Journal d'ophtalmologie clinique et expérimentale
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Structural and Perfusional Findings in Surgically Resolved Myopic Foveoretinal Detachment Eyes and those in Early Stages of Myopic Traction Maculopathy

Miguel A. Quiroz-Reyes, Erick A. Quiroz-Gonzalez, Jorge Morales-Navarro, Miguel A. Quiroz-Gonzalez, Boris Moreno-Andrade, Mario Carranza-Casas, Ana L. Diazceballos-Garcia, Alejandra Nieto-Jordan, Virgilio Lima-Gomez, Federico Graue-Wiechers

Purpose: To compare quantitative changes in macular perfusion in normal eyes, healthy highly myopic eyes, non-operated eyes with Myopic Foveoschisis (MF)/Foveoretinal Detachment (FRD), and operated eyes with early stages of Macular Traction Maculopathy (MTM) and fully resolved myopic FRD.

Methods: This retrospective, consecutive, comparative, interventional, single-surgeon, multicentric, case–control study was conducted in 118 eyes (104 individuals) between October 2017 and April 2021. Subjects included normal emmetropic eyes (control emmetropia, n=25), healthy myopic eyes (control high myopia, n=20), non-operated eyes with FRD (non-surgical observational group, n=28), and operated and structurally fully resolved myopic eyes with FRD (surgically treated group, n=45). Long-term postoperative structural, functional and perfusional follow-up evaluations were performed using Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT angiography. The primary outcome measures included structural and perfusional macular status across groups.

Results: In the surgical group, the mean evolution time of myopic FRD was 6.2 ± 3.5 months. The mean follow-up time was 23.9 ± 12.1 months. The mean time for the myopic FRD resolution was 5.0 ± 2.1 weeks. The median best-corrected visual acuity in the FRD surgical group improved from 0.90 logarithm of the minimum angle of resolution (logMAR; 0.60-1.00) to 0.30 logMAR (0.09-1.00), which was highly significant (p<0.0001). Quantitative Vessel Density (VD) evaluation findings were significantly different among groups (p<0.001). The superficial Foveal Avascular Zone (FAZ) area was significantly greater in the non-surgical group (p<0.0001). Better final visual acuity results were significantly correlated with less SD-OCT structural postoperative findings and greater VD quantification values (p<0.05). Central subfield foveal thickness was significantly greater in the observational group and significantly lesser in the surgery group (both p<0.05).

Conclusion: The results showed a high incidence of postoperative microstructural abnormalities on SD-OCT (48.5%) in the surgical group, high incidence of statistically significant VD quantitative deficiencies and FAZ abnormalities, and significant VD improvement in the fully surgically resolved myopic FRD, relative to the nonsurgical group (p<0.05).