Pathophysiology of Myopic Foveoschisis

Myopic foveoschisis is one of the major causes of central visual impairment in highly myopic eyes with posterior staphyloma. Optical coherence tomography is an essential tool to aid with the diagnosis because the main anatomical changes are small retinal elevations and retinoschisis. The pathogenesis includes a combination of various tractional forces received from the vitreous cortex, epiretinal membrane, internal limiting membrane, and retinal arteries. Retinoschisis is typically the first symptom, which can then develop into a retinal detachment due to traction on the inner retina. The stress on the fovea eventually creates a small tear in the macula leading to retinal detachment. Thus, myopic foveoschisis can be regarded as a preliminary state of macular hole formation with retinal detachment, which would require vitreoretinal surgery to repair the damage.