Pathology of macular foveoschisis associated with degenerative myopia

Abstract

This is a clinicopathological paper on the histologic findings in myopia-associated macular foveoschisis. The findings on ophthalmic pathological study of a 73-year-old woman with high myopia are reviewed. Multiple retinoschisis cavities involving both the macula and retinal periphery were disclosed. Our paper offers tissue evidence and supports recent ocular coherence tomography reports of eyes with high myopia and associated macular foveoschisis.

Figure 1

(a) Clinical photographs of the fundus of the right and (b) left eyes. Bilateral optic nerve crescents and staphylomas are seen in both eyes. There are also degenerative changes seen in the macular areas of both eyes. (c) Fluorescein angiogram of the right eye in the early (a) and late (b) phases demonstrating staining of the optic nerve crescents and small window defects along the macular region.

Figure 2

(a) Photomicrograph of the right eye demonstrating areas of macular foveoschisis. A region containing the staphyloma is also seen (black arrow). (b) Higher magnification of macular foveoschisis seen in multiple layers of the retina including the outer plexiform layer, inner plexiform layer, nerve fiber layer, and the outer plexiform layer in the perifoveal region. A thin fibrous preretinal membrane is seen (black arrow). (hematoxylin and eosin, original magnification, (a) x50; (b) x100). (c) Photomicrograph of the left eye demonstrating classical retinoschisis in the outer plexiform layer, ganglion cell layer, and nerve fiber layer. (d) Higher magnification demonstrating neuronal bridges between both nuclear layers (asterisk). A fibrous preretinal membrane is seen (black arrow). (hematoxylin and eosin, original magnification, (a) x50; (b) x100).