This 61YO female presented with 20/40 vision in her right eye from a mildly symptomatic macular pucker.
Color imaging shows a moderate macular pucker. Swept source OCT shows a variably adherent hyperreflective pucker, moderate retinal thickening with loss of the inner retinal layer detail, and a small foveal prolapse. En face imaging shows variable inner retinal striae from the pucker, and 3D reconstruction shows another unique perspective.
Learning Points:
Herniation of the central fovea is a rare finding with macular pucker. A recent case series (Shah et al, Retina 2023;43:182-190) found that larger foveal herniation height was associated with greater preoperative retinal thickness and worse pre- and postoperative vision.
However, vitrectomy with membrane peeling still results in significant anatomic and visual improvement. We have been observing our patient since she has been completely asymptomatic.
