Surgical treatment for optic neuropathy in high myopia

Abstract

AIM: To improve the effectiveness of surgical treatment for optic neuropathy in high-degree myopia. MATERIAL AND METHODS: A total of 54 patients (96 eyes) aged 18-30 with high myopia and signs of optic neuropathy were observed. The main group consisted of 20 patients (28 eyes) who underwent meridional scleral reinforcement with type I collagen-based implant placed over the posterior segment. The control group included 34 patients (68 eyes) who were given a 10-day vitamin and vascular therapy course. In most of the controls (21 patient, 21 eyes) indirect revascularization with ligation of the superficial temporal artery was performed. Ophthalmological examination was done before the beginning of the treatment and then at 1, 6, and 12 months. Results. At the end of the follow-up period best corrected visual acuity in the main group was 19.2% higher, on average, than baseline values, but remained unchanged in the controls. Light sensitivity of the retina in both group increased by 7% and 2% respectively. Electrically evoked phosphene thresholds decreased by 22.5% and 10.4% respectively. The main group also demonstrated a near-constant mean peripapillary nerve fiber layer (RNFL) thickness and a 16.4% higher than baseline blood flow velocity in the ophthalmic artery. In the control group the latter parameter showed no change. CONCLUSIONS: Scleral reinforcement surgery in patients with high myopia complicated by optic neuropathy enables improvement of visual functions and regional blood flow as well as stabilization of RNFL thickness and volume, thus, preventing subsequent development of optic nerve atrophy.