Retinal Detachment Without Macular Hole in Highly Myopic Eyes

A study by the Tokyo Medical and Dental University Graduate School, Tokyo, Japan, found a significant prevalence level of foveal retinal detachment without macular hole in patients with highly myopic eyes who had severe myopic degenerative changes and posterior staphyloma.

Clinicians performed complete ophthalmic examinations and studied cross-sectional images of the macula with optical coherence tomography (OCT) in 134 eyes of 78 consecutive patients with high myopia (refractive error of -8D or more). The patients were divided into two groups according to the presence (Group One: 78 eyes of 45 patients) or absence (Group Two: 56 eyes of 33 patients) of posterior staphyloma. Slitlamp examination with a Goldmann three-mirror lens indicated that none of the eyes had a macular hole.

In seven (9.0 percent) of eyes in Group One, OCT revealed foveal retinal detachment, and 2 of those 7 had foveal retinoschisis. OCT revealed no retinal detachment or retinoschisis in any eye in Group Two. Visual acuity of the seven eyes with foveal retinal detachment in Group One ranged from 20/40 to 20/200. Two of these 7 eyes had visual acuity 20/50 or better. No patients complained of recent, progressive visual impairment. All 7 eyes with foveal retinal detachment had severe myopic fundus changes (focal chorioretinal atrophy or bare sclera).

In eyes with this type of retinal detachment, visual acuity varies and foveal retinal detachment tends to be missed on routine examination. Researchers suggest periodic examination by OCT in patients with highly myopic eyes who have severe myopic degenerative changes and posterior staphyloma