Early vitrectomy for myopic foveoschisis before foveal detachment.

OBJECTIVE

To compare the surgical outcomes of myopic foveoschisis (MF) with preoperative attached versus detached fovea.

DESIGN

A retrospective interventional case series.

PARTICIPANTS

Eyes with MF that underwent vitrectomy were included and were divided into an attached fovea group (26 eyes) and a detached fovea group (54 eyes).

METHODS

Preoperative and postoperative best-corrected visual acuity (BCVA) and optical coherence tomography were analysed. The impact of cataract and posterior vitreous detachment were also assessed.

RESULTS

Surgical complications were low and comparable between the two groups (p = 0.830), and the BCVA was similar between the groups at postoperative 6 and 12 months. Ellipsoid zone (EZ) restoration at 6 months was significantly greater in the attached fovea group (12/26 eyes, 46%) than in the detached group (12/54 eyes, 22%; p = 0.037). A trend toward greater restoration was observed at 12 months in the attached group (15/26 [58%] versus 24/54 [44%]; p = 0.098). Eliminating the effect of cataract, the pseudophakic subgroup analyses showed only those with a baseline attached fovea had improved BCVA (p = 0.028). Furthermore, only the 55 eyes with attached posterior vitreous preoperatively showed significant BCVA improvement at 12 months (p < 0.001), whereas the 25 eyes with a preoperative detached vitreous did not (p = 0.390).

CONCLUSIONS

Early vitrectomy in MF before foveal detachment preserves outer retinal integrity and may result in better visual acuity outcomes. Future studies are needed to confirm this and should investigate the impact of posterior vitreous detachment on the outcomes.