Myopic Traction Maculopathy: Diagnostic and Management Strategies
Autor: | Michele Palmieri, Irene Gius, Alessandro Finzi, Rino Frisina, Barbara Parolini, Luigi Tozzi |
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Rok vydání: | 2020 |
Předmět: |
Pars plana
medicine.medical_specialty genetic structures business.industry medicine.medical_treatment Retinoschisis Retinal detachment Vitrectomy medicine.disease eye diseases Foveoschisis 03 medical and health sciences Ophthalmology 0302 clinical medicine medicine.anatomical_structure 030221 ophthalmology & optometry medicine Full-thickness macular hole Maculopathy sense organs Choroid business 030217 neurology & neurosurgery |
Zdroj: | Clinical Ophthalmology. 14:3699-3708 |
ISSN: | 1177-5483 |
Popis: | Pathologic myopia (PM) is an ocular disorder characterized by a spherical equivalent (SE) of more than - 6.0 diopters (D) or by an axial length (AL) of more than 26.5 millimeters (mm). PM is associated with myopic maculopathy (MM). The ATN classification describes all the aspects of MM which regroups atrophic, tractional and neovascular consequences to the sclera, choroid and retina of highly myopic eyes. The advent of OCT allowed to define the ultrastructural characteristics of the tractional changes in MM, described by the term myopic traction maculopathy (MTM). They include foveoschisis/maculoschisis/retinoschisis (FS/MS/RS), retinal/foveal detachment (RD/FD), lamellar macular holes (LMH) and full-thickness macular holes (FTMH) with or without RD (MHRD). The MTM staging system (MSS) describes all foveal and retinal changes related to MTM and their natural history interpreting them as different stages of a single progressive disorder. The management of MTM can be just observation for the earliest cases with good vision or surgery for the severe stages with vision loss. There are two possible surgical approaches: ab externo, that acts on the alteration of the scleral shape and includes posterior scleral reinforcement and macular buckle. Ab interno, that targets the alteration of the foveal profile and consists in pars plana vitrectomy with removal of all the epiretinal tractions, maneuvers on the internal limiting membrane, and the use of intravitreal tamponade and laser. As they target two different sides of the same pathology, the two techniques have to be selected on the base of the MTM stage, single or combined. |
Databáze: | OpenAIRE |
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