Preoperative Parameters Associated with Vitrectomy Outcomes in Myopic Traction Maculopathy Without a Full-Thickness Macular Hole

TL;DR

This study identifies preoperative factors that influence the outcomes of vitrectomy surgery for myopic traction maculopathy, emphasizing the importance of early intervention and monitoring.

Contribution

The study provides new insights into prognostic factors for vitrectomy outcomes in MTM without full-thickness macular holes.

Findings

Better preoperative visual acuity and lower foveal height correlate with improved postoperative visual outcomes.

Longer axial length and higher MTM/ATN grades are linked to thinner postoperative foveal thickness.

Foveal detachment and ellipsoid zone disruption are associated with worse surgical outcomes.

Abstract

Pathologic myopia has become a major global cause of blindness, making timely surgical management for myopic traction maculopathy (MTM) increasingly important. This study aimed to identify prognostic factors associated with functional and anatomical outcomes following surgery for MTM and to determine the optimal timing for intervention. This retrospective study included 33 eyes from 28 patients with MTM without full-thickness macular hole who underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade. Better preoperative best-corrected visual acuity (BCVA) and lower foveal height were associated with better postoperative BCVA, whereas longer axial length, higher MTM, and higher Atrophy–Traction–Neovascularization (ATN) classification grade were correlated with thinner postoperative central foveal thickness. Foveal detachment (FD), ellipsoid zone (EZ) disruption, and advanced MTM grade were associated with poorer functional and anatomical outcomes. Postoperative visual outcomes should be interpreted with caution, as they may have been influenced by lens-related factors, including combined cataract surgery, post-vitrectomy cataract progression, and posterior capsule opacity. Nonetheless, consistent anatomical improvement was observed, supporting early surgical consideration in eyes with MTM showing progressive macular traction or EZ disruption, even in the absence of FD. These findings highlight the importance of serial OCT monitoring and individualized surgical timing based on preoperative assessments.

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