To examine the majority of postequatorial retina in eyes with myopic macular retinoschisis (MRS) by ultra-widefield OCT (UWF-OCT) and to determine whether paravascular vitreal adhesions play a role in the development of MRS.
Retrospective single-center observational case series.
One hundred and fifty highly myopic participants who were >50-years-of-age with and without an MRS were studied. High myopia was defined as an eye with an axial length >26.5 mm.
All participants underwent UWF-OCT imaging with a scan width of 23 mm and a depth with 5 mm using a prototype swept source OCT device. The vitreoretinal adhesions to the foveal retina and retinal vessels, and paravascular abnormalities, e.g., paravascular retinal cysts, paravascular retinoschisis, and paravascular lamellar holes, were analyzed in the UWF-OCT images. The findings in eyes with an MRS were compared to those in eyes without an MRS.
The relationships between an MRS and vitreal adhesions to the retinal vessels or to the fovea were determined.
An MRS was found in 49 of the 150 eyes (33%). Vitreal adhesions to the retinal vessels were found more frequently in eyes with an MRS than eyes without an MRS (63% vs 44%; P=0.04). In contrast, the number of eyes with adhesions to the fovea in eyes with an MRS was not significantly different from that in eyes without an MRS (57% vs 59%). Paravascular lesions, e.g., retinal cysts, retinoschisis, lamellar holes, were more common in eyes with an MRS than eyes without an MRS (71% vs 36%, 61% vs 17 %, and 20% vs 8%; P<0.001, P<0.001 and P=0.03, respectively). Multivariate analysis showed that the presence of paravascular vitreal adhesions was a significant predictor for MRS development (OR=2.56, P=0.02).
The results indicate that paravascular vitreoretinal adhesions may play a more important role in the development of an MRS than vitreous adhesions to the fovea. Paravascular vitreoretinal adhesions may be related to the development of the different types of paravascular lesions including retinal cysts and paravascular retinoschisis which could then lead to the formation of an MRS.

Copyright © 2020. Published by Elsevier Inc.