Swiss-cheese macula.

A 61-year-old female presented with poor vision (20/200, N36) and a postmacular hole surgery done a year ago.

Left eye fundus and the red-free image shows posterior pole retinal detachment (RD) and multiple full-thickness defects within the macular area, giving a “Swiss cheese” appearance. Optical coherence tomography (OCT) shows full-thickness defects with bridging retinal tissue, cystic changes, and neurosensory detachment [Fig. 1].

Figure 1

Composite image includes fundus and optical coherence tomography pictures

Paracentral retinal breaks after internal limiting membrane (ILM) peeling are rare.[12345] Postulated mechanisms include mechanical trauma while grasping ILM, weakening of glial structure because of Muller cells damage leading to photoreceptor apoptosis and contracture of remnant ILM tissues. They are stationary but are responsible for poor vision.

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