Abstract:AIM: To investigate the changes of fundus autofluorescence (FAF) patterns in myopic maculoschisis eyes with macular detachment (MD) following macular buckling (MB) surgery. METHODS: Patients who received MB surgery for myopic maculoschisis with MD between August 2018 and August 2020 were reviewed. All participants underwent comprehensive preoperative and postoperative ophthalmic evaluations. Autofluorescence (AF) imaging was conducted using a Spectralis HRA+optical coherence tomography (OCT) device. RESULTS: A total of 49 eyes (from 49 patients) were included. The mean age of participants was 55.02±11.21y (range: 31–77y), with 33 females (67.35%, F:M=2.1:1). The duration of postoperative follow-up was 32.61±16.00mo, with a range of 12 to 69mo. Three different preoperative AF patterns at the macula were identified: unremarkable AF (20 eyes, 40.8%), patchy hyper-AF (15 eyes, 30.6%), and diffuse hypo-AF (14 eyes, 28.6%). Compared with preoperative visual acuity, the mean visual improvement at final visit was 9.84±6.04, 16.60±6.87, and 12.27±5.61 (P<0.05) letters in the eyes with unremarkable AF, patchy hyper-AF, and diffuse hypo-AF, respectively. Early postoperative FAF imaging captured at 1mo after surgery revealed two different AF patterns in 36 eyes: unremarkable AF (10 eyes, 27.8%) and round-like hyper-AF (26 eyes, 72.2%). Furthermore, the above 26 eyes with round-like hyper-AF all evolved into unremarkable AF gradually during the following observation period. Particularly, a total of 13 eyes (26.5%) displayed retinal pigment epithelium (RPE) atrophy at the edge of buckle, which were first detected after a mean follow-up of 14.73±6.21mo. CONCLUSION: FAF patterns in myopic maculoschisis eyes with MD show potential as biomarkers for evaluating MB surgery. Postoperative RPE atrophy at the edge of buckle deserves vigilant clinical attention.
