CHARACTERISTICS AND MANAGEMENT OF MYOPIC TRACTION MACULOPATHY IN MYOPIC EYES WITH AXIAL LENGTH LESS THAN 26.5 mm

Abstract

Purpose:To explore the characteristics and underlying mechanisms of myopic traction maculopathy (MTM) with axial length less than 26.5 mm and to assess the effectiveness of macular buckling for the treatment of MTM.Methods:Thirty-eight MTM eyes with axial length less than 26.5 mm were prospectively enrolled. Thirty-one eyes received surgery, and they were followed up for at least 6 months. Characteristics of MTM and surgical outcomes were evaluated.Results:Of the MTM eyes, 92.11% (35/38) showed posterior staphyloma. Narrow macular staphyloma was the most common type (54.29%, 19/35), followed by peripapillary (37.14%, 13/35). Three cases (8.57%) had wide macular staphyloma, and 44.74% of cases (17/38) had vitreoretinal traction. Twenty-two MTM eyes of type T3 underwent macular buckling surgery, and all the cases achieved foveal reattachment after the surgery. The mean best-corrected visual acuity improved significantly at the 6-month follow-up (P < 0.001). Nine MTM eyes of type T4 or T5 received combined surgery, all macular holes recovered, and the best-corrected visual acuity also improved postoperatively (P = 0.008) as of the 6-month visit.Conclusion:Posterior staphyloma might serve as the initial force of the pathogenesis of MTM in eyes with axial length ˂26.5 mm. Macular buckling is a productive way to improve the MTM.

Incidence and Risk Factors for Retinal Detachment Following Pediatric Cataract Surgery

“…Compared with previous studies that showed that an increase in AL is associated with a higher likelihood of RD, our findings indicate that a shorter preoperative AL reduces the risk of RD. [14][15][16] This aligns with the established link between longer eyes and increased risk of detachment. 17 While several reports have identified longer AL as a risk factor for detachment in children after surgery, most have only briefly touched upon this subject.…”

“…The findings of Mimura et al and Chen et al provide evidence for this claim. 14,17 It is possible that the shorter AL (≤ 23.4 mm in our patient group helped to protect against increased vitreoretinal traction), which may have contributed to the development of retinal tears or detachment after pediatric cataract surgery. This protective mechanism warrants further investigation given its potential clinical implications.…”

Differences in the Progression between Myopic Maculoschisis Eyes with and without Macular Detachment in the Natural Course of the Disease: A Retrospective Longitudinal Study based on the New Myopic Traction Maculopathy Staging System

“…In addition, our previous study presented favorable outcomes of MTM eyes after receive MB surgery, some of which had VIFs. 26 Dome-shaped macula is recognized as a protective factor for the occurrence of MTM. 27 One of the morphological results of MB surgery is the formation of an iatrogenic dome-shaped macula, leading to an effective mitigation of MTM and preventing its deterioration.…”

Visualized analysis of research on myopic traction maculopathy based on CiteSpace

“…Parolini et al [41] retrospectively reviewed 157 MTM eyes after MB or PPV or combined surgery, and concluded that PPV is better in addressing the tangential traction existing on the vitreo-retinal surface, while MB is better in resolving the perpendicular traction induced by posterior staphyloma. As the PPV and MB focus on two different aspects of the MTM pathology, surgeons should select proper approaches according to the MTM stages and classifications, separately or combined [50][51][52] .…”