Morphological study of foveal retinoschisis and retinal detachment in highly myopic eyes

Objective To describe the morphological characteristics of foveal retinoschisis and retinal detachment in highly myopic eyes. Design Retrospective observational case series. Participants Twenty-nine patients (38 eyes) of high myopia with foveal retinoschisis and retinal detachment. Methods All patients with foveal retinoschisis and retinal detachment were performed complete ophthalmic examinations, B-scan and studied cross-sectional images of the maculae with optical coherence tomography (OCT). 10 eyes underwent vitreous surgery. Main Outcome Measures Morphological characteristics. Results On biomicroscopy, the maculae of all 38 eyes had a microcystic appearance and shallow elevation without macular hole. B-scan showed posterior retinal edema or with 0.5 to 2mm detachment. OCT disclosed foveal retinoschisis and retinal detachment in all eyes. The neuroretina splitted into a thick inner layer and a thin outer layer or a thin inner layer and a thick outer layer or a thin inner layer, a thick inter layer and a thin outer layer. A hyperreflective preretinal structure resembling the posterior hyaloid was stretched over the retinoschisis and drew the retina. Vitreous surgery performed on 10 eyes, including posterior vitreous detachment, removal of the premacular vitreous cortex. In all eyes, foveal detachment and retinoschisis gradually decreased in height, and attained foveal attachment finally. Conclusion Foveal retinoschisis and retinal detachment in highly myopic eyes with staphyloma is better characterized with OCT than with biomicroscopy. Vitreomacular traction forms the posterior hyaloid and the staphyloma maybe the major cause of it.