Retinal Detachment Associated with Degenerative Retinoschisis : Anatomical and Functional Analysis

Abstract

Purpose : Retinal detachment (RD) associated with retinoschisis (RS) can occur with the development of outer layer breaks (OLB) and requires surgical treatment. The anatomical success rate of first surgery appears to be lower in patients with RD associated with RS than rhegmatogenous RD (RRD) (with no RS), but few large population studies are available to support this finding. The aim of our study is to analyse the functional and anatomical outcomes of primary surgery in patients with RS-associated RD

Methods : Medical records of 2260 patients operated between 2014 and 2018 at CHU de Quebec- Université Laval for retinal detachment were reviewed. All patients who had degenerative retinoschisis and rhegmatogenous retinal detachment (RRD) were included in the study. Pre-, intra- and post-operative data were analyzed including demographic data, number and location of retinal breaks, number of quadrants affected, macula and lens state, type of surgery and visual acuity throughout follow-up. Retinal redetachement after first surgery was also analyzed for patients with RS-associated RD and RRD to compare the surgical success rate between both groups.

Results : 1.8% of patients had a RD associated with RS in the total cohort (41/2260). The anatomical success rate of first surgery was 78 % in patients with RS-associated RD (9/41) and 90% in patients with RRD (171/1760) ( p value 0.02). In patients with RS- associated RD: mean age was 67 ± 12 years, number of affected quadrants ( 1 quadrant (q) in 9 patients (22%), 2 q in 27 patients (66%), 3 q in 4 patients (10%) and 4 q in 1 patient (2%)). The type of the first surgery in patoents with RS-associated RD was scleral buckle (SB) in 2 patients (5%), pars plana vitrectomy (PPV) in 14 patients (34%) and SB + PPV in 25 patients (61%). PPV alone was associated with an anatomical success rate of 78.6% (11/14) and SB + PPV had a success rate of 80.0% (20/25). Visual acuity was 0.58 ± 0.80 logMAR at baseline, 1.53± 1.24 logMAR at 3 months of follow-up and 0.55 ± 0.70 logMAR at final follow-up.

Conclusions : Our study highlights the anatomical and functional characteristics of patients with RS-associated RD and shows that RD associated with RS remains a challenge to treat with a success rate of first surgery significantly lower than patients with RRD.

This is a 2020 ARVO Annual Meeting abstract.