Success of myopic traction maculopathy surgery depends on morphology, timing

ByMichela Cimberle

Fact checked byChristine Klimanskis, ELS

When managing myopic traction maculopathy, the timing of surgery should be carefully evaluated, avoiding early or delayed intervention, according to a speaker at the American Society of Retina Specialists annual meeting.

An international, multicenter, retrospective study focused on 272 eyes that had myopic traction maculopathy (MTM) without macular hole that underwent vitrectomy with standard or fovea-sparing internal limiting membrane peeling, MTM with macular hole that underwent vitrectomy, or macular hole retinal detachment resulting from MTM progression that underwent vitrectomy.

When managing myopic traction maculopathy, the timing of surgery should be carefully evaluated, avoiding early or delayed intervention, according to a speaker at the American Society of Retina Specialists annual meeting.
*Image: Adobe Stock*

“Each group achieved significant visual improvement at 6 months,” Taku Wakabayashi, MD, PhD, of Wakabayashi Eye Clinic in Japan, said.

However, the difference in postoperative visual acuity between the groups was significant, with the best outcomes observed in the eyes with MTM without foveal detachment (20/46), followed by MTM with foveal detachment (20/60), MTM with macular hole (20/96) and macular hole retinal detachment (20/178).

“To conclude, surgery for less advanced stages of MTM without foveal retinal detachment or macular hole generally resulted in better visual outcomes. However, the question remains: Is early surgery better? My answer is not simply yes,” Wakabayashi said.

He observed that 17% of eyes with mild MTM and good preoperative vision of 20/25 or better experienced visual deterioration of three lines or more. Timing of surgery is crucial, and while delaying for too long is not advisable, intervention at this early stage was probably premature, Wakabayashi said.

“I recommend surgery before macular hole develops and when preoperative vision is between 20/30 and 20/200, as this timing offers a reasonable benefit-risk ratio,” he said.

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Source:

Wakabayashi T, et al. Predicting visual outcomes after vitrectomy based on preoperative retinal morphology and timing of surgery for myopic traction maculopathy. Presented at: American Society of Retina Specialists annual meeting; July 17-20, 2024; Stockholm.

Disclosures: Wakabayashi reports no relevant financial disclosures.

American Society of Retina Specialists Meeting

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Success of myopic traction maculopathy surgery depends on morphology, timing

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