Abstract

Purpose

To study UK practice patterns for the management of retinal detachment secondary to macular hole (MHRD) and macular retinoschisis (MRS) in pathological myopia (PM). To review the anatomical and visual outcomes of the surgically managed cases.

Methods

A prospective observational case series for the management of MHRD was undertaken in association with the British Ophthalmological Surveillance Unit (BOSU). The results were combined with retrospective data, collected by the COllaboration of British RetinAl Surgeons (COBRA), on the management of both MHRD and MRS in PM in the UK. A total of 20 cases of MHRD and 53 cases of MRS (27 surgical cases and 26 cases managed conservatively) are reported in this combined study.

Results

MHRD: Mean baseline best corrected visual acuity (BCVA) was 1.60 logMAR. All cases underwent pars plana vitrectomy (PPV). Mean post-operative BCVA was 1.49 logMAR (p = 0.674). The macular hole was closed in 5/20 (25%) cases, open/flat in 10/20 (50%) cases and open/elevated in 4/20 cases (20%). MRS: Mean baseline BCVA was 0.87 logMAR in the surgical group and 0.45 logMAR in the conservatively managed group (p = 0.002). All eyes that had surgical intervention underwent PPV. Mean post-operative BCVA was 0.68 logMAR (p = 0.183). Anatomical outcomes demonstrated a persistent MRS in 2/27 (7.4%) cases, partial resolution in 7/27 (25.9%) cases and complete resolution in 16/27 (59.2%) cases.

Conclusions

PPV is the only surgical procedure performed for the management of MHRD and MRS amongst the study participants. Success rates and visual outcomes are limited for MHRD and consistent with the current literature for MRS.

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Acknowledgements

The British Ophthalmological Surveillance Unit, The Royal College of Ophthalmologists, The COBRA Study Group and The Whipps Cross University Hospital Charitable Trust.

COllaboration of British RetinAl Surgeons (COBRA)

Stephen J. Charles, David Charteris, Richard J. Haynes, D. Alistair H. Laidlaw, David H. Steel, David Yorston, Tom H. Williamson, Hadi Zambarakji.

Author information

Author notes

  1. Members of the COllaboration of British RetinAl Surgeons (COBRA) study group are listed below Acknowledgements.

Affiliations

  1. The Eye Treatment Centre, Whipps Cross University Hospital, Barts Health NHS Foundation Trust, London, UK

    • Heidi Laviers
    •  & Hadi Zambarakji
  2. Moorfields Eye Hospital NHS Foundation Trust, London, UK

    • Ji-Peng Olivia Li
    • , Anna Grabowska
    •  & David Charteris
  3. Manchester Royal Eye Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK

    • Stephen J. Charles
  4. Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, UK

    • Richard J. Haynes
  5. Ophthalmology Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    • D. Alistair H. Laidlaw
    •  & Tom H. Williamson
  6. Sunderland Eye Infirmary, NHS Trust, Sunderland, UK

    • David H. Steel
  7. Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK

    • David H. Steel
  8. Tennent Institute of Ophthalmology, Gartnavel Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK

    • David Yorston

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  1. On behalf of the COllaboration of British RetinAl Surgeons (COBRA) study group

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Corresponding author

    Correspondence to Hadi Zambarakji.

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    https://doi.org/10.1038/s41433-018-0166-4