Optic pit-like maculopathy in a patient without any detectable disc anomalies

Area of Science:

• Ophthalmology
• Retinal Diseases
• Macular Disorders

Background:

• Macular schisis involves splitting of inner retinal layers at the macula.
• Acquired macular schisis is often linked to optic disc pit maculopathy but can occur with other conditions.
• Few cases of retinoschisis without optic disc pit have been documented.

Observation:

• A patient presented with acquired macular schisis without high myopia or optic disc abnormality.
• Optical coherence tomography revealed inner and outer retinal layer schisis, subretinal fluid, and significant choroidal thickening (pachychoroid).
• The optic disc appeared normal on examination and imaging.

Findings:

• The patient's condition suggests retinoschisis can develop without typical optic disc anomalies.
• Pachychoroid and subretinal fluid were noted, indicating potential vascular or structural contributions.
• Vitreous traction is hypothesized as a possible mechanism, despite a normal-appearing optic disc.

Implications:

• This case expands the understanding of acquired macular schisis etiology.
• It suggests that vitreous traction may play a role in retinoschisis development, independent of optic disc pits.
• Further research with larger cohorts is needed to explore alternative mechanisms for retinoschisis without optic pit.