Background and Clinical Significance: To describe two cases within the spectrum of non-myopic foveomacular retinoschisis, including stellate non-hereditary idiopathic foveomacular retinoschisis (SNIFR) and central anomalous retinoschisis with mid-peripheral traction (CARPET), and to highlight the role of multimodal imaging in identifying vitreoretinal traction in their pathogenesis and management. Case Presentation: First Case Report: A 57-year-old man presenting with bilateral visual decline. Multimodal imaging, including spectral-domain and en face optical coherence tomography (OCT), demonstrated characteristic features of SNIFR, with schisis at the Henle fibre layer and outer plexiform layer and persistent posterior hyaloid adhesion. Medical treatment was ineffective. Over two years, complete posterior vitreous detachment occurred, followed by spontaneous anatomical resolution of the schisis and full visual recovery. Second Case Report: A 63-year-old man with severe unilateral visual loss. Imaging revealed marked mid-peripheral vitreoretinal traction extending toward the posterior pole; associated with foveoschisis, central neurosensory detachment, and an outer lamellar macular hole, consistent with CARPET syndrome. The patient underwent pars plana vitrectomy with traction release. Postoperatively, complete anatomical resolution of both macular and peripheral schisis was achieved, with partial visual recovery. Conclusions: These cases support vitreoretinal traction as an important pathogenic mechanism in selected forms of non-myopic foveomacular retinoschisis. SNIFR may resolve spontaneously following posterior vitreous detachment, whereas CARPET represents a more severe tractional phenotype that may require surgical intervention. Careful multimodal imaging assessment of the vitreoretinal interface is essential for accurate diagnosis and management. These findings further characterise CARPET and expand the clinical spectrum of traction-related non-myopic foveomacular retinoschisis.
Ruiz-Moreno et al. (Fri,) studied this question.