Purpose:

To report a case of myopic foveoschisis treated with 23 g pars plana vitrectomy (PPV) assisted with a lutein-based dye.

Methods:

We report a case of a fourty-five years old female patient who presented with decreased visual acuity and complaints of metamorphopsia on her right eye with 6 months duration. Ophthalmologic examination revealed an epiretinal membrane and foveoschisis of the right eye. She has high myopia (-20,00 diopters in her right eye and -17,00 diopter in her left eye). 23-gauge PPV was performed, along with triamcinolone-assisted mechanical detachment of posterior hyaloid membrane. Doubledyne G-assisted peeling of the epiretinal membrane and ILM was achieved using ILM 23Ga forceps (Grieshaber, USA). A non-expansile 20% sulfur hexafluoride (SF6) gas solution was used to tamponade the eye. The patient remained in prone position for 7 days. The postoperative period was uneventful with rapid anatomic and functional recovery. Spectralis spectral-domain optical coherence tomography (SD-OCT) was used pre- and postoperatively to assess anatomic results.

Effectiveness / Safety:

The ideal vital dye should be safe for intraocular use, for reliable and selective staining of the intraocular membranes, and for rapid elimination from the eye. Doubledyne showed efficacy in the intraoperative identification of the epiretinal membrane and ILM, thus confirming its usefulness for chromovitrectomy. No dye-related adverse events were reported. Vitrectomy along with lutein based dye for epiretinal and internal limiting membrane peel, can be effective to treat cases of myopic foveoschisis. Good functional and anatomical outcomes after 23-gauge PPV suggest that tractional forces at the vitreoretinal interface could contribute to the pathogenesis of myopic foveoschisis.

Contact Details:

Email: filipe.henriques.oftalmologia@gmail.com
Cell Phone: +351918362497

Filipe Henriques