This 71YO female was seen on 2/9/21 with a completely asymptomatic variably adherent macular pucker. Vision was 20/80, and observation was recommended. On 8/24/21, vision improved to 20/40, and the macular traction had decreased.
When last examined on 1/18/23, the membrane had completely and spontaneously peeled itself as part of a macular posterior vitreous detachment. The back surface of the posterior hyaloid is seen nasally. Vision was 20/50.
Learning Points:
Spontaneous macular pucker separation is a known but rare event, occurring in about 2% of eyes with pre-existing posterior vitreous detachment (PVD) and 13% of eyes without PVD (Yang et al., Retina 2014;34:2079-2087).
We generally avoid macular pucker, vitreomacular traction, or macular hole surgery in visually happy patients. This patient also reminds us that these conditions can sometimes resolve on their own.
