Abstract
Purpose
The purpose of this study was to evaluate the clinical features, optical coherence tomography (OCT) findings, and surgical outcomes of eyes with macular retinoschisis associated with glaucomatous optic neuropathy and normal intraocular pressure (IOP).
Methods
In this retrospective interventional observational study, 11 eyes of 11 patients who underwent pars plana vitrectomy for macular retinoschisis and glaucomatous optic neuropathy were studied. All eyes had a vertical cup-to-disc ratio of ≥0.7 and retinal nerve fiber layer (RNFL) defects. Intraocular pressure (IOP) was <21 mmHg in all eyes, and there was no presence of congenital optic disc pits or high myopia in any eyes. The best-corrected visual acuity (BCVA) and the appearance of the fundus and OCT images were evaluated.
Results
The retinoschisis extended from the optic disc to the macula in all 11 eyes, and foveal detachment was present in 10 eyes. OCT showed vitreous adhesions near the RNFL defects and over the retinal vessels. The retinoschisis in the RNFL resolved immediately after the vitrectomy, and the BCVA improved significantly (p = 0.004). Macular retinoschisis resolved or decreased in all cases, although it required an average of 11 ± 3 months. The optic disc cup and RNFL defects were more clearly visible after resolution of the retinoschisis.
Conclusions
Macular retinoschisis can develop from vitreous traction near the RNFL defect in eyes with glaucomatous optic neuropathy and normal IOP. We suggest that the traction on the structurally fragile RNFL contributed to the retinoschisis.
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Acknowledgements
The authors declare that no government or non-government financial support was involved in the work for this submission. Contributions of authors are as follows: management, analysis, interpretation, and preparation of data (MI, YI, TR, YK, KH, DK, AH); interpretation and preparation of the manuscript (MI, YI, RT, YK, AH). The study and data accumulation were carried out with approval from the Institutional Review Board of the Kyorin University School of Medicine, and conformed to the tenets of the Declaration of Helsinki. Informed consent for the research was obtained from all patients.
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The authors have no proprietary or commercial interest in any materials discussed in these reported clinical observations or this article.
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Inoue, M., Itoh, Y., Rii, T. et al. Macular retinoschisis associated with glaucomatous optic neuropathy in eyes with normal intraocular pressure. Graefes Arch Clin Exp Ophthalmol 253, 1447–1456 (2015). https://doi.org/10.1007/s00417-014-2830-0
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DOI: https://doi.org/10.1007/s00417-014-2830-0