Vitrectomy Resolves a Majority of Myopic Foveoschisis Cases

Cutter is reintroduced to remove final piece of humor, during a pars plana vitrectomy.
Central foveal thickness decreases and early resolution of inner retinoschisis may serve as early biomarkers of surgical success.

The complete resolution of myopic foveoschisis (MFS) often occurs within 1 year of receiving pars plana vitrectomy (PPV), according to a study published in Ophthalmology Retina. 

Researchers reviewed the medical records of consecutive patients with MFS who underwent vitreoretinal surgery and were followed postoperatively for at least 6 months (39 eyes, 36 patients, mean age 63.9±10.1 years, 29 women, mean follow-up 14.8±12.9 months). They measured central foveal thickness (CFT) and determined the presence of a foveal involvement, inner retinoschisis (IRS), outer retinoschisis (ORS) and foveal detachment (FD). The team defined anatomical success as the resolution of foveal ORS and FD.

The investigators determined that anatomical success occurred in 82% of participants at the study conclusion, and in more than 80% of cases within the first year. After 3 months, CFT significantly decreased in 79% of patients. 

Researchers noted that IRS, which presented in 18 eyes (46%) at baseline, resolved in all cases after a median 1 month period. Foveal ORS, which presented in 100% of study participants, resolved in 82% of patients after 3 months. Patients with FD (n=23), experienced a resolution in 91% of cases. After a median 12 months, extrafoveal ORS resolved in 59% of cases (100% of participants at baseline). 

The mean BCVA significantly improved from 0.80±0.64 logMAR (Snellen Eq 20/148) to 0.48±0.52 logMAR (Snellen Eq 20/70), according to the report. 

“The complete resolution of MFS is a slow process that occurs within 12 months after surgery in most cases,” according to the researchers. “The decrease in CFT and early resolution of IRS could be used as early biomarkers of surgical success.”

Study limitations include its retrospective nature and the inability to measure all participants with the same device.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.  

Reference

Beaumont W, Couturier A, Gaudric A, Tadayoni R, Philippakis E. Myopic foveoschisis completely resolves within 12 months after vitrectomy. Ophthalmol Retina. Published online June 14, 2022. doi:10.1016/j.oret.2022.06.003