Classification and Management of Myopic Traction Maculopathy: A Consensus from the Taiwan Retina Society

李承雍 Cheng-Yung LeeTaiwan Speaker Classification and Management of Myopic Traction Maculopathy: A Consensus from the Taiwan Retina SocietyWith the increasing prevalence of myopia, myopic traction maculopathy (MTM) has become more frequently encountered and often requires surgical management. However, its definitions, classifications, and treatment strategies remain inconsistent. To address the lack of standardized classification and management strategies, a panel of vitreoretinal specialists from the Taiwan Retina Society convened to develop a practical consensus. After reviewing current evidence, six key questions and corresponding statements were formulated through structured discussion and voting among ten panelists. MTM was defined as maculoschisis or maculoschisis with foveal disruption, encompassing lamellar macular hole, full-thickness macular hole, and macular hole with retinal detachment, the latter regarded as the end stage. A classification integrating the extent of maculoschisis and the type of foveal pathology was proposed. The panel emphasized the role of multimodal imaging, including optical coherence tomography, fundus photography, axial length measurement, and visual function assessment, in diagnosis and follow-up. Full-thickness macular hole and macular hole with retinal detachment were considered clear surgical indications, whereas surgery for maculoschisis or lamellar macular hole may be appropriate when visual deterioration occurs. The consensus recommends fovea-sparing internal limiting membrane peeling (foveola-ILM non-peeling) and the inverted internal limiting membrane flap technique as effective surgical approaches.