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Orr S, Hatamnejad A, Sodhi S, Golding J, Pattathil N, Choudhry N. Novel features of degenerative retinoschisis identified using ultra-widefield multicolor channels: A review of 139 eyes. Acta Ophthalmol 2024; 102:e961-e969. [PMID: 38533620 DOI: 10.1111/aos.16683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND/OBJECTIVE To utilize ultra-widefield multimodal imaging (Optos PLC) to describe novel findings in degenerative retinoschisis. METHODS This retrospective, non-comparative case series of degenerative retinoschisis received a waiver of consent from Advarra IRB, Protocol 00066379. Initial ultra-widefield pseudocolour, colour-separated, autofluorescence, and peripheral OCT imaging were analysed for characterizing features. RESULTS In total, 139 eyes were included. A hyporeflective reticular pattern associated with retinoschisis was seen on pseudocolour images in 39% of cases, but visible in 53% on green-separated images. Fine hyper-reflective foci were observed in 49%. In 27%, retinoschisis was confirmed with OCT. CONCLUSIONS Ultra-widefield pseudocolour and green-separated images are valuable for the diagnosis and characterization of degenerative retinoschisis. The findings described may prompt the evaluation of subtle retinoschisis with peripheral OCT.
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Affiliation(s)
- Samantha Orr
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
| | - Amin Hatamnejad
- Octane Imaging Lab, Toronto, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
| | - Simrat Sodhi
- Octane Imaging Lab, Toronto, Ontario, Canada
- University of Cambridge, Cambridge, UK
| | - John Golding
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
| | - Niveditha Pattathil
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, Toronto, Ontario, Canada
- Octane Imaging Lab, Toronto, Ontario, Canada
- Department of Ophthalmology & Visual Sciences, University of Toronto, Toronto, Ontario, Canada
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Jalalizadeh RA, Smith BT. Characterization and diagnosis of retinoschisis and schisis detachments using spectral domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2023; 261:375-380. [PMID: 35984486 DOI: 10.1007/s00417-022-05801-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/03/2022] [Accepted: 08/04/2022] [Indexed: 01/17/2023] Open
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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Affiliation(s)
| | - Bradley T Smith
- The Retina Institute, 2201 S Brentwood Blvd, Saint Louis, MO, 63144, USA.
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Wang XF, Chen FF, Zhou X, Cheng XX, Xie ZG. A novel mutation in RS1 and clinical manifestations in a Chinese twin family with congenital retinoschisis. Front Genet 2022; 13:993157. [PMID: 36212125 PMCID: PMC9538544 DOI: 10.3389/fgene.2022.993157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: We aim to analyze the clinical and genetic features in a Chinese family with congenital retinoschisis by whole-exome sequencing and comprehensive clinical examination.Methods: Six members were recruited from a Chinese family. Three of them were diagnosed as congenital retinoschisis, including two twin siblings. All subjects received a full eye examination. Whole-exome sequencing (WES) and Sanger sequencing were performed on two twin probands and all participants, respectively.Results: A novel splice site mutation RS1.c.53-1G>A was identified in a Chinese congenital retinoschisis family. The mean onset age was 16.7 ± 2.4 years old. The average BCVA in patients was 0.37 ± 0.05. A typical spoke-wheel pattern was observed in all affected eyes. OCT examination results showed fovea schisis and schisis cavities were located in the inner nuclear layer in 100% eyes (6/6). ERG b/a ratio was decreased markedly, but was still more than 1 in the four eyes that were available.Conclusion: The present study discovered a new pathogenic splice cite variant of RS1 in congenital retinoschisis, which expands the mutational spectrum. In contrast to previous research, the phenotype of patients with the same mutation within one family was highly similar. Early molecular testing is crucial for early diagnosis, clinical management, and genetic counseling of patients with congenital retinoschisis.
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Affiliation(s)
- Xiao-Fang Wang
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Fei-Fei Chen
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhou
- Department of Ophthalmology, The First People’s Hospital of Kunshan Affiliated with Jiangsu University, Suzhou, China
| | - Xin-Xuan Cheng
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zheng-Gao Xie
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
- *Correspondence: Zheng-Gao Xie,
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Ness S, Subramanian ML, Chen X, Siegel NH. Diagnosis and Management of Degenerative Retinoschisis and Related Complications. Surv Ophthalmol 2021; 67:892-907. [PMID: 34896193 DOI: 10.1016/j.survophthal.2021.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
Degenerative retinoschisis is a common condition characterized by elevation of the inner layers of the peripheral retina. While uncomplicated retinoschisis (i.e. with no associated retinal layer breaks) is almost invariably a benign process, retinal detachment associated with isolated outer layer breaks (termed schisis-detachment) is fairly common. Historically, schisis-detachment has been treated with a variety of interventions ranging from retinopexy to intraocular surgery. Based on published descriptions of the natural history of the disease, these interventions are likely unnecessary in many cases and may place the patient's vision at unnecessary risk. Progressive symptomatic schisis-related retinal detachment, on the other hand, is a vision threatening condition that requires intervention. While clinical examination remains the mainstay of diagnosis, recent advances in multimodal imaging can provide supplemental information in subtle cases and may prove valuable for long-term disease monitoring. When evaluating patients with peripheral retinal elevation, it is important for ophthalmologists to make an accurate diagnosis and understand the risk-benefit ratio associated with intervention. Thus, we summarize the current literature on the natural history, clinical and imaging diagnosis, and surgical management of degenerative retinoschisis and its related complications.
