Meeting News Coverage

Various treatments available for myopic traction maculopathy

WAIKOLOA, Hawaii — Multiple options are available to treat myopic traction maculopathy, a speaker said here.

“The pathogenesis of myopic traction maculopathy is not completely understood, but I think it’s a very important clue that this virtually always occurs within a posterior staphyloma,” Mark W. Johnson, MD, said at Retina 2013.

Johnson said internal limiting membrane (ILM) peeling, surgical repair, gas tamponade and pharmacologic vitreolysis can all successfully resolve myopic traction maculopathy.

Mark W. Johnson, MD

Mark W. Johnson

Surgical repair is typically successful when major traction mechanisms are identified and relieved, he said, including ILM peeling in some cases.

According to Johnson, the ILM should be peeled broadly to near the staphyloma margins, and it can resolve myopic traction maculopathy in eyes without preretinal traction elements.

He said gas tamponade is critical in eyes with macular hole, and pharmacologic induction of posterior vitreous detachment may be helpful in eyes with selected traction mechanisms, such as vitreomacular traction.

“When you look at this on OCT, the pathoanatomy intuitively suggests that there is a gradual stretching or splitting of the retina over time,” he said. “This is likely caused by a relative tautness of the inner retina compared to the outer retina, within the concavity of the posterior staphyloma. Why you have this tautness of the inner retina is still debated.”

Disclosure: Johnson has no relevant financial disclosures.

WAIKOLOA, Hawaii — Multiple options are available to treat myopic traction maculopathy, a speaker said here.

“The pathogenesis of myopic traction maculopathy is not completely understood, but I think it’s a very important clue that this virtually always occurs within a posterior staphyloma,” Mark W. Johnson, MD, said at Retina 2013.

Johnson said internal limiting membrane (ILM) peeling, surgical repair, gas tamponade and pharmacologic vitreolysis can all successfully resolve myopic traction maculopathy.

Mark W. Johnson, MD

Mark W. Johnson

Surgical repair is typically successful when major traction mechanisms are identified and relieved, he said, including ILM peeling in some cases.

According to Johnson, the ILM should be peeled broadly to near the staphyloma margins, and it can resolve myopic traction maculopathy in eyes without preretinal traction elements.

He said gas tamponade is critical in eyes with macular hole, and pharmacologic induction of posterior vitreous detachment may be helpful in eyes with selected traction mechanisms, such as vitreomacular traction.

“When you look at this on OCT, the pathoanatomy intuitively suggests that there is a gradual stretching or splitting of the retina over time,” he said. “This is likely caused by a relative tautness of the inner retina compared to the outer retina, within the concavity of the posterior staphyloma. Why you have this tautness of the inner retina is still debated.”

Disclosure: Johnson has no relevant financial disclosures.

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