Autologous Internal Limiting Membrane Fragment Transplantation for Rhegmatogenous Retinal Detachment Due to Paravascular or Juxtapapillary Retinal Breaks Over Patchy Chorioretinal Atrophy in Pathologic Myopia

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Pathologic myopia is often associated with characteristic features including axial elongation, chorioretinal degeneration, and posterior staphyloma, like Curtin1,2 exposed. Stirpe and Michels3 and Chen et al4 showed that retinal detachment in pathologic myopia can also be associated with posterior breaks, most commonly macular holes and occasionally paravascular breaks associated with abnormally firm vitreoretinal adhesions. Identification of posterior breaks in highly myopic eyes with retinal detachment can be difficult and the management of them even more so. The optimal management strategy in cases also associated with posterior staphyloma and retinal pigment epithelium/choroidal atrophy has been the subject of much debate. Treatment modalities, such as pars plana vitrectomy (PPV) with long-term silicone oil or long-term gas tamponade, macular buckles, laser retinopexy, cryotherapy, and transcleral diathermy, have been described by Kuriyama et al,5 Matsumura et al,6 and Bovey and Gonvers,7 but the optimum treatment remains unclear. Several peripapillary lesions have been described in high myopia, including optic and conus pits, juxtapapillary holes, and intrachoroidal cavitations, as described by Freund et al,8 Ohno-Matsui et al,9 Shimada et al,10 and Regenbogen and Stein.
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