The increasing application of optical coherence tomography (OCT) has led to identification of a new cause for visual loss in degenerative myopia—myopic tractional maculopathy (MTM).1, 2, 3 MTM typically manifests as foveal schisis; rarely, it is severe enough to cause a tractional retinal detachment (TRD).4 Most reports describe MTM as an isolated phenomenon.1, 2, 3, 4 We report a rare case of MTM associated with rhegmatogenous retinal detachment (RRD).

Myopic foveoschisis is characterized by an intraretinal splitting in a myopic posterior staphyloma, caused by anteroposterior and/or tangential traction, sometimes combined with foveal detachment, culminating in a lamellar or full-thickness macular hole.1, 2, 3 Our case was unusual, because the macular TRD was surrounded by convex RRD on all sides, indicating the two pathologies as discrete but synchronous phenomena. It is probable that an acute posterior vitreous detachment simultaneously opened the peripheral retinal tears, as well as pulled at the tenacious vitreomacular adhesions into a TRD. It has been suggested that when the area of adhesion is small (⩽500 μ), a macular hole results; a broader adhesion (∼1500 μ) causes a retinal schisis/detachment.5 Removal of posterior vitreous cortex and epimacular membranes relieved the traction, while possibly deroofing an inner macular schisis into a lamellar hole. It is advisable to include OCT in the preoperative evaluation of a myopic RRD associated with macular staphyloma to reveal such undetected pathologies, which have implications for surgical management.

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