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Jerome Sherman, Samantha Slotnick, Richard Madonna, Sanjeev Nath, Raniah Hallal, Dan Epshtein; Peripapillary Retinoschisis : A Novel Clinical Entity Revealed By SD OCT. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3606.
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© ARVO (1962-2015); The Authors (2016-present)
To document the presence of peripapillary retinoschisis (PPRS), a new clinical entity seen more frequently in highly myopic eyes with the help of SD OCT.
A retrospective review of 600 eyes was performed with OCTs that contained several sections through and around the optic nerve head. SD OCTs were obtained with 1 of 4 systems (Zeiss Cirrus, Topcon 3D OCT, Heidelberg Spectralis, Optovue RTVue).
Of the 600 eyes, 19 exhibited retinoschisis around the optic disc.17 eyes were myopic with refractive errors ranging from -5 to -18. The 18D myopic eye had a 360° PPRS which did not extend into the macula but appeared to be responsible for the VA reduction to 10/400. The other 16 eyes had normal or near normal VA and none had a macula retinoschisis. 8 of these 17 eyes had one or more zones of vitreo-retinal traction (as revealed with SD OCT) and may be the etiology of the schisis (see image). The splits were variable in location and often appeared to exist in several layers, most often found in the inner and outer plexiform layers. One of the 2 eyes without myopia was a 4D hyperope (VA 20/40) with a PPRS that extended into the macula. The other was an emmetropic eye with a Morning Glory-like congenital disc anomaly but with 20/20 VA. The 2 eyes without myopia did not exhibit vitreo- retinal traction. Most eyes tested demonstrated field defects, most frequently enlargement of the blind spot. All 4 SD OCT systems utilized were able to delineate the PPRS.
PPRS appears to be a clinical entity more prevalent in high myopia. PPRS is generally invisible on ophthalmosopy but can be detected with SD OCT images around the optic disc. Scans through the macula will miss the PPRS unless the peri-papillary area is included in the scan.
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