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Kelly Ma, Shaban Demirel, Stuart Keith Gardiner, Brad Fortune, Steven L Mansberger; Peripapillary Retinoschisis in Glaucomatous and Suspect Eyes. Invest. Ophthalmol. Vis. Sci. 2016;57(12):860.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the structural and clinical characteristics of peripapillary retinoschisis (PPRS).
We performed a case-control study using data from the Portland Progression Project (P3), a longitudinal study following open angle glaucoma and ocular hypertension subjects. We examined functional, structural, and demographic characteristics in 10 eyes of nine patients with PPRS on radial raster spectral-domain optic coherence tomography scans (SD-OCT) of the optic nerve head (ONH) and compared them to 30 eyes of 30 patients without PPRS. Cup to disc ratio was determined by glaucoma-trained ophthalmologists.
The PPRS was present in the nerve fiber layer (NFL) in all 10 eyes with an additional subject having concurrent schisis of the inner plexiform layer, and the outer plexiform layer. PPRS most commonly occurred (8/10, 80%) in the superior quadrant. The location of PPRS did not significantly correlate to location of the visual field defects, when present (p>.05). When comparing the case to control group, we did not find a difference in age, visual acuity, visual field mean deviation, nor central corneal thickness (p>0.05 for all). The group with PPRS had a significantly larger cup to disk ratio than disease-matched controls (p= 0.01). PPRS resolved in 5 of 10 eyes over 48 or more months of follow-up with all demonstrating retinal nerve fiber layer (RNFL) thinning in the region of retinoschisis after resolution as compared to RNFL thickness prior to retinoschisis development.
Cup to disc ratios were significantly larger in eyes exhibiting PPRS. This finding suggests increased cupping and associated remodeling of the ONH extracellular matrix may contribute to this finding, although further studies are needed. Permanent thinning of RNFL may follow resolution of PPRS as compared to pre-PPRS development.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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