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V. Sarup, I. Kreissig, H. Lincoff; Changing Patterns of Retinoschisis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5272.
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This is a report about an eye with bullous retinoschisis that was stationary for 18 months, progressed over 4 months and then regressed over 7 years to its original bullous contour. Byer has reported extension or regression in separate patients.1 A 38–year–old female was referred for an asymptomatic retinal detachment in the left eye. Fundus examination revealed a transparent, bullous elevation of the retina in the superotemporal quadrant with a round retinal hole at 1 O’clock. It looked like retinoschisis but because the hole was appropriately placed for a rhegmatogenous detachment, the retina was tested by a laser application through the hole and subsequently with a balloon buckle.2, 3 Both tests confirmed retinoschisis. The patient was made aware of her infero–nasal field defect and asked to report any extension. Twenty–two months later (4 months after the last exam) a fundus examination revealed that the retinal elevation had asymptomatically extended posteriorly and inferiorly to 6.00 O’clock. It approached but did not invade the macula. Examination revealed tiny breaks at 3 and 5 O’clock. Binocular occlusion for 72 hours did not alter the shape or extent of the retinal elevation. Nevertheless, cryopexy and a circumferential sponge buckle were applied to the original hole at 1 and the breaks at 3 & 5 O’clock without effect. An examination 5 years later, revealed the retinoschisis to have regressed to its original extent superotemporally. A visual field examination, however, revealed that the area of absolute scotoma was consistent with the extended retinal elevation operated upon 5 years before. Biomicroscopy confirmed an extensive shallow elevation of the internal layers. This report reveals how bullous retinoschisis can extend and regress asymptomatically. It brings out the diagnostic challenge of retinal elevations that have features of both retinoschisis and retinal detachment.
1. Byer NE. Long–term natural history study of senile retinoschisis with implications for management. Ophthalmology. 1986;93:1127–1137.
2. Lincoff H, Kreissig I, Stopa M. A modified laser test for the identification of retinoschisis. American Journal Of Ophthalmology. 2003;136:925–926.
3. Lincoff H, Kreissig I, Hahn YS. A temporary balloon buckle for the treatment of small retinal detachments. Ophthalmology. 1979;86:586–596.
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