Retinal detachment associated with a macular hole in severely myopic eyes

PURPOSE: To investigate factors associated with extensive retinal detachment in severely myopic eyes with a macular hole. METHOD: Fifty-two consecutive eyes with a macular hole and severe myopia were retrospectively studied. RESULTS: An extensive retinal detachment, defined as extending beyond the cuff of subretinal fluid, was observed in 37 eyes (71%). Extensive retinal detachment developed in 36 (95%) of 38 eyes with a posterior staphyloma and in one (7%) of 14 eyes without a posterior staphyloma (P < .0001). Extensive retinal detachment also developed in 32 (89%) of 36 eyes with complete posterior vitreous detachment and in five (31%) of 16 eyes without posterior vitreous detachment (P < .0001). CONCLUSION: Posterior staphyloma rather than anteroposterior vitreomacular traction may contribute to the development of retinal detachment associated with a macular hole in severely myopic eyes. (C) 1999 by Elsevier Science Inc. All rights reserved.