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Prognostic Factors Related with Surgical Outcome of Vitrectomy in Myopic Traction Maculopathy

Korean Journal of Ophthalmology 2020년 34권 1호 p.67 ~ 75
 ( Kim Chung-Young ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Ophthalmology

김민석 ( Kim Min-Seok ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Ophthalmology
 ( Kim Kyoung-Lae ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Ophthalmology
우세준 ( Woo Se-Joon ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Ophthalmology
박규형 ( Park Kyu-Hyung ) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Ophthalmology

Abstract


Purpose: To investigate prognostic factors related to the surgical outcome of vitrectomy in myopic traction maculopathy (MTM).

Methods: Medical records of patients with MTM who underwent pars plana vitrectomy with internal limiting membrane peeling and follow-up over 12 months were reviewed retrospectively. Best-corrected visual acuity (BCVA), fundoscopic examination and spectral-domain optical coherence tomography findings were evaluated postoperatively. Functional success was defined as visual acuity gain and anatomical success was defined as reduction or resolution of foveoschisis without complications.

Results: This study included 40 eyes of 36 patients. BCVA improved from 0.70 ± 0.44 to 0.63 ± 0.57 logarithm of minimum angle of resolution and central macular thickness decreased from 526.6 ± 132.1 to 277.8 ± 92.1 μm at final follow-up. Functional success was achieved in 24 (60.0%) eyes, and 33 (82.5%) eyes reached anatomical success. Presence of foveal detachment (FD) and higher category of myopic maculopathy were associated with both functional (p = 0.014, 0.021, respectively) and anatomical (p = 0.011, 0.022, respectively) failure. Longer preoperative axial length showed an association with functional failure but not with anatomical failure (p = 0.041). In multivariate analysis, FD was the only prognostic factor for both functional and anatomical outcome (p = 0.041, 0.043, respectively). Preoperative BCVA (r2 = 0.259, p = 0.001), axial length (r2 = 0.172, p = 0.008), and myopic maculopathy category (r2 = 0.336, p < 0.001) showed significant correlation with final BCVA.

Conclusions: More severe myopic maculopathy and the presence of FD are associated with poorer functional and anatomical outcomes of pars plana vitrectomy in MTM. Better preoperative BCVA, shorter axial length, and less severe myopic maculopathy are correlated with better final BCVA.

키워드

Myopic foveoschisis; Myopic traction maculopathy; Optical coherence tomography; Vitrectomy
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