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Affiliation(s)
- Steven Ness
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
| | - Manju L Subramanian
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Xuejing Chen
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Nicole H Siegel
- Retina Service, Department of Ophthalmology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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Gao F, Dong J, Wang D, Chen F, Hu F, Chang Q, Xu P, Liu W, Li J, Huang Y, Wu J, Xu G. Comprehensive analysis of genetic and clinical characteristics of 30 patients with X-linked juvenile retinoschisis in China. Acta Ophthalmol 2021; 99:e470-e479. [PMID: 33124204 PMCID: PMC8359357 DOI: 10.1111/aos.14642] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/05/2020] [Accepted: 09/06/2020] [Indexed: 12/13/2022]
Abstract
Purpose To provides the clinical and genetic characteristics of a series of Chinese patients with X‐linked juvenile retinoschisis (XLRS) through multimodal imaging and next‐generation sequencing. Methods Thirty patients (60 eyes) from 29 unrelated families of Chinese origin with XLRS were screened using multigene panel testing, and underwent a complete clinical evaluation. All variants identified in this study and reported in the Human Gene Mutation Database were analysed. Results Twenty‐five distinct variants in the retinoschisin gene were identified, of which eight were novel, and one was de novo. Missense mutations were the most prevalent type, and mutation hot spot was localized in the discoidin domain. The mean Snellen best‐corrected visual acuity was 0.28 ± 0.17. Of all eyes presenting with schisis, 92.86% had lamellar schisis and 62.5% had peripheral schisis. Schisis changes mostly involved inner and outer nuclear layers. X‐linked juvenile retinoschisis (XLRS) patients had a high incidence of complications, and peripheral schisis was a risk factor for it. No obvious genotype–phenotype association was observed. Conclusion This study provides comprehensive analyses of the genetic and clinical characteristics of XLRS in a cohort of Chinese patients. The fourth de novo mutation in RS1 was identified. And we show that XLRS has a wide spectrum of clinical characteristics; hence, molecular diagnosis is crucial for its diagnosis, differential diagnosis and genetic counselling. Peripheral schisis is a risk factor for the high incidence of complications, and no clear genotype–phenotype correlations were found.
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Affiliation(s)
- Feng‐Juan Gao
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Jian‐Hong Dong
- Department of Ophthalmology Central Hospital of Xuhui District Shanghai China
| | - Dan‐Dan Wang
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Fang Chen
- BGI‐Shenzhen Shenzhen China
- Laboratory of Genomics and Molecular Biomedicine Department of Biology University of Copenhagen Copenhagen Denmark
- Shenzhen Engineering Laboratory for Birth Defects Screening BGI‐Shenzhen Shenzhen China
| | - Fang‐Yuan Hu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Qing Chang
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Ping Xu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Wei Liu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Jian‐Kang Li
- BGI‐Shenzhen Shenzhen China
- Department of Computer Science City University of Hong Kong Kowloon Hong Kong SAR China
| | - Ying Huang
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
| | - Ji‐Hong Wu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
| | - Ge‐Zhi Xu
- Eye Institute Eye and ENT Hospital College of Medicine Fudan University Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration Science and Technology Commission of Shanghai Municipality Shanghai China
- Key Laboratory of Myopia (Fudan University) Chinese Academy of Medical Sciences National Health Commission Shanghai China
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DETECTION OF NEUROSENSORY RETINAL DETACHMENT COMPLICATING DEGENERATIVE RETINOSCHISIS BY ULTRA-WIDEFIELD FUNDUS AUTOFLUORESCENCE IMAGING. Retina 2021; 40:819-824. [PMID: 31397744 PMCID: PMC7176347 DOI: 10.1097/iae.0000000000002488] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine whether neurosensory retinal detachment complicating degenerative retinoschisis (RS) can be reliably detected with ultra-widefield fundus autofluorescence evaluation. METHODS Consecutive patients diagnosed with RS who had ultra-widefield fundus autofluorescence imaging were included in this retrospective case series. According to the fundus autofluorescence patterns, we divided the eyes into two groups: 1) eyes with RS and a hyperautofluorescent leading edge and 2) eyes with RS and without hyperautofluorescence. Peripheral spectral domain optical coherence tomography images at the level of RS were obtained. RESULTS Thirty-eight eyes that met eligibility criteria were identified. Review of ultra-widefield fundus autofluorescence demonstrated 21/39 (55%) eyes with distinctive hyperautofluorescence over the area of RS (Group A) and 17/38 (45%) eyes without any form of hyperautofluorescence (Group B). Spectral domain optical coherence tomography images confirmed the presence of full-thickness neurosensory retina separation from the underlying retinal pigment epithelium in the areas of hyperautofluorescence in 10/10 eyes (100%) from Group A. None (0/11; 0%) of the eyes from Group B showed full-thickness neurosensory retina separation on the spectral domain optical coherence tomography imaging of the retina-RS interface. CONCLUSION Hyperautofluorescent findings suggest the presence of a neurosensory retinal detachment. Retinal detachment associated with RS can be reliably detected on ultra-widefield fundus autofluorescence and may be a useful diagnostic imaging modality.
