[Skip to Navigation]
JAMA Ophthalmology Clinical Challenge
July 8, 2021

Split Down the Middle of the Fovea

Author Affiliations
  • 1Edward S. Harkness Eye Institute, NewYork–Presbyterian Hospital, Columbia University Irving Medical Center, New York
  • 2Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Ophthalmol. 2021;139(9):1037-1038. doi:10.1001/jamaophthalmol.2020.6869

A woman in her 50s with hypertension who was otherwise in good health presented for new ophthalmologic evaluation in the setting of mild, long-standing blurred vision with slight metamorphopsia in the right eye. She had a history of high myopia (approximately 9 diopters [D] OD; 8 D OS). Examination revealed an otherwise normal left eye with 20/20 best-corrected visual acuity (BCVA). The right eye demonstrated a BCVA of 20/25 and normal anterior segment, including lenticular examination. Dilated fundus examination showed wrinkling of the neurosensory retina at the fovea (Figure 1A) without posterior vitreous detachment. Spectral-domain optical coherence tomography revealed hyperreflective layering on the foveal surface consistent with epiretinal membrane, as well as splitting of the outer plexiform layer with hyporeflective cavities (Figure 1B).

Add or change institution
×