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JAMA Ophthalmology Clinical Challenge
May 27, 2021

Bilateral Macular Schisis in a Woman

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago
  • 2Associate Deputy Editor, JAMA Ophthalmology
JAMA Ophthalmol. Published online May 27, 2021. doi:10.1001/jamaophthalmol.2020.5292

A 64-year-old woman in excellent general health who was not taking any medications was referred for evaluation of an epiretinal membrane of her right eye. She reported no blurry vision, metamorphopsia, photopsias, floaters, or nyctalopia, and she had no history of refractive surgical procedures, ocular surgical procedures, or trauma. Her family history was negative for ocular conditions, and there was no consanguinity in her family.

Her visual acuity was 20/20 OU with correction (plano +0.25 × 153 OD and −0.50 + 0.25 × 009 OS). External and anterior segment examination results were unremarkable except for mild nuclear sclerotic cataracts. Results of a dilated ophthalmoscopic examination showed radial spokelike striae of the fovea, with a central cyst in the right eye and macular edema of the left eye. Optical coherence tomography (OCT) imaging of the right macula showed cystlike changes in the outer retina in the foveal and parafoveal regions and in the inner retina in the temporal macula. Optical coherence tomography imaging of the left macula showed cystlike changes in the outer retina in the inferior macula (Figure). Of note, OCT scans of the optic nerves did not reveal an optic disc pit.

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