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Characterization and diagnosis of retinoschisis and schisis detachments using spectral domain optical coherence tomography

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To characterize retinoschisis in a large series using spectral domain optical coherence tomography (SD-OCT), including rates of schisis detachment and macular involvement in cases of peripheral retinoschisis.

Methods

In this retrospective, cross-sectional, descriptive study, consecutive patients with diagnosis of retinoschisis in at least one eye were identified using billing codes between January 2012 and May 2021. Charts were reviewed to verify diagnosis of retinoschisis or schisis detachment. SD-OCT and clinical examination was used to identify frequency of macular schisis, peripheral schisis, and schisis detachment, and characteristics of retinoschisis including frequency of inner and outer wall breaks, distribution of layers split, and location of involvement of peripheral pathology. SD-OCT images of insufficient quality were excluded from the pertinent analysis.

Results

281 eyes of 191 patients were included. 195 (69.4%) eyes had peripheral retinoschisis, 15 (5.3%) had schisis detachment, 66 (23.5%) had macular retinoschisis alone, and 5 (1.8%) had combined macular and peripheral retinoschisis. Of the eyes without macular retinoschisis, 7.0% had schisis detachment. Of the remainder, 4 (2.1%) had inner wall breaks, and 24 (12.3%) had outer wall breaks. In eyes with peripheral retinoschisis, splitting occurred in the outer plexiform layer in 58.9%, the retinal nerve fiber layer in 8.9%, a combination of layers in 26.8%, and indeterminate in 5.4%. Location of peripheral involvement was inferotemporal in 58.5%, superotemporal in 14.1%, temporal in 13.7%, and inferior in 12.2%.

Conclusion

SD-OCT helped to identify the presence of schisis detachment and breaks, confirmed diagnosis in challenging cases, and demonstrated the layer of splitting within the neurosensory retina. This series represents the largest such study to date.

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Funding

This study was funded by the Retina Research and Development Foundation.

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Authors and Affiliations

  1. The Retina Institute, 2201 S Brentwood Blvd, Saint Louis, MO, 63144, USA

    Rohan A. Jalalizadeh & Bradley T. Smith

Authors
  1. Rohan A. Jalalizadeh
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  2. Bradley T. Smith
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Corresponding author

Correspondence to Bradley T. Smith.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with ethical standards of the Institutional Review Board of St. Luke’s Hospital in Chesterfield, Missouri, USA, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was not needed for this study as it was retrospective and observational in nature.

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The authors declare no competing interests.

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Jalalizadeh, R.A., Smith, B.T. Characterization and diagnosis of retinoschisis and schisis detachments using spectral domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 261, 375–380 (2023). https://doi.org/10.1007/s00417-022-05801-8

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  • DOI: https://doi.org/10.1007/s00417-022-05801-8

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