Purpose: To report a case of myopic macular retinoschisis and full-thickness macular hole (FTMH) that both resolved with topical medical therapy alone. Methods: A retrospective chart review was performed. Results: A patient with myopic retinoschisis with an FTMH and increased symptoms of metamorphopsia was treated with topical medical therapy consisting of 1% prednisolone, 4 times daily, and 0.07% bromfenac, daily. Anatomic changes at 6 weeks included drawing together of the inner retinal edges around the MH and its subsequent closure with marked resolution of the myopic retinoschisis. Conclusions: Severe myopic macular retinoschisis and an FTMH both resolved with topical therapy consisting of steroidal and nonsteroidal anti-inflammatory medications. This rapid resolution contradicts current theories of the pathogenesis of myopic macular retinoschisis.
BabaTOhno-MatsuiKFutagamiS, et al. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia. Am J Ophthalmol. 2003;135(3):338-342. doi:10.1016/s0002-9394(02)01937-2
2.
ZhouYYangSYuanY, et al. Progression and new onset of macular retinoschisis in myopic choroidal neovascularization eyes after Conbercept therapy: a post-hoc analysis. Eye (Lond). 2019;34(3):523. doi:10.1038/s41433-019-0516-x
3.
TakanoMKishiS.Foveal retinoschisis and retinal detachment in severely myopic eyes with posterior staphyloma. Am J Ophthalmol. 1999;128(4):472-476. doi:10.1016/s0002-9394(99)00186-5
4.
Henaine-BerraAZand-HadasIMFromow-GuerraJGarcía-AguirreG.Prevalence of macular anatomic abnormalities in high myopia. Ophthalmic Surg Lasers Imaging Retina. 2013;44(2):140-144. doi:10.3928/23258160-20130219-01
5.
ParoliniBPalmieriMFinziA, et al. The new myopic traction maculopathy staging system. Eur J Ophthalmol. 2021;31(3):1299-1312. doi:10.1177/1120672120930590
VanderBeekBLJohnsonMW.The diversity of traction mechanisms in myopic traction maculopathy. Am J Ophthalmol. 2012;153(1):93-102. doi:10.1016/j.ajo.2011.06.016
8.
LeeGWKimJHKangSWKimJ.Structural profile of dome-shaped macula in degenerative myopia and its association with macular disorders. BMC Ophthalmol. 2020;20(1):202. doi:10.1186/s12886-020-01473-2
9.
ZhengFWongCWSabanayagamC, et al. Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide-field optical coherence tomography in Singapore adults with high myopia. Acta Ophthalmol. 2021;99(2):e144-e153. doi:10.1111/aos.14527
10.
PugazhendhiSAmbatiBHunterAA.Pathogenesis and prevention of worsening axial elongation in pathological myopia. Clin Ophthalmol. 2020;14:853-873. doi:10.2147/OPTH.S241435
11.
ShimadaNTanakaYTokoroTOhno-MatsuiK.Natural course of myopic traction maculopathy and factors associated with progression or resolution. Am J Ophthalmol. 2013;156(5):948-957.e1. doi:10.1016/j.ajo.2013.06.031
12.
GohilRSivaprasadSHanLTMathewRKiousisGYangY.Myopic foveoschisis: a clinical review. Eye (Lond). 2015;29(5):593-601. doi:10.1038/eye.2014.311
13.
GaucherDHaouchineBTadayoniR, et al. Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome. Am J Ophthalmol. 2007;143(3):455-462. doi:10.1016/j.ajo.2006.10.053
14.
GuiJAiLHuangT.Vitrectomy with or without internal limiting membrane peeling for myopic foveoschisis. BMC Ophthalmol. 2020;20(1):83. doi:10.1186/s12886-020-01354-8
15.
KokameGTJohnsonMWLimJ, et al. Closure of full-thickness macular holes associated with macular edema with medical therapy. Ophthalmologica. 2022;245(2):179-186. doi:10.1159/000516018
16.
SmallKWAvetisjanJShayaF.Closure of macular holes with topical therapy and why the hydration theory of macular hole formation may be inaccurate. Invest Ophthalmol Vis Sci. 2022;63(7):3769-F0190.
17.
NiffeneggerJHFongDSWongKLModjtahediBS.Treatment of secondary full-thickness macular holes with topical therapy. Ophthalmol Retina. 2020;4(7):695-699. doi:10.1016/j.oret.2020.01.014
18.
OnoTTeradaYMoriYKataokaYNakaharaMMiyataK.Spontaneous resolution of myopic foveoschisis and a macular hole with retinal detachment. Am J Ophthalmol Case Rep. 2019;13:143-146. doi:10.1016/j.ajoc.2019.01.002
19.
GolanSBarakA.Third time spontaneous closure of myopic macular hole. Retin Cases Brief Rep. 2015;9(1):13-14. doi:10.1097/ICB.0000000000000072
20.
TornambePE.Macular hole genesis: the hydration theory. Retina. 2003;23(3):421-424. doi:10.1097/00006982-200306000-00028
21.
WangSWHungKCTsaiCYChenMSHoTC.Myopic traction maculopathy biomarkers on optical coherence tomography angiography—an overlooked mechanism of visual acuity correction in myopic eyes. Eye (Lond). 2019;33(8):1305. doi:10.1038/s41433-019-0424-0
22.
BringmannAWiedemanP.Muller glial cells in retinal disease. Ophthalmologica. 2011;227(1):1-19.
23.
SokolJTSchechetSAKomatiR, et al. Macular hole closure with medical treatment. Ophthalmol Retina. 2021;5(7):711-713. doi:10.1016/j.oret.2020.11.018
