Causative Factors of Retinal Detachment in Macular Holes

Morita, Hiroyuki; Ideta, Hidenao; Ito, Kyutaro; Yonemoto, Junichi; Sasaki, Kyoshiro; Sumiyoshi, Tetsuya

doi:10.1097/00006982-199111030-00002

Cited by 123 publications

(64 citation statements)

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“…A literature review reveals that the formation of MH in high myopia involves complex traction forces from various directions, including vitreous anterior-posterior traction, oblique or tangential traction from partially or undetached posterior hyaloid, traction from epiretinal membrane, internal limiting membrane (ILM) induced tangential traction, posterior outward traction from the staphyloma, and retinal vessel traction. [6][7][8][9][10][11] These factors, alone or in combination, may induce MH formation through mechanisms different from those underlying idiopathic MH. Before the MH formation, the macula may have normal configuration, may show schisis cavity, or may develop schisis with subfoveal detachment.…”

Section: Introductionmentioning

confidence: 99%

The development and evolution of full thickness macular hole in highly myopic eyes

Yang

2015

Eye

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Purpose To evaluate the morphological changes before and after the formation of a full-thickness macular hole (MH) in highly myopic eyes. Patients and methods Retrospective observational case series. From 2006 to 2013, clinical records of patients with MH and high myopia who had optical coherence tomography (OCT) before the development of MH were reviewed. All patients had been followed for more than 1 year since MH formation to observe the morphological changes.Results Twenty-six eyes of 24 patients were enrolled. The initial OCT images could be classified into four types: (1) normal foveal depression with abnormal vitreo-retinal relationship (eight cases), (2) macular schisis without detachment (six cases), (3) macular schisis with concomitant/subsequent detachment (nine cases), and (4) macular atrophy with underlying/adjacent scar (three cases). After MH formation, one case in type 1 and one case in type 4 group developed retinal detachment (RD). In type 2 group, four cases developed RD at the same time of MH formation. The preexisting detachment in type 3 group extended in eight cases and improved in one case. Among all the cases, 14 eyes received vitrectomy and 7 eyes received gas injection. MH sealed in nine eyes after vitrectomy and four eyes by gas injection. Conclusion The study revealed four pathways of MH formation in highly myopic eyes. MH from macular schisis tended to be associated with detachment. However, the evolution and the results of surgical intervention were not always predictable.

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Section: Introductionmentioning

confidence: 99%

The development and evolution of full thickness macular hole in highly myopic eyes

Yang

2015

Eye

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“…Macular hole with posterior retinal detachment (RD) is a well-known complication of posterior staphyloma in highly myopic eyes. 4 There were some highly myopic patients who presented with poor vision without a macular hole or RD, which made it difficult to explain the reason for poor visual acuity based on biomicroscopy. Recent studies using OCT demonstrated asymptomatic macular holes, foveal retinal detachment without a macular hole, and myopic traction maculopathy in highly myopic eyes.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with foveoschisis and foveal detachment without macular hole in high myopia

Chen

et al. 2007

Eye

127

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Purpose To investigate the associated factors of foveoschisis and foveal detachment without macular hole in highly myopic eyes. Methods A cross-sectional study of 124 eyes of 68 highly myopic patients was performed. The patients underwent complete ocular examination, fundus photography, and optical coherence tomography (OCT). Results Of the 124 eyes, 10 (8%, 10/124) had foveoschisis or foveal detachment without a macular hole on OCT examination. On the basis of univariate analysis, six variables were associated with the pathologic changes, including age over 40 years (P ¼ 0.018), spherical equivalent over 10 D (P ¼ 0.042), axial length over 31 mm (P ¼ 0.001), macular chorioretinal atrophy (P ¼ 0.00003), posterior staphyloma (P ¼ 0.0003), and vitreoretinal interface factors, including epiretinal membrane, posterior vitreoschisis, and vitreomacular traction (P ¼ 0.00002). In the multivariate analysis, three factors were independently associated with foveoschisis and foveal detachment without macular hole in high myopia: axial length, macular chorioretinal atrophy, and vitreoretinal interface factors. Conclusions Foveoschisis and foveal detachment without macular hole are sight-threatening disorders in highly myopic eyes. Axial length, macular chorioretinal atrophy, and vitreoretinal interface factors were independently associated with these pathological conditions. Thus, both intraocular and outer ocular wall factors play important roles and merit further study.

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“…As Morita et al[ 10] have described, the existence of posterior staphyloma and chorioretinal atrophy associated with high myopia are factors leading to detachment of the retina in the presence of a macular hole. There have also been several reports that have suggested that the presence of an epiretinal membrane and residual vitreous around the macular hole prevent reattachment of the retina in macular hole retinal detachment of highly myopic eyes [9, 14, 15].…”

Section: Discussionmentioning

confidence: 99%

“…However, except for eyes with high myopia, few cases of macular hole are accompanied by retinal detachment. It has been suggested that the risk of a macular hole causing retinal detachment is significantly increased in eyes with high myopia, posterior staphyloma, and chorioretinal atrophy [9, 10]. The presence of posterior staphyloma and retinochoroidal atrophy at the macula in highly myopic eyes weakens retinochoroidal adhesion.…”

Section: Introductionmentioning

confidence: 99%

Scleral Resection Technique Combined with Vitrectomy for a Macular Hole Retinal Detachment in Highly Myopic Eyes

Kono¹,

Takesue²,

Shiga³

2006

Ophthalmologica

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Purpose: To evaluate scleral resection technique combined with vitrectomy for macular hole retinal detachment of highly myopic eyes. Materials and Methods: Seventeencases (17 eyes) of macular hole retinal detachment in highly myopic eyes, in which the patient underwent vitrectomy combined with scleral resection technique formacular hole retinal detachment between January 1996 and December 2003 at Fukuoka University Chikushi Hospital, were studied.Following pars plana vitrectomy, as much as possible of the residual vitreous and/or epiretinal membrane was removed. A scleral resection was performed in 2 quadrants of the equatorial region of the temporal sclera. Finally, a fluid-air exchange with SF₆ gas injection was performed to achieve retinal attachment. Pre- and postoperative axial length of the eyeballs were measured by B-scan ultrasonography. Results: All cases had the retina reattached at the initial surgery, and visual acuities were stabilized or improved after the surgery. The posterior staphyloma became obscure in 13 out of 17 eyes (76.8%). The macular hole closed in 14 of 17 eyes (82.4%) ophthalmoscopically. There were no cases in which retinal redetachment occurred during follow-up periods of more than 6 months. Conclusion: In cases of macular hole retinal detachment of a highly myopic eye, scleral resection technique combined with vitrectomy changed the shape of the eyeballs and allowed successful retinal reattachment at the initial surgery.

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Causative Factors of Retinal Detachment in Macular Holes

Cited by 123 publications

References 0 publications

The development and evolution of full thickness macular hole in highly myopic eyes

The development and evolution of full thickness macular hole in highly myopic eyes

Factors associated with foveoschisis and foveal detachment without macular hole in high myopia

Scleral Resection Technique Combined with Vitrectomy for a Macular Hole Retinal Detachment in Highly Myopic Eyes

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