Foveal retinoschisis and retinal detachment in severely myopic eyes with posterior staphyloma

PURPOSE: To evaluate the tomographic features of the retina in patients with severe myopia and posterior staphyloma. METHODS: In a prospective study of 32 eyes of 19 consecutive patients with severe myopia and posterior staphyloma, we performed complete ophthalmic examinations and studied cross-sectional images of the macula with optical coherence tomography, Patients' age ranged from 41 to 83 years (average, 62.7 years), Best-corrected visual acuity ranged from 20/500 to 20/40 (average, 20/120), The study included 26 phakic and six pseudophakic eyes. The refractive errors of 26 phakic eyes ranged from -8 to -31 diopters (average, -16.7 diopters), Although refractive errors were within -8 diopters in six pseudophakic eyes, the eyes had apparent posterior staphyloma, The axial lengths measured by A-mode ultrasonography ranged from 25.7 to 32.7 mm (average, 29.2 mm). Slit-lamp examination with contact lens showed that none of the eyes had a macular hole. RESULTS: In nine eyes with shallow retinal elevation on slit-lamp examination, optical coherence tomography disclosed a foveal retinal detachment with retinoschisis in eight eyes and a foveal retinal detachment in one eye. Two of the remaining 23 eyes had retinoschisis. CONCLUSIONS: Foveal retinal detachment and retinoschisis are common features in severely myopic eyes with posterior staphyloma. Retinal detachment may precede the formation of a macular hole in severely myopic eyes. (Am J Ophthalmol 1999;128:472-476. (C) 1999 by Elsevier Science Inc. All rights reserved.).