Research progress in the classification, diagnosis and treatment of myopic traction maculopathy / 中华实验眼科杂志

ABSTRACT

Myopic traction maculopathy (MTM) is a general term for multiple pathological changes such as myopic retinoschisis (MRS), macular hole (MH), and macular detachment (MD) in highly myopic eyes.The new MTM classification methods based on optical coherence tomography, the size and the location of the outer MRS, the relationship of MTM with posterior staphyloma, occurrence of MH and MD deepen the understanding of the disease and effectively assess the condition and prognosis of the disease.The pathogenesis of MTM may be related to the perpendicular and tangential traction produced by vitreoretinal adhesion, internal limiting membrane, and the posterior staphyloma.In the natural course of MTM, the morphology and visual function of most patients with MRS remain stable, and the progression of MRS is related to the severity of schisis and damage to the outer retinal microstructure.Surgical treatment is effective for advanced MTM with significantly impaired visual function.Vitrectomy is the main treatment method for MTM.Macular buckling or combined surgery can be chosen for MRS with MH and/or MD, and posterior scleral reinforcement is also an option for the treatment of MTM with long axial length, posterior staphyloma and poor results of vitrectomy to achieve the goal of relieving internal and external traction and repositioning the retina.The effectiveness of the surgery is also related to a variety of factors.Enzymatic vitreolysis and scleral cross-linking techniques have also provided new ideas for the treatment of MTM.This article summarized the clinical features and treatment strategies of MTM to guide its diagnosis and treatment.