BMJ Case Reports 2017; doi:10.1136/bcr-2016-217671
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment

  1. Ashish Markan
  1. Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Prateek Kakkar, prateekkak{at}
  • Accepted 15 June 2017
  • Published 14 July 2017


Macular hole-associated retinal detachment in high myopia is described as a final stage in progression of myopic traction maculopathy (MTM).1–3 Shimada et al4 described the progressive stages of MTM from macular retinoschisis to serous retinal detachment in high myopia. Stage 4 MTM is characterised as disappearance of retinoschisis with progression to retinal detachment due to macular hole formation. It is hypothesised that vitreoschisis and abnormal vitreo-retinal interface create the premacular tangential traction.5 6 Intraoperative triamcinolone acetonide is used to visualise the residual posterior vitreous cortex (PVC). We hereby describe the utility of microscope-integrated optical coherence tomography (MIOCT) in assisting complete removal of PVC and internal limiting membrane (ILM) peeling with multilayered inverted ILM flap in the treatment of myopic macular hole retinal detachment. MIOCT helped identify vitreoschisis and confirm the position of ILM flaps over the macular hole intraoperatively.


  • Contributors AK was involved in planning, reporting and forming the concept and design of our report. He was also the surgeon and the one who operated the MIOCT. AK also contributed to the preparation of manuscript and proofreading. PK contributed in reporting, data acquisition, analysis, manuscript preparation and proofreading. RR contributed in planning, manuscript preparation, analysis and proofreading. AM helped in data acquisition and analysis for the report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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