two. The median height of the postoperative intraretinal cavities was 704 μm (range, 445-1287 μm). Inner retinal breaks were identified in all eyes, of which four were located in the paravascular area. The intraretinal cavity and schisis remained stable during the initial follow-up for an average of 35 months; later on, at > 5 years after the initial presentation two patients developed retinal detachment and one patient underwent vitrectomy with the retina reattached postoperatively.

Large intraretinal cavities and schisis can be observed after MTM surgery, associated with paravascular inner breaks. The condition can progress after a long stable period; therefore, continuous follow-up is necessary.