Abstract
Purpose :
In glaucomatous eyes, retinoschisis may occur around the papilla due to weakness of the lamina cribrosa, and the incidence is 1-6%, which is significantly higher than in normal eyes.
In this study, we experienced five cases of peripapillary retinoschisis complicated by glaucoma.
Methods :
We report on five cases of retinal detachment associated with glaucoma experienced at Yamaguchi University in the past.
Results :
Patients ranged in age from 62 to 80 years, three male eyes and two female eyes, and all had no papillary pits.
The two eyes with good vision did not undergo surgery, and the retinoschisis resolved with continued glaucoma eye drops.
Three eyes with visual acuity 20/100 to 20/40 underwent vitrectomy (one eye with fovea spearing ILM peeling, and one eye with invert ILM flap), and visual acuity was improved. A case is described in detail in which a macular hole developed after the initial surgery and required reoperation.
(Case)64-year-old female. She was being treated for glaucoma in both eyes and was referred to Yamaguchi University because of retinal separation in the left eye.
At the time of initial examination, she had visual acuity of 20/40 in the left eye and IOP of 16 mmHg. OCT of the left eye showed retinal separation from the papilla to the macula and macular hole in the outer segment, with a central retinal thickness of 412 μm.
Three months later, the retinal separation worsened in the left eye, and visual acuity decreased to 20/63. For treatment, PEA + IOL + vitrectomy + fovea sparing ILM peeling + SF6 gas injection was performed.
Postoperatively, the separation space was reduced and her visual acuity improved to 20/50.
However, 3 months after surgery, a macular hole developed, and an invert ILM flap over the papilla plus SF6 gas injection was performed.
One month after surgery, the hole was closed and visual acuity 20/40 was achieved. 2.5 years later, there was no recurrence and visual acuity improved to 20/20.
Conclusions :
In peripapillary retinoschisis associated with glaucoma, there are cases of mild improvement with glaucoma eye drops, but in cases of vision loss, vitrectomy is expected to improve retinal morphology and maintain or improve visual acuity.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.