Objective To observe the long-term efficacy and safety of macular buckling (MB) in the treatment of high myopia traction maculopathy. MethodsA retrospective clinical study. From January 2014 to December 2017, 57 eyes of 57 patients with high myopia traction maculopathy who underwent MB treatment at Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study. Among them, there were 15 males with 15 eyes, average age was 51.80±10.72 years; there were 42 females with 42 eyes, average age was 59.14±11.51 years. There were 21 eyes of 21 cases with highly myopic macular hole with macular detachment (MHMD), and 36 eyes in 36 cases with highly myopic foveoschisis with macular detachment (FSMD), and they were grouped accordingly. All patients underwent best corrected visual acuity (BCVA), optical coherence tomography (OCT), and axial length (AL) measurements. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. All patients underwent MB, either on its own or combined with vitrectomy. Patients with significant vitreous macular traction on OCT were treated with combined surgery. One, 3, 6 months and 1, 2, 3, and 4 years after the operation, the same equipment and methods before the operation were used to conduct related examinations, and the long-term efficacy and safety of the two groups of eyes were observed. ResultsBefore surgery, the logMAR BCVA of eyes in MHMD group and FSMD group were 1.35±0.47 and 1.17±0.59, respectively; 4 years after surgery, they were 1.02±0.49 and 0.73±0.55, respectively. The BCVA improved significantly at postoperative 4 years than preoperative in both groups (P=0.039, 0.001). In the eyes with MHMD, the BCVA was found to be significant improved 3 years after surgery (P=0.042). Whereas, in the eyes with FSMD, the BCVA was found to be significantly improved 3 months after surgery (P=0.013). Macular reattachment was achieved in 100% of cases, while macular hole closure rate was achieved in 66.7% in the MHMD group. In the FSMD group, either macular reattachment rate or the foveoschisis resolution rate was 97.2%. After surgery, choroidal neovascularization was observed in 2 eyes, and 3 eyes with intraretinal cyst. ConclusionMB may represent a safe and effective surgical option for the treatment of high myopia maculopathy.
Objective To observe the choroidal thickness and its relationship with age and refraction status in Chinese population. Methods 180 healthy volunteers (360 eyes) were enrolled in this study. Based on the age, the volunteers were divided into A (20-29 years old), B (30-39 year old), C (40-49 years old), D (50-59 year old), E (60-69 year old), and F (70-85 year old) group, with 33, 31, 29, 30, 31, 26 volunteers respectively. And the volunteers were divided into ＜60 years old group with 123 volunteers and ge; 60 years old group with 57 volunteers. Enhanced depth imaging (EDI) choroidal scans were obtained in all eyes by using spectraldomain optical coherence tomography. Subfoveal choroidal thickness (CT) and CT at 1 mm/3 mm temporal, nasal, superior, inferior to the fovea (S 1 mm, I1 mm, T1 mm, N 1 mm, S, I3 mm, T3 mm, N3 mm) were measured. The differences of CT between different quadrants, genders, eyes and ages were comparatively analyzed. The correlations between age, refraction status and CT in the volunteers of ＜60 years old and ge; 60 years old group were analyzed. Results The subfoveal CT was (262.78plusmn;84.38) mu;m. The differences were significant between subfoveal CT and all the quadrants CT (P＜0.05) except for S1 mm and T1 mm (P＞0.05 ). There was no difference between genders or eyes in subfoveal CT (P＞0.05 ). There was no difference between A, B, C, D group in subfoveal CT (P＞0.05 ). The subfoveal CT of E and F group were thinner than A, B, C, D group (P＜0.05). In the ＜60 years old group, there was a positive correlation between refraction status and CT (r=0.147,P＜0.05); but no correlation between age and CT (r=－0.055, P＞0.05 ). In the ge; 60 years old group, there was a significant negative correlation between CT and age (r=－0.543, P＜0.05), but no correlation between refraction status and CT (r=-0.008, P＞0.05). Conclusions The average subfoveal CT in Chinese population was (262.78plusmn;84.38) mu;m. The refraction status is the main influence factors in subjects ＜60 years old, while the age is the main influence factors in subjects ge;60 years old.
Objective To evaluated the efficacy of vitreoretinal surgery for X-linked retinoschisis (XLRS) and its complications. Methods Twentyone XLRS patients (27 eyes) with retinal detachment or vitreous hemorrhage who were treated by vitreoretinal surgery were enrolled in this study. There were microcystislike splitting in all the eyes. The mean visual acuity was 0.11±0.09 and the mean area of macular splitting was (1.09±0.56) mm2. Among the eyes, there were 12 eyes with rhegmatogenous retinal detachment, five eye with traction retinal detachment, six eyes with vitreous hemorrhage and four eyes with retinal detachment and vitreous hemorrhage. All the patients underwent a standard threeport pars plana vitrectomy. Internal limiting membrane peeling, laser photocoagulation, and C3F8 gas or silicone oil tamponade were carried out in different condition. The follow-up was 9-122 months (average 51 months). The preoperative visual acuity and anatomic structure of retina were observed. Results The mean visual acuity at last visit was increased to 0.26±0.15, the difference was significant (t=-6.320, P=0.000). It improved in 20 eyes (74.1%), remained unchanged in seven eyes (25.9%). The retina remained attached in 27 eyes. The mean area of macular splitting was decreased to (0.29±0.21) mm2, the difference was significant (t=10.358, P=0.000). The complications were found in four eyes (14.8%) which including two eyes with proliferative vitroretinopathy and traction retinal detachment six and eight months after surgery, one eye with cataract four months after surgery, and one eye with vitreous hemorrhage 15 months after surgery. The retina remained attached in these four eyes after reoperation. Conclusion Vitreoretinal surgery can significantly improve visual acuity, resume the anatomic structure of retina.