Retinal vascular microfolds in highly myopic eyes

Purpose

Retinal microfolds attributable to retinal vessels were first observed after vitrectomy for myopic foveoschisis and were believed to indicate inward retinal traction, possibly leading to high myopia-specific retinal diseases. We report retinal microfolds in high myopia without vitrectomy.

Design

Observational case series.

Methods

This is an institutional study. Seven eyes of seven patients in which retinal microfolds were observed using optical coherence tomography (OCT) were included in the study. We used an OCT-ophthalmoscope to confirm the precise location of the microfolds. We also investigated the relationship between the presence of microfolds and subjective distortion detected by examination of the corresponding retinal area using the Amsler grid chart in three eyes.

Results

All microfolds detected by OCT coincided with the retinal vessels using the OCT-ophthalmoscope. The folds coincided only with the retinal arterioles in six eyes (86%) and with both arterioles and veins in one (14%). Subjective distortion was detected in the retinal area corresponding to the microfolds in two eyes (67%) but was not detected in one eye (33%).

Conclusions

The incidence of retinal microfolds is 2.9%, and thus they are not uncommon in highly myopic eyes without vitrectomy. The coincident appearance of the folds and vessels suggests that inflexibility of the retinal vessels and retinal stretching attributable to ocular elongation may cause the microfolds. The presence of these microfolds indicates that inward retinal vascular traction could be common in highly myopic eyes.