Vitrectomy for bilateral macular schisis without apparent optic disc anomalies

Area of Science:

• Ophthalmology
• Retinal Diseases

Background:

• Macular schisis, characterized by fluid accumulation in retinal layers, can cause visual acuity loss.
• While often associated with optic disc anomalies, its occurrence without apparent disc issues is noted.

Observation:

• A 78-year-old male presented with bilateral visual acuity loss.
• Optical coherence tomography revealed bilateral macular schisis with external retinal fluid accumulation, notably without vitreous traction.
• Standard fundus examination and fluorescein angiography were unremarkable.

Findings:

• Both eyes underwent phacoemulsification, intraocular lens implantation, and vitrectomy, omitting laser, gas, or fenestration.
• A slow, progressive resorption of fluid and improvement in visual acuity (VA) were observed post-procedure.

Implications:

• Macular schisis may occur in patients lacking apparent optic disc anomalies.
• Vitrectomy, even without adjunctive procedures like laser or gas, demonstrates therapeutic potential for visual recovery in macular schisis, even with preoperative posterior vitreous detachment (PVD).