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Postoperative outcomes of idiopathic epiretinal membrane associated with foveoschisis
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    Re: Lam et al.: Postoperative outcomes of idiopathic epiretinal membrane associated with foveoschisis
    • Wei Gui, Vitreoretinal Surgeon VMR Institute for Vitreous Macula Retina
    • Other Contributors:
      • Jean-Pierre Hubschman, Vitreoretinal Surgeon
      • J. Sebag, Vitreoretinal Surgeon

    Recently, Lam et al. [1] concluded that patients with macular pucker and foveoschisis had a higher risk of postoperative macular oedema. Since only 5/17 cases had baseline fluorescein angiography it is unclear how they distinguished foveoschisis due to tangential traction, versus cystoid macular edema (CME). Is it possible that postoperative CME was recurrent and not new? In our experience, resolution of foveoschisis takes much longer than the relatively swift resolution in 25% and partial resolution in 68.8% of cases at 1 month, so perhaps CME was a confounding factor. Indeed, Figure 3 appears more like exudative cyst than ‘foveoschisis’.

    Previous studies [2] found that nearly half of patients with macular pucker had multiple centers of retinal contraction which were associated with a higher prevalence of intraretinal cysts and greater macular thickening. Was en face OCT performed to determine the number of contraction centers and its relationship to foveoschisis as well as outcomes of surgery? Additionally, anomalous PVD with vitreoschisis [3] and vitreo-papillary adhesion [4] may be important in the pathogenesis of macular pucker. Did the authors correlate these with foveoschisis and postoperative outcomes?

    There was no significant difference in postoperative visual acuity (VA) between the foveoschisis and control groups, but this may not be the best outcome measure in macular pucker surgery. Studies [5] have shown that quantifying contrast sensitivity fu...

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    Conflict of Interest:
    None declared.