Development of Macular Hole and Macular Retinoschisis in Eyes with Myopic Choroidal Neovascularization

• Published in: American journal of ophthalmology 2008, Vol.145 (1), p.155-161.e1
• Main Authors: Shimada, Noriaki, Ohno-Matsui, Kyoko, Yoshida, Takeshi, Futagami, Soh, Tokoro, Takashi, Mochizuki, Manabu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atrophy; Biological and medical sciences; Choroid - pathology; Choroidal Neovascularization - diagnosis; Choroidal Neovascularization - etiology; Eyes & eyesight; Female; Humans; Macular degeneration; Male; Medical imaging; Medical sciences; Middle Aged; Miscellaneous; Myopia, Degenerative - complications; Myopia, Degenerative - diagnosis; Ophthalmology; Optics; Patients; Retina - pathology; Retinal Perforations - diagnosis; Retinal Perforations - etiology; Retinopathies; Retinoschisis - diagnosis; Retinoschisis - etiology; Review boards; Risk Factors; Tomography; Tomography, Optical Coherence; Vision disorders
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2007.08.029

Purpose To determine whether the chorioretinal atrophy (ChRA) adjacent to a choroidal neovascularization (CNV) is related to the development of a macular hole or macular retinoschisis in highly myopic eyes. Design Observational case series. Methods One hundred and eighty-one eyes of 125 patients with high myopia were divided into three groups: group 1 had a myopic CNV surrounded by ChRA larger than 1 disk area (43 eyes), group 2 had a myopic CNV surrounded by a ChRA smaller than 1 disk area (45 eyes), and group 3 did not have CNV (93 eyes). Optical coherence tomography (OCT) was used to evaluate the macular morphologic features, for example, macular holes and macular retinoschisis. Results A macular hole was detected by OCT in six eyes (14%) in group 1 and in none of the eyes in groups 2 and 3. The hole always existed at the border between an old CNV and the surrounding ChRA. A macular retinoschisis was detected in four eyes (9%) in group 1 and in eight eyes (9%) in group 3. The macular retinoschisis seen in group 1 appeared markedly less column-like than those in group 3. It was somewhat difficult to differentiate a retinal detachment from retinoschisis in the eyes in group 1. Conclusions Eyes at the atrophic stage of myopic CNV have a higher risk of developing a macular hole, and we recommend periodic OCT examinations for macular holes or macular retinoschisis, even in asymptomatic, highly myopic eyes, after the CNV has progressed to the atrophic stage.