Abstract:Myopic traction maculopathy (MTM) is a common vision-threatening complication in patients with high myopia. With the global increase in high myopia, the prevalence of MTM has been rising worldwide, leading to a growing burden of disease, economic costs, and social impact. The emergence and development of optical coherence tomography (OCT) have provided robust technical support for the staging of MTM. Based on the evolving understanding of its pathological mechanisms and natural course, various staging systems have been proposed and applied in clinical practice, offering crucial guidance for the personalized management of MTM patients. Additionally, innovations and refinements in surgical techniques and materials, such as pars plana vitrectomy (PPV), posterior scleral reinforcement, and macular buckling (MB), have expanded the therapeutic options for MTM. This article systematically reviews the staging systems and treatment strategies for MTM, focusing on the role of OCT-based staging in guiding individualized treatment plans. It also summarizes the current evidence on the efficacy and safety of existing and emerging surgical approaches, including PPV, MB, and their combined procedures. The review further proposes that future research should focus on developing predictive models integrating multimodal data to clarify surgical timing and indications, as well as conducting large-scale, multicenter randomized controlled trials to explore the selection of PPV, MB, or combined surgeries. The review aims to discuss personalized treatment for MTM, providing theoretical foundations and practical directions for optimizing clinical management for MTM patients.
