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Retinoschisis in eyes with pachychoroid and retinal pigment epithelial atrophy

  • Jiwon Baek
  • Jae Hyung Lee
  • Won Ki LeeEmail author
Retinal Disorders

Abstract

Purpose

To describe the clinical characteristics and courses for eyes with retinoschisis associated with pachychoroid.

Methods

A retrospective interventional case series study. Twenty-one eyes (18 patients) with pachychoroid that showed retinoschisis without evidence of neovascularization that had been followed for 1 year were included. Multimodal imaging, including fundus photography, spectral-domain optical coherence tomography (OCT) with an enhanced depth protocol, fluorescein angiography (FA), and indocyanine green angiography (ICGA), was provided and treatment outcomes were analyzed.

Results

Focal RPE atrophy was present below or adjacent to the schisis in all eyes, and the mean atrophy area was 1.38 ± 1.37 mm2. Intraretinal fluids of the schisis originated from the atrophy area and involved the retinal layer which was correlated with the extent of outer retinal defect. Dilated Haller layer vessel and choroidal vascular hyperpermeability were observed under the area with atrophy in all eyes. After 1 year of treatment, 11 eyes (52%) still had fluid and 7 of them had fluid at the macula. Nonetheless, the mean central macular thickness decreased (144.4 to 121.8, P < 0.001), visual acuity improved (0.65 to 0.47, P = 0.026), and subfoveal choroidal thickness decreased (442.2 μm to 394.9 μm, P < 0.001).

Conclusion

Atrophy of RPE can cause retinoschisis in eyes with pachychoroid. The intraretinal fluid that originated from underlying choroid and choroidal thickness decreased as intraretinal fluid diminished.

Keywords

Pachychoroid Retinoschisis RPE atrophy Intraretinal fluid Intraretinal cystic cavities Choroidal hyperpermeability 

Notes

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest for any author of this article.

Financial disclosure(s)

Won Ki Lee has served on advisory boards for Novartis, Bayer, Allergan, Alcon, and Santen, and has received consultancy fees from these companies. He has received payments for lectures from Novartis, Bayer, Allergan and Alcon. Jiwon Baek and Jae Hyung Lee has no financial disclosures to report.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was waivered because of the retrospective design of the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  2. 2.Department of Ophthalmology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  3. 3.Retina CenterNune Eye HospitalSeoulRepublic of Korea

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