Myopic Tractional Retinal Detachment

Published on 09/05/2015 by admin

Filed under Opthalmology

Last modified 22/04/2025

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Myopic Tractional Retinal Detachment

Introduction:

In the presence of high myopia, a localized tractional retinal detachment within the macula is an uncommon occurrence. The underlying mechanism is not entirely clear, but tractional forces are thought to be the predominant factor.

Clinical Features:

A localized elevation of the retina isolated to the macula is visible clinically in the absence of any visible, peripheral retinal breaks.

OCT Features:

The presence of a large neurosensory detachment of the retina, isolated to the macula, is present (Fig. 9.5.1). There are often associated vitreous membranes with tractional insertions on the detachment. Other pathologic features of high myopia are usually present such as posterior staphyloma, macular schisis and/or macular hole.

Figure 9.5.1 OCT of a myopic tractional retinal detachment shows a large neurosensory detachment of the retina (arrowheads). There is also significant overlying macular schisis and a posterior staphyloma. Towards the left side of the OCT, there is mirror artifact.

Ancillary Testing:

Treatment:

Initial observation may occasionally result in spontaneous release of vitreomacular traction with improvement in the retinal detachment. More commonly, surgical intervention is required with vitrectomy.

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Handbook of Retinal OCT Optical Coherence Tomography