Retinal wrinkling and macular heterotopia in diabetic retinopathy

Retinal wrinkling of the posterior pole was studied in 40 eyes from 31 patients with diabetic retinopathy. Vitreoretinal traction was thought to produce the wrinkling in 32 of the eyes, in 13 of which macular heterotopia also developed, presumably from the same tractional forces. Epiretinal membrane formation was the apparent causal factor producing retinal wrinkling in six eyes and postphotocoagulation chorioretinal scarring in two eyes, in none of which macular heterotopia developed. Retinal wrinkling alone was associated with only mild or no visual acuity loss. Macular heterotopia was associated with more severe loss of visual acuity and with other visual symptoms. Displacement of retinal vessels was an important clue to the diagnosis of macular heterotopia.