This case report identified paracentral acute middle maculopathy as the cause of severe and irreversible vision loss after cataract surgery. Cataract surgeons should be aware of known risk factors for the development of paracentral acute middle maculopathy. In those patients, extra care regarding anesthesia, intraocular pressure, and some other aspects of cataract surgery must be taken. Paracentral acute middle maculopathy is currently understood as a clinical sign evident on spectral-domain optical coherence tomography, and it is probably evidence of deep ischemic insult to the retina. It should be a differential diagnosis in cases of marked low vision acuity associated with no fundus abnormalities in the immediate postoperative period, as demonstrated in the presented case.

The authors report the anatomical and functional response to topical use of carbonic anhydrase inhibitor (CAI) in the treatment of foveoschisis in a case of X-linked juvenile retinoschisis (XLJR). A 9-year-old boy with visual impairment in both eyes, was admitted to Hilton Rocha Fundation ophthalmologic clinic. Fundus examination revealed radial cystoid appearance in a petaloid configuration in the fovea, and retina pigment epithelium alterations at superior mid-peripheral retina in both eyes. Optical coherence tomography (OCT) showed foveal cystoid structures, loss of foveal depression and splitting at inner retinal layers in the macula. Following treatment with topical dorzolamide 2% for 7 months, there was dramatic regression of both macular and peripheral schisis cavities and improvement of visual acuity in both eyes.