March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
The Widening Spectrum of Findings in Retinoschisis
Author Affiliations & Notes
  • Richard J. Madonna
    Clinical Sciences, SUNY College of Optometry, New York, New York
  • Nicholas Beaupre
    Clinical Sciences, SUNY College of Optometry, New York, New York
    VA Hudson Valley Healthcare System, Montrose, New York
  • Jerome Sherman
    Clinical Sciences, SUNY College of Optometry, New York, New York
    SUNY Eye Institute, New York, New York
  • Footnotes
    Commercial Relationships  Richard J. Madonna, Carl Zeiss Meditec (R); Nicholas Beaupre, None; Jerome Sherman, Topcon, Carl Zeiss Meditec, Optos, Optovue, Heidelberg (R)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2661. doi:
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      Richard J. Madonna, Nicholas Beaupre, Jerome Sherman; The Widening Spectrum of Findings in Retinoschisis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2661.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To utilize a series of case reports to illustrate the wide variety of clinical presentations seen in retinoschisis (RS) and to underscore the importance of SD OCT in the diagnosis and management of these patients.

 
Methods:
 

Retrospective analysis of 24 patients with a diagnosis of RS, including X-linked, acquired, and those associated with congenital anomalies. All patients were imaged with one of four commercially available SD OCTs. Images were taken around the optic nerve, macula and retinal periphery.

 
Results:
 

SD OCT imaging revealed a wide spectrum of findings in RS, ranging from those invisible to ophthalmoscopy to those clearly visible on fundus examination and affecting large areas of the retina. Myopes greater than 6 diopters, who made up 12 of the 24 patients, presented with the most unexpected findings and often presented with schisis invisible to ophthalmoscopy. One of our patients, an asymptomatic 8 diopter myope, had 20/20 visual acuity without a macular schisis but with multiple splits at different retinal levels along the inferior and superior arcades, nasal to the disc and temporal to the macula extending to the ora (Figure). Other patients presented with 360 degree peripapillary schisis, schisis associated with retinal detachment, and foveal schisis, all invisible to ophthalmoscopy. The retinoschises found in the patients with high myopia appear to be related to vitreoretinal traction along the vascular arcades, revealed as vascular microfolds on SD OCT, along with global elongation of the eye.

 
Conclusions:
 

Imaging with SD OCT has shown that RS is a much more common group of diverse disorders than previously believed. Imaging findings have provided keys to understanding the pathophysiology of the condition and insight into more effective treatments for those requiring it.  

 
Keywords: retina • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) 
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