Myopic macular schisis: Insights into distinct morphological subtypes and novel biomechanical hypothesis
Issued Date
2023-01-01
Resource Type
ISSN
11206721
eISSN
17246016
Scopus ID
2-s2.0-85153620765
Pubmed ID
37073079
Journal Title
European Journal of Ophthalmology
Rights Holder(s)
SCOPUS
Bibliographic Citation
European Journal of Ophthalmology (2023)
Suggested Citation
Al-Sheikh M., Govetto A., Phasukkijwatana N., Matteucci M., Repetto R., Romano M.R., Virgili G., Zweifel S., Barthelmes D., Bailey Freund K., Sadda S.V.R., Sarraf D. Myopic macular schisis: Insights into distinct morphological subtypes and novel biomechanical hypothesis. European Journal of Ophthalmology (2023). doi:10.1177/11206721231166164 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82499
Title
Myopic macular schisis: Insights into distinct morphological subtypes and novel biomechanical hypothesis
Author's Affiliation
Siriraj Hospital
Humanitas Gavazzeni Hospital
VA Greater Los Angeles Healthcare System
Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi di Varese
Università degli Studi di Genova
Azienda Ospedaliera Careggi
Jules Stein Eye Institute
UniversitatsSpital Zurich
Vitreous Retina Macula Consultants of New York
Doheny Eye Institute
Save Sight Institute
Humanitas Gavazzeni Hospital
VA Greater Los Angeles Healthcare System
Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi di Varese
Università degli Studi di Genova
Azienda Ospedaliera Careggi
Jules Stein Eye Institute
UniversitatsSpital Zurich
Vitreous Retina Macula Consultants of New York
Doheny Eye Institute
Save Sight Institute
Other Contributor(s)
Abstract
Purpose: To analyze the features of myopic macular schisis (MMS) in different retinal layers and to explore the role of Müller cells in the pathophysiology of such condition. Methods: Spectral-domain optical coherence tomography (SD-OCT) images of myopic eyes with staphyloma and macular schisis were reviewed. The morphological features of MMS were analyzed and correlated with their geographical location in the parafoveal and perifoveal region. A biomechanical model was adopted to explain MMS morphological differences. The effect of the different schisis subtypes with best corrected visual acuity (BCVA) was also explored. Results: A total of 36 eyes from 26 patients were included in this study. MMS was classified into inner, middle and outer retinal subtypes. The prevalence of middle retinal schisis was significantly lower in the parafovea, within a central 3 mm-diameter circle (p < 0.001) centered at the fovea. The prevalence of inner retinal schisis was significantly higher outside the central 3-mm diameter circle, in the perifoveal region (p < 0.001). No significant differences were noted in the prevalence of outer retinal schisis for these two locations (p = 0.475). The presence of middle retinal schisis within the central 3-mm diameter circle showed a weak association with lower BCVA (p = 0.058). The presence of outer retinal schisis within the central 3-mm diameter circle was significantly related with lower BCVA (p = 0.024). Conclusion: Three major forms of MMS are distinguished: inner, middle and outer retinal schisis. This classification may have clinical importance as only the outer grade of schisis was associated with vision loss.