Lee Cheng-Yung, Ho Tzyy-Chang, Chen San-Ni, Chen Shih-Jen, Wu Tsung-Tien, Hsieh Yi-Ting, Wu Wei-Chi, Cheng Cheng-Kuo, Wu Pei-Chang, Kuo Shu-Chun, Yang Chung-May
Department of Ophthalmology, National Taiwan University Hospital Hsin-Chu Hospital, Hsinchu City, Taiwan.
Department of Ophthalmology, National Taiwan University Hospital, No 7, Chung-Shan S. Rd., Taipei, 10002, Taiwan.
Int Ophthalmol. 2025 May 5;45(1):174. doi: 10.1007/s10792-025-03526-1.
To develop a vitrectomy-based consensus on the definition, diagnosis, and management of myopic traction maculopathy (MTM).
Relevant literature was initially reviewed. Six key questions and six consensus statements were developed based on reference articles. Ten panelists then voted on the statements for consensus development.
MTM was defined as maculoschisis or maculoschisis with foveal disruption, including a lamellar macular hole (LMH), full-thickness macular hole (FTMH), and macular hole with retinal detachment (MHRD). A classification combining the status of maculoschisis and the type of foveal pathology was formulated. MHRD was regarded as the end stage of the MTM. Modern optical coherence tomography images of the macula, standard color fundus photography, periodical axial length measurement, and regular visual function tests with best-corrected visual acuity and Amsler's grid were four essential tools used for the diagnosis and follow-up of MTM. FTMH and MHRD are reliable surgical indications. Surgery may be indicated for maculoschisis, with or without LMH, if visual deterioration is observed. A visual acuity of less than 20/40 was set as the relative empirical requirement for surgery. The panel reached a consensus on the use of fovea-sparing ILM peeling and the inverted ILM flap technique for MTM with various structural changes.
The proposed consensus on the six important aspects of the MTM may serve as a valuable reference for clinicians in relevant fields in daily practice.
就近视性牵引性黄斑病变（MTM）的定义、诊断和治疗制定基于玻璃体切除术的共识。
首先对相关文献进行综述。基于参考文献文章提出了六个关键问题和六个共识声明。然后十名小组成员就这些声明进行投票以达成共识。
MTM被定义为黄斑劈裂或伴有黄斑中心凹破坏的黄斑劈裂，包括板层黄斑裂孔（LMH）、全层黄斑裂孔（FTMH）和伴有视网膜脱离的黄斑裂孔（MHRD）。制定了一种结合黄斑劈裂状态和黄斑中心凹病变类型的分类方法。MHRD被视为MTM的终末期。黄斑区的现代光学相干断层扫描图像、标准彩色眼底照片、定期眼轴长度测量以及使用最佳矫正视力和阿姆斯勒方格表进行的常规视觉功能测试是用于MTM诊断和随访的四项基本工具。FTMH和MHRD是可靠的手术指征。如果观察到视力下降，对于伴有或不伴有LMH的黄斑劈裂可能需要进行手术。将视力低于20/40设定为相对经验性的手术要求。小组成员就针对具有各种结构变化的MTM使用保留黄斑中心凹的内界膜剥除术和倒置内界膜瓣技术达成了共识。
所提出的关于MTM六个重要方面的共识可能为相关领域的临床医生在日常实践中提供有价值的参考。
