Atlas of Ophthalmology

Bilateral Macular Retinoschisis in Mild Myopia (Colour Image Photography, SD-OCT)

Retina -> Aquired Macular Diseases
Patient: 50 years of age, female, mild myopia, BCVA -8.5dpt=0.25 at OD, -8.0dpt=0.3 at OS. Ocular Medical History: decreasing vision at both eyes. General Medical History: empty. Main Complaint: low vision. Purpose: to present bilateral retinoschisis in mild myopia. Methods: Colour image photography, Spectral Optical Coherence Tomography (Heidelberg Engineering). Findings: Colour image photography in OD: regular findings in macula, no typical myopic chorioretinal atrophy. Colour image photography in OS: regular findings in macula, no typical myopic chorioretinal atrophy. SD-OCT in OD: showing macular retinoschisis with evident column-like structures superior and inferior to the central fovea, small central focal retinal detachment (*), partially detached posterior hyaloid. SD-OCT in OS: showing macular retinoschisis with evident column-like structures superior and inferior to the central fovea, no central focal retinal detachment , partially detached posterior hyaloid. Discussion: Takano et al. (1) reported, that macular retinoschisis can be detected by optical coherence tomography (OCT) in highly myopic eyes before the development of macular holes. He observed this condition in 9% to 34% of highly myopic eyes with a posterior staphyloma. It was suggested, that in approximately half of the patients with a macular retinoschisis, a macular hole or retinal detachment developed within two or more years. Vitreous traction and scleral and chorioretinal changes are considered to be causative factors for the formation of macular retinoschisis. Intravitreal ranibizumab injection is effectitve on treating myopic CNVs, but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis. Huang J et al. (2) reported, that 7 of the 11 eyes with preexisted retinoschisis developed more severe retinoschisis, the mean maximal retinal thickness increased from 380 to 467 µm. Literature: (1) M. Takano, S. Kishi. Foveal retinoschisis and retinal detachment in severely myopic eyes with staphyloma. Am J Ophthalmol, 128 (1999), pp. 472–476. (2) Huang J, Chen T, Lu Y, Long L, Dai H. Retinoschisis and intravitreal ranibizumab treatment for myopic choroidal neovascularization. Chin Med J (Engl). 2014;127(11):2053-7.

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