Morphological features analysis of eyes with myopic macular retinoschisis in high myopia

Abstract Background Myopic macular retinoschisis (MRS) is a vision-threatening disease characterized by macular neuroepithelial layer splitting with or without foveal detachment. Patients with high myopic and posterior staphyloma carry a higher risk of MRS, which may progress to severe vision loss. Epiretinal membrane is a non-vascularized fibrocellular proliferation on the macular inner surface, mainly mediated by Müller cells. Currently, studies on the relationships among MRS, posterior staphyloma and epiretinal membrane are limited, and the role of epiretinal membrane remains underrecognized. Methods This retrospective cross-sectional study that included 69 patients (138 eyes) diagnosed with unilateral or bilateral MRS between November 2018 and June 2020 aimed to analyze the complications of MRS and the morphological types of posterior staphyloma in patients with high myopia. Collect clinical data, including age, sex, best corrected visual acuity, axial length, complications of MRS and posterior staphyloma morphology. OCT was used to assess the complications of MRS and B-ultrasound was applied to classify posterior staphyloma. Accompanying conditions, such as epiretinal membrane, macular hole and choroidal neovascularization, were recorded. Results A total of 69 patients (138 eyes) were included. Thirty-eight patients (55.1%) had unilateral MRS and 31 (44.9%) had bilateral MRS, resulting in 100 MRS eyes and 38 non-MRS eyes. The median axial length was 30.61 mm (IQRs, 28.71–31.99). Among the MRS eyes, ERM was present in 74 eyes (74.0%). After adjustment for age, sex, axial length, posterior staphyloma and inter-eye correlation, ERM remained significantly associated with MRS (adjusted OR: 4.20, 95% CI: 1.87–9.42, P < 0.001). Among the 129 eyes with gradable posterior staphyloma morphology, the fusiform pattern was the most common subtype (57 eyes, 44.2%). Conclusions Epiretinal membrane was common in eyes with MRS and seemed to be associated with MRS development. Posterior staphyloma morphology in MRS patients has diverse characteristics. Clinical trial number Not applicable.