Comparison of Myopic Maculopathy Progression in Patients with Myopic Traction Maculopathy undergoing Vitrectomy or Macular Buckling.

Abstract

To compare the progression of myopic maculopathy in patients with stage 3 myopic traction maculopathy (MTM) undergoing either pars plana vitrectomy (PPV) or macular buckling (MB). A total of 61 eyes diagnosed with stage 3 MTM were retrospectively divided into two groups: PPV group (30 eyes) and MB group (31 eyes). Best-corrected visual acuity (BCVA), axial length (AL), myopic maculopathy progression, retinal and choroidal thickness were measured and compared. The mean follow-up period was 70.9±13.67 months. The average myopic maculopathy stage in the PPV group progressed from 1.87±0.57 to 2.4±0.72 (P < 0.001). In the MB group, the stage advanced from 2.03±0.66 to 2.1±0.7 (P = 0.5). Progression to a different stage occurred in 14 eyes (46.67%) in the PPV group, compared to only 2 eyes (6.45%) in the MB group. 16.67% of eyes in the PPV group (5 out of 30) and 6.45% of eyes in the MB group (2 out of 31) showed progression within the same MM stage. Additionally, 9 eyes (29.03%) in the MB group exhibited retinal pigment epithelium injury adjacent to the macular buckle ridge (MB-related atrophy). Postoperatively, foveal retinal thickness (197.8±61.53 μm vs. 164.4±49.07 μm, P = 0.02) and central choroidal thickness (81.95±47.7 μm vs. 61.44±50.77 μm, P = 0.032) were significantly greater in the MB group. For patients with stage 3 MTM, PPV may accelerate the progression of myopic maculopathy, whereas MB may not. Therefore, MB may be a preferable surgical option for these patients.