MORPHOLOGIC CHARACTERISTICS OF MACULAR HOLE AND MACULAR HOLE RETINAL DETACHMENT ASSOCIATED WITH EXTREME MYOPIA.

PURPOSE: To investigate the surgical results and morphologic characteristics of macular hole (MH) and macular hole retinal detachment (MHRD) associated with extreme myopia. METHODS: We retrospectively reviewed consecutive cases with axial length ≥28 mm who were treated with pars plana vitrectomy for MH or MHRD. The choroidal and scleral thickness at the fovea, presence of dome-shaped macula, and the height of posterior staphyloma 3 mm from the fovea were measured from postoperative optical coherence tomography images. RESULTS: Significant improvement in visual acuity was obtained postoperatively in both MH (16 eyes; 15 patients) and MHRD (19 eyes; 18 patients) groups (P < 0.05). Final MH closure rate was not significantly different between the groups (MH: 15/16, MHRD: 14/19, P = 0.19). Axial length was not significantly different between the groups (MH: 30.5 ± 1.5 mm, MHRD: 29.6 ± 1.3 mm, P = 0.098). Eyes with MH had significantly greater choroidal thickness (MH: 61.9 ± 66.0 µm, MHRD: 24.1 ± 19.8 µm, P = 0.045), greater scleral thickness (MH: 294 ± 77 µm, MHRD: 232 ± 89 µm, P = 0.008), higher frequency of dome-shaped macula (MH: 6/16, MHRD: 1/19, P = 0.032), and lower staphyloma height (MH: 190 ± 113 µm, MHRD: 401 ± 156 µm, P < 0.001). CONCLUSION: Surgical outcomes were generally favorable. The pathogenetic differences between the two conditions may be attributable to differences with respect to eye morphology.

Axial length changes in highly myopic eyes and influence of myopic macular complications in Japanese adults.

PURPOSE: To investigate changes of the axial length in normal eyes and highly myopic eyes and influence of myopic macular complications in Japanese adults. STUDY DESIGN: Retrospective longitudinal case series. METHODS: The changes in the axial length of 316 eyes from 316 patients (mean age, 63.8 ± 9.0 years; range, 34-82; 240 females) examined using IOLMaster with a follow-up period of at least 1 year were studied. This study included 85 non-highly myopic eyes (|refractive error| ≤ 5 diopters; 63 females; non-highly myopic group), 165 highly myopic eyes (refractive error ≤ -6 diopters or axial length ≥ 26 mm; 124 females) without macular complications (no complications group), 32 eyes (25 females) with myopic traction maculopathy (MTM group), and 34 eyes (28 females) with myopic choroidal neovascularization (CNV group). RESULTS: All groups showed a significant increase in the axial length during the follow-up period (mean follow-up, 28.7 ± 16.8 months; range, 12-78) (P < 0.01). Changes in the axial length/year in the no complications group (0.041 ± 0.05 mm) were significantly greater than those in the non-highly myopic group (0.007 ± 0.02 mm) (P < 0.0001). Furthermore, changes in the CNV group (0.081 ± 0.04 mm) were significantly greater than those in the no complications (P < 0.0001) and MTM (0.040 ± 0.05 mm) (P = 0.0059) groups, whereas no significant difference was found between the changes in the MTM and no complications groups (P = 0.91). Multiple regression analyses indicated that CNV eyes (P < 0.0001) and female patients' eyes (P = 0.04) showed greater changes in the axial length/year. CONCLUSIONS: All groups showed an increase in the axial length, which was greater for highly myopic eyes. In particular, CNV eyes showed greater increases, indicating that larger changes in the axial length may require careful follow-up.