Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Ophthalmology

Purpose: To investigate the anatomical and visual outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) removal for patients with symptomatic myopic foveoschisis(MF) with or withoutmacular hole (MH). Patients & methods: This is prospective interventional case series study included 20 eyes (20 patients) with symptomatic MF; subgroup A (10 eyes) MFwithoutMH, and subgroup B (10 eyes) withMH. All cases underwent PPV combined with ILM peeling and fluid-air exchange in subgroup A and silicone oil temponade in subgroup B. Main outcome measures were the rate of resolution of MF, central foveal thickness (CFT) and rate of MH closure measured by Optical coherence tomography (OCT) and best-corrected visual acuity (BCVA). Results: Mean preoperative logMAR BCVAwas1.6 ± 0.2 in subgroup A (2/60) on Snellen chart and 1.6 ± 0.4 in subgroup B (2/60) on Snellen chart with no statically significant difference between both subgroups (p=0.935). In subgroup A, OCT showed that the highest foveal detachment was 849 ± 296.1 æm (429 - 1238 æm). In subgroup B, it was 987.2 ± 326.2 æm (610-1570 æm), with no statistically significant difference between both subgroups (p=0.406). The diameter of the MH was 430.3 ±241.9 æm (180-976 æm). After and ILM peeling, the mean logMAR BCVA in the both subgroups increased significantly to 1.0± 0.2 logMAR in subgroup A (6/60) on Snellen chart and to 1.1 ± 0.3 logMAR in subgroup B (5/60) on Snellen chart(p< 0.001) and no statistically significant difference between both subgroups (p=0.640). OCT showed that all patients achieved complete postoperative reattachment with CFT of 181± 34.4 æm (130-220æm) in subgroup A, and 183.6± 33.6 æm (127-227 æm) in subgroup B with no statistically significant difference between both subgroups (p<0.762) and was statistically significant difference from preoperative values in both subgroups (p< 0.001). In subgroup B, MH closed in 6 cases (60%). Conclusions: The study showed that PPV and ILM peeling appears to be effective in the treatment of MF with or without MH

Issued also as CD