Outcomes Of Surgery For Myopic Foveoschisis

1. Elaine Huang
2. BK Loh
3. Doric Wong

Singapore National Eye Centre, Singapore.

Purpose
To determine the visual and anatomical outcomes of surgery for myopic foveoschisis.

Methods
Retrospective review of 17 patients who underwent surgery between June 2006 to May 2010 at the Singapore National Eye Centre. All patients underwent trans pars plana vitrectomy with internal limiting membrane peel and gas tamponade.

Results
Mean age was 59.3+/-8.7 years with 7 males, 10 females. Mean refractive error was –12.9+/-5D with axial length of 29.6+/-1.3 mm. Mean interval from symptom onset to surgery was 8.7+/-8.6 months. C2F6 was used in 11 patients and C3F8 in 6. Mean duration of post-operative follow-up was 12.3+/-7.5 months. Mean pre-operative best corrected visual acuity(BCVA) was 6/60(logMar 1.07+/-0.45) and mean post-operative BCVA was 6/21(logMar 0.53+/-0.7) with 5.44+/-8.6 Snellen lines of visual improvement after surgery (p=0.016). 81.3% had post-operative visual improvement of 3 or more Snellen lines. The visual acuity in 12.5% remained unchanged post-op although anatomical improvement was achieved. 6.3% had worsened post-operative vision as a result of chorioretinal atrophy of the macula, although resolution of the foveal detachment was documented on optical coherence tomography. Foveal detachment was present in 88.2% pre-operatively with resolution of the detachment in all patients post-op. The mean post-operative reduction in central retinal thickness was 441.9+/-175.3 (pre-op 654.7+/-179.7, post-op 212.8+/-56.7), p<0.001.

Conclusions
Visual outcomes were better with surgery performed before significant retinal pigment epithelial/chorioretinal atrophy set in. The presence of foveal detachment did not preclude visual improvement after surgery. No recurrence of schisis or detachment was noted over the period of follow-up.