PMC3076115_01
Fundus photograph and drawing of the fundus of a patient with a large macular splitting tear. Left: Fundus photograph showing a large macular break splitting the macula vertically. The edge of the break is rolled over, and the subretinal hemorrhage covers the retinal pigment epithelium over the macula. Note that macular xanthophyll pigment can be seen at both lateral edges of the retinal break. Right: Schematic drawing of the fundus showing the retinal detachment in the right eye. Multiple retinal breaks including a macular split are shown. A retinal break with an operculum can be seen at the 12:30 o'clock position.
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During the vitrectomy, the macular break was found to be a vertical split of the retina through the fovea (Figure 1, left). In addition to the retinal break, there was a giant retinal tear at the temporal retina of about 90  in length (Figure 1, right).
Left: Photograph of the posterior pole during the removal of the silicone oil. Note the macular splitting break is sealed with a small glial recurrence. Right: Montage of the postoperative eye. The entire retina is attached with an encircling scleral buckle. The perisilicone proliferation was minimal in this case.
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The silicone oil was removed six months after the surgery, and the retina was observed to be still attached (Figure 2).