Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan; and.
Musashino Red-Cross Hospital, Musashino, Japan.
Retina. 2020 Aug;40(8):1500-1511. doi: 10.1097/IAE.0000000000002627.
To determine the morphological and physiological outcomes and safety of vitrectomy with fovea-sparing internal limiting membrane peeling for myopic macular retinoschisis (MRS).
Highly myopic eyes (refractive error greater than -8.0 diopters or an axial length longer than 26.5 mm) with MRS that underwent vitrectomy with fovea-sparing internal limiting membrane peeling were analyzed retrospectively. The best-corrected visual acuity, retinal morphology, and the central and paracentral retinal sensitivities at 2°/6° by microperimetry were evaluated before and after the surgery. Postoperative microscotomas were also determined.
Thirty-three eyes with MRS; 16 eyes with and 17 eyes without a foveal retinal detachment, were studied. All 33 eyes had an improvement of MRS and foveal retinal detachment partially or completely after surgery, and none developed a full thickness macular hole. The postoperative best-corrected visual acuity, the central retinal sensitivity, and the retinal sensitivity at 2° were significantly better than the preoperative values. Sixteen eyes developed postoperative microscotomas at paracentral 2° and/or 6°.
The results showed that vitrectomy with fovea-sparing internal limiting membrane peeling is an effective and safe method to treat an MRS regardless of the presence of a foveal retinal detachment. However, careful follow-up should be performed to detect postoperative microscotomas.
观察保留中心凹的内界膜剥除术治疗近视性黄斑劈裂（MRS）的形态学和生理学转归及安全性。
回顾性分析了行保留中心凹的内界膜剥除术的高度近视（屈光不正>-8.0 屈光度或眼轴长度>26.5mm）伴 MRS 患者的临床资料。比较术前和术后最佳矫正视力、视网膜形态以及微视野计测量的中央和旁中心视网膜敏感度。
33 只眼伴 MRS，其中 16 只眼合并中心凹视网膜脱离，17 只眼不合并中心凹视网膜脱离。所有患眼的 MRS 和部分或完全性中心凹视网膜脱离在术后均得到改善，无全层黄斑裂孔形成。术后最佳矫正视力、中央视网膜敏感度和 2°处视网膜敏感度均较术前显著提高。16 只眼术后在旁中心 2°和/或 6°出现微视野缺损。
结果表明，保留中心凹的内界膜剥除术是治疗 MRS 的一种有效且安全的方法，无论是否合并中心凹视网膜脱离。然而，应密切随访以发现术后微视野缺损。
