An 84-year-old man underwent vitreoretinal surgery for an epiretinal membrane (ERM). His decimal best-corrected visual acuity was 0.7 (20/32) OD (Figure, A). During surgery, both the ERM and internal limiting membrane (ILM) were peeled in 1 continuous piece. The firmness of the ERM was judged normal with no engagement sites.

One day after the surgery, a white lesion appeared in the peeled area (Figure, B). This lesion was hyperreflective across all layers in the optical coherence tomographic images, with normal retinal circulation on fluorescein angiography (Figure, B), and the patient developed degeneration of the inner and outer retinal layers. The white lesion gradually blended into the surrounding normal tissue, but the border remained throughout the follow-up period. The postoperative best-corrected visual acuity improved to 0.9 (20/25) OD, although he reported a circular visual field defect.

The pattern suggested a maculopathy associated with mechanical trauma from peeling rather than a vascular occlusion.^1-5

Corresponding Author: Koju Kamoi, MD, PhD, Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan (koju.oph@tmd.ac.jp).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.