Abstract
Purpose :
To investigate visual and anatomic outcomes in patients who have undergone primary interventions for schisis-detachment.
Methods :
A retrospective review was conducted on eyes that underwent a procedure for schisis-related retinal detachment (RD) between January 2015 and November 2022. Eyes with X-linked retinoschisis, isolated macular schisis, RD unrelated to schisis, and <6 months of follow-up were excluded. Primary outcome measures were the incidence of redetachment following the initial intervention, as well as visual and anatomic outcomes at 6 months and the final visit.
Results :
After reviewing 174 eyes, 67 eyes of 67 patients met the inclusion criteria. The mean (standard deviation, SD) follow-up duration was 38.3 (24.3) months. Macular involvement was observed in 27 eyes (40.3%), and proliferative vitreoretinopathy (PVR) was present in 8 eyes (11.9%) at the time of primary RD. The initial repair methods included laser retinopexy in 23 eyes (34.3%), vitrectomy in 23 eyes (34.3%), combined vitrectomy and buckle in 13 eyes (19.4%), and buckle alone in 8 eyes (11.9%). The initial procedure failed in 7 eyes (30.4%) that underwent laser and 9 eyes (20.5%) that underwent surgery (P=0.381) after a median time (interquartile range, IQR) of 70 days (14-623) and 65 days (29-187), respectively. Single surgery anatomic success (SSAS) for RD repair was achieved in 81.8% of eyes (36/44) at 3 months. The anatomic success rate for reattachment was 91.3% at 6 month and 95.7% at the final visit in the laser group, and 97.7% at 6 months and at the final visit in the surgical group, with 8 eyes and 5 eyes remaining silicone oil-filled at these visits. The mean (SD) logarithm of the minimal angle of resolution (logMAR) visual acuity at the 6 month and final visit was 0.52 (0.55, Snellen equivalent: 20/66) and 0.37 (0.54, 20/47), showing no significant change compared to vision at the time of RD diagnosis (0.46 (0.66), 20/58) (P=0.844 and 0.276).
Conclusions :
The treatment of schisis-detachment appears to lead to generally acceptable anatomical outcomes with preservation of vision. However, the relatively high redetachment rate suggests that these types of RDs may be more difficult to treat than non-schisis related rhegmatogenous RDs.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.