Classification and management of myopic traction maculopathy: a vitrectomy-based consensus from taiwanese experts.

Abstract

Purpose: To develop a vitrectomy-based consensus on the definition, diagnosis, and management of myopic traction maculopathy (MTM).

Methods: Relevant literature was initially reviewed. Six key questions and six consensus statements were developed based on reference articles. Ten panelists then voted on the statements for consensus development.

Results: MTM was defined as maculoschisis or maculoschisis with foveal disruption, including a lamellar macular hole (LMH), full-thickness macular hole (FTMH), and macular hole with retinal detachment (MHRD). A classification combining the status of maculoschisis and the type of foveal pathology was formulated. MHRD was regarded as the end stage of the MTM. Modern optical coherence tomography images of the macula, standard color fundus photography, periodical axial length measurement, and regular visual function tests with best-corrected visual acuity and Amsler's grid were four essential tools used for the diagnosis and follow-up of MTM. FTMH and MHRD are reliable surgical indications. Surgery may be indicated for maculoschisis, with or without LMH, if visual deterioration is observed. A visual acuity of less than 20/40 was set as the relative empirical requirement for surgery. The panel reached a consensus on the use of fovea-sparing ILM peeling and the inverted ILM flap technique for MTM with various structural changes.

Conclusions: The proposed consensus on the six important aspects of the MTM may serve as a valuable reference for clinicians in relevant fields in daily practice.