Macular complications occurred in two isolated patients who had pericentral pigmentary retinopathy. One patient demonstrated bilateral bull's-eye maculopathy and a unilateral full-thickness macular hole. Later, she developed central retinal artery occlusion in the fellow eye. The second patient had a rhegmatogenous retinal detachment that was reattached by scleral buckling surgery, but a full-thickness macular hole was found 3 months postoperatively. In both patients, foveal ischemia may have played a role for the development of macular hole, resulting in poor visual prognosis in pericentral pigmentary retinopathy.