Hassan Mortada (Cairo, Egypt)


To describe the clinical and OCT findings as well as the management of posterior pole retinal detachment and retinoschisis without a macular hole in highly myopic eyes.


Six highly myopic eyes presented with retinal detachment involving the posterior pole. The degree of myopia ranged between -15 and -24 diopters. Fundus biomicroscopy could not reveal the presence of a macular hole. OCT examination revealed the following findings: splitting of a thickened retina into thick inner layer and a thinner outer layer, intraretinal strands between the inner and outer retinal layers, partially detached posterior hyaloid exerting traction on the inner layer and no macular hole could be found. All patients underwent PPV combined with triamcinolone acetinoide-assisted peeling of the posterior hyaloid. None of the eyes was subjected to ILM peeling or tamponade.


The posterior pole retinal detachment and retinoschisis showed gradual flattening to become completely attached in 2 to 6 months. BCVA improved more than 2 lines in all eyes. None of the eyes showed late development of a macular hole.


Posterior detachment and retinoschisis without a macular hole may develop in highly myopic eye with posterior staphyloma. Tangential and A/P vitreous traction are probably the causative mechnism. Vitrectomy with posterior hyaloid peeling, without ILM peeling or internal tamponade, is sufficient to achieve reattachment.