THE IMPACT OF POSTERIOR STAPHYLOMA ON CLINICAL OUTCOMES OF HIGH MYOPIC MACULAR HOLE: A Retrospective Cohort Study

To discuss the influence of posterior staphyloma types on clinical outcomes of patients with high myopic macular hole (HMMH) and discover clinical characteristics related to postoperative visual acuity, vessel densities, and retinal function.

This study included 44 eyes with HMMH, of whom 18 underwent internal limiting membrane (ILM) peeling technique and 26 eyes underwent inverted ILM flap technique. Ophthalmic examinations were performed preoperatively and postoperatively, including best-corrected visual acuity, intraocular pressure, optical coherence tomography angiography, and multifocal electroretinogram (mf-ERG). Three-dimensional magnetic resonance imaging (3D-MRI) reconstruction and ocular B-ultrasound were used to classify and grade posterior staphylomas.

Axial length was correlated with both depth and width of posterior staphyloma. Also, superficial capillary plexus vessel densities of narrow macular staphyloma type were significantly higher than that of the wide type in the peeling group. Furthermore, in grade 2 and grade 3, and both wide and narrow macular staphyloma types, the macular hole (MH) closure rate of the flap group was significantly higher than that of the peeling group. Correlation analysis showed that the presence of retinal detachment and initial best-corrected visual acuity (BCVA) were correlated with the final BCVA in the flap group, the age was correlated with the postoperative vessel density in the flap group, and microstructure restoration were correlated with the postoperative vessel density in both flap and peeling group.

Under similar posterior staphylomas condition, the inverted ILM flap technique may provide better MH closure outcomes and retinal function.