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Abigail Fahim, Naser Ali, Taylor Blachley, Michel Michaelides; Fundus Findings Associated with Complications in X-Linked Retinoschisis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3260.
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Complications of vitreous hemorrhage and retinal detachment cause a precipitous decline in vision in a subset of patients with X-linked retinoschisis (XLRS), an otherwise a slowly progressive condition. We compared the frequency of specific fundus findings in XLRS patients with and without vitreous hemorrhage and retinal detachment to determine whether any fundus findings are associated with these complications.
A retrospective observational chart review was performed with 65 patients with XLRS, confirmed by detection of a disease-causing variant in RS1. The presence of macular and peripheral retinal findings (including macular schisis, macular atrophy, peripheral retinoschisis, metallic sheen, vascular sheathing, pigmentary changes, white spiculations, and vitreous veils) and the presence of complications of vitreous hemorrhage and retinal detachment were determined by review of examination notes, fundus photographs, and optical coherence tomography (OCT). Fisher exact tests and univariable logistic regression analysis were used to determine the association between peripheral retinal findings and complications.
The presence of peripheral retinoschisis was significantly associated with both vitreous hemorrhage and retinal detachment. Out of 10 eyes with complications, 9 (90%) had peripheral retinoschisis, compared with only 33 out of 116 eyes (28%) without complications (p=0.0014). In addition, each additional peripheral finding increased the odds of RD by a factor of 4.06 (95% CI 1.58-10.39, p=0.028). There were no complications in the 28 eyes with a normal periphery (p=0.84) or in the 35 eyes with metallic sheen (p=0.42). Seven eyes (8%) showed normal macular structure on OCT.
The data suggest that patients with peripheral retinoschisis are at increased risk for complications of vitreous hemorrhage and retinal detachment. Furthermore, patients with additional peripheral retinal findings together with peripheral schisis may carry additional risk for retinal detachment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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