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Development of Macular Hole and Macular Retinoschisis in Eyes with Myopic Choroidal Neovascularization
American Journal of Ophthalmology, Volume 145, Issue 1, January 2008, Pages 155-161.e1
Abstract: PurposeTo determine whether the chorioretinal atrophy (ChRA) adjacent to a choroidal neovascularization (CNV) is related to the development of a macular hole or macular retinoschisis in highly myopic eyes.DesignObservational case series.MethodsOne hundred and eighty-one eyes of 125 patients with high myopia were divided into three groups: group 1 had a myopic CNV surrounded by ChRA larger than 1 disk area (43 eyes), group 2 had a myopic CNV surrounded by a ChRA smaller than 1 disk area (45 eyes), and group 3 did not have CNV (93 eyes). Optical coherence tomography (OCT) was used to evaluate the macular morphologic features, for example, macular holes and macular retinoschisis.ResultsA macular hole was detected by OCT in six eyes (14%) in group 1 and in none of the eyes in groups 2 and 3. The hole always existed at the border between an old CNV and the surrounding ChRA. A macular retinoschisis was detected in four eyes (9%) in group 1 and in eight eyes (9%) in group 3. The macular retinoschisis seen in group 1 appeared markedly less column-like than those in group 3. It was somewhat difficult to differentiate a retinal detachment from retinoschisis in the eyes in group 1.ConclusionsEyes at the atrophic stage of myopic CNV have a higher risk of developing a macular hole, and we recommend periodic OCT examinations for macular holes or macular retinoschisis, even in asymptomatic, highly myopic eyes, after the CNV has progressed to the atrophic stage.
