**6. Monitoring**

*A Practical Guide to Clinical Application of OCT in Ophthalmology*

**MTM Surgery procedure**

(1) Due to vitreomacular traction from the

(2) Due to traction associated with a remnant

cortical vitreous layer after PVD

perifoveal PVD

**Table 2.**

*tomography.*

Common difficulties encountered during vitrectomy in these high myopic eyes are: (1) inability of the smaller gauge instruments to reach the retinal tissue at the macula due to longer axial length; (2) In eyes with posterior staphyloma, the vitreous is strongly adherent to the edge of the staphyloma resulting in retinal breaks during PVD induction; (3) Staining of ILM with various dyes is usually inadequate and patchy making ILM peeling difficult in these scenarios; (4) Glaucoma is associated with high myopia resulting in an already compromised optic nerve head which can get worsened following vitrectomy; (5) Scleral thinning associated with high myopia

*Surgical decision-making in myopic traction maculopathy based on pathoanatomy seen on optical coherence* 

(3) Due to epiretinal membrane formation Vitrectomy with posterior cortical vitreous removal

(4) Due to intrinsic stiffening of the ILM (a) Vitrectomy with posterior cortical vitreous removal

(5) With associated full-thickness MH or FRD (a) Vitrectomy with posterior cortical vitreous removal

*Abbreviations: MTM—myopic traction maculopathy; PVD—posterior vitreous detachment; ERM—epiretinal* 

*membrane; ILM—Internal limiting membrane; MH—Macular hole; FRD—Foveal retinal detachment.*

with ERM removal

with ILM peeling (b) Macular buckle alone

Vitrectomy with posterior cortical vitreous removal

Vitrectomy with posterior cortical vitreous removal

(c) combined vitrectomy and macular buckle

(c) Combined vitrectomy and macular buckle

with ILM peeling with gas tamponade

(b) Macular buckle alone

*(a–b) Pre and post-operative images of a patient with myopic foveoschisis with FRD. At 6 months post-op,* 

*there is complete resolution of the retinal thickening and subretinal fluid.*

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**Figure 4.**

Following surgery for MTM, resolution of retinal thickening and/or foveal detachment is monitored using OCT. Complete resolution of retinal thickness or subretinal fluid is achieved in 6–9 months after surgery [24] (**Figure 4**). Patients with high myopia and unilateral MTM require regular OCT monitoring of the fellow eye to assess progression to myopic pre-MTM [25].
