Vitrectomy and internal limiting membrane peeling for extensive macular schisis in choroideremia

Journal article

Purpose: To report outcomes of pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling for extensive macular schisis in choroideremia and provide surgical insights. Methods: Retrospective case series of five eyes from four patients with choroideremia and extensive macular schisis who underwent PPV with ILM peeling at a single tertiary center between 2011 and 2025. Data collected included pre- and post-operative best-corrected visual acuity (BCVA), surgical technique, spectral-domain optical coherence tomography (SD-OCT) imaging, intraoperative findings, and post-operative complications. Results: All five eyes showed complete resolution of macular schisis on SD-OCT without foveal retinal pigment epithelium atrophy. BCVA improved in all cases. Intraoperative challenges included retinal fragility, peripheral schisis-like changes, and difficulty with ILM visualization and adherence. No iatrogenic retinal breaks or detachments occurred. Conclusion: Vitrectomy for extensive macular schisis in choroideremia can yield favourable anatomical and functional outcomes but requires tailored techniques to address retinal fragility and minimize iatrogenic trauma.

Authors: Abdalla Elsayed, MEA; Barone, V; MacLaren, RE

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Graefe's Archive for Clinical and Experimental Ophthalmology
• Publication date: 2026-03-18
• DOI: 10.1007/s00417-026-07162-y
• EISSN: 1435-702X
• ISSN: 0721-832X
• Language: English
• Keywords: Internal limiting membrane; Retinal detachment; Visual acuity; Pars plana; Macular hole; Choroideremia; Vitrectomy; Retinal