Axial Length-Based Comparison of Clinical Characteristics and Visual Outcomes in Macular Pseudohole, Epiretinal Membrane Foveoschisis, and Lamellar Macular Hole

Purpose To evaluate clinical and optical coherence tomography (OCT) findings and visual outcomes in patients with macular pseudohole (MPH), epiretinal membrane foveoschisis (ERM-FS), and lamellar macular hole (LMH) based on axial length (AL). Methods We retrospectively reviewed consecutive patients diagnosed with MPH, ERM-FS, and LMH who underwent vitrectomy and were followed for at least 6 months postoperatively. In each disease group, eyes were categorized into three groups based on AL; normal (< 24 mm), myopic (≥ 24 to < 26 mm), and highly myopic (≥ 26 mm). Analyzed factors included age, AL, preoperative and postoperative best-corrected visual acuity (BCVA), and OCT parameters such as the presence of inner and outer retinal cysts, epiretinal proliferation, and ellipsoid zone disruption. Results A total of 171 eyes from 170 patients (79 males and 91 females) were included: 74 eyes with MPH, 59 eyes with ERM-FS, and 38 eyes with LMH. Postoperative BCVA significantly improved in all AL groups across all disease types. In the MPH group, postoperative BCVA was significantly better in the highly myopic group than in the myopic group (p = 0.04). There were no significant differences in the frequency of the OCT findings among the AL groups in any of the diseases. However, the presence of outer cysts at 6 months postoperatively tended to be more frequent in the highly myopic group (p = 0.065). Conclusion Vitrectomy improved visual acuity in all AL groups across MPH, ERM-FS, and LMH. AL did not significantly affect the frequency of abnormal findings for the preoperative and postoperative OCT.