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Mandura RA. Acquired Senile Retinoschisis of the Peripheral Retina Imaged by Spectral Domain Optical Coherent Tomography. Cureus 2021; 13:e14540. [PMID: 34017655 PMCID: PMC8130636 DOI: 10.7759/cureus.14540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/05/2022] Open
Abstract
Senile retinoschisis (SR) is a rare eye disease characterized by the abnormal separation of the neurosensory retina layers typically at the outer plexiform layer. Retinal detachment (RD) can be associated with SR in approximately 0.05% of the cases in which urgent treatments are indicated. The utility of spectral domain optical coherent tomography (SD-OCT) is helpful in diagnosing SR and distinguishing it from RD. This is a case of a 63-year-old man who presented with right eye floaters for a duration of two months. There were no other optic symptoms such as flashes of light, decreased vision, or pain. The best-corrected visual acuity was 20/25 in both eyes. Dilated fundus examination of the right eye revealed two elevated dome-shaped, mobile, transparent, smooth, and round peripheral retinal lesions in the inferotemporal quadrant suggestive of SR. SD-OCT was utilized to diagnose SR and rule out RD. In conclusion, SD-OCT is a very valuable diagnostic tool that can be utilized for SR which is a rare condition that can have serious visual consequences if not diagnosed and managed properly.
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Affiliation(s)
- Rahaf A Mandura
- Department of Ophthalmology, King Abdulaziz University, Jeddah, SAU
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Navaratnam J, Salvanos P, Vavvas DG, Bragadóttir R. Ultra-widefield autofluorescence imaging findings in retinoschisis, rhegmatogenous retinal detachment and combined retinoschisis retinal detachment. Acta Ophthalmol 2021; 99:195-200. [PMID: 32602221 DOI: 10.1111/aos.14521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/26/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Retinoschisis (RS), rhegmatogenous retinal detachment (RRD) and combined RS retinal detachment (RSRD) may resemble clinically and pose a diagnostic challenge. This study investigates the role of the fundus autofluorescence (AF) in differentiating RS, RRD and RSRD. METHODS Fundus AF changes of 34 eyes diagnosed with RRD, 30 eyes with RS and 12 eyes with RSRD were retrospectively analysed. Ultra-widefield AF (UW-AF) image intensities obtained with the Optomap 200Tx were interpreted as hypo-, hyper- and isoautofluorescent or a mixed pattern with hypo- and hyperautofluorescence over and at the posterior margin (PM) of RRD, RS and RSRD. RESULTS All RS eyes revealed isoautofluorescence over the area of RS, and nine eyes (30%) showed hypoautofluorescent PM. Among RRD, acute (≤2 weeks) and chronic (>2 weeks) RRD demonstrated distinct AF characteristics. Sixty-two per cent of RRD eyes had acute RRD. From those, 16 eyes (76%) demonstrated hypoautofluorescence over the detached area and 19 (90%) eyes with hyperautofluorescent PM. Sixty-two per cent of chronic RRD eyes demonstrated isoautofluorecence over the detached area. Eight RSRD eyes (67%) revealed hyperautofluorescence in the detached area. The positive predictive value (PPV) for hypoautofluorescence over the area of subretinal fluid (SRF) in RRD was 95%. The PPV for hyperautofluorescence over the area of SRF in RSRD was 100% and for isoautofluorescence for schitic area in RSRD and RS was 76%. CONCLUSION The UW-AF can be a useful non-invasive adjuvant tool to distinguish between RRD, RS and RSRD. Hypo- or hyperautofluorescence over the area of interest and hyperautofluorescent PM indicates the presence of SRF.
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Affiliation(s)
- Jesintha Navaratnam
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- University of Oslo Oslo Norway
| | - Panagiotis Salvanos
- University of Oslo Oslo Norway
- Department of Ophthalmology Drammen Hospital Vestre Viken Hospital