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Marilette Stehouwer, Stevie Tan, Ton G. van Leeuwen, Frank D. Verbraak; Differentiation Between Peripheral Senile Retinoschisis And Retinal Detachment, The Additional Value Of OCT Scans Of The Peripheral Retina Obtained With The SL Scan-1 (Topcon). Invest. Ophthalmol. Vis. Sci. 2012;53(14):2109.
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Senile retinoschisis is sometimes difficult to distinguish from a local retinal detachment by clinical examination alone. This study evaluated SD-OCT scans of the peripheral retina to improve the differentiation between retinal detachment and senile retinoschisis.
Patients with a peripheral lesion, diagnosed as senile retinoschis or as difficult to distinguish between retinal detachment and retinoschisis, were recruited from the outpatient clinic of the Academic Medical Center. OCT scans of the far peripheral retinal lesions were obtained with the SL SCAN-1, through a 3 mirror contact lens, while the lesions were simultaneously observed with the slitlamp. The SL SCAN-1 is a SD-OCT integrated into a common Topcon slitlamp, SLD light source, Δ 30 nm, central wavelength 830 nm, scan resolutions 8-9 micron in tissue, scan depth 2 mm, scan speed 5000 A-scans per second and 1024 A-scans per B-scan.
Twenty patients were included into this study,in five of them the clinical diagnosis was unclear. In these five individuals, the OCT scans visualized retinoschisis in two patients and retinal detachment in three patients. Of the fifteen patients diagnosed with senile retinoschisis, the OCT scans showed a characteristic retinoschisis in only seven. Five patients had a combination of retinoschisis and retinal detachment and three patients had a retinal detachment without signs of retinoschisis. Cystoid alterations of the detached neurosensoric retina were seen on the OCT scan in three out of the six patients with a retinal detachment.
Senile retinoschisis may mimic a peripheral retinal detachment and vice versa when differentiated by funduscopic or biomicroscopic examination alone. Differentiation is important with respect to therapeutic decisions. OCT scans of the far peripheral retina, which can be made with the SL SCAN-1 through a 3 mirror contactlens, can contribute significantly in this differentiation. The obtained scans clearly visualised the anatomic differences between a retinoschisis, a local retinal detachment, and visualised even a combination of a retinoschisis with a local, possible secondary, retinal detachment.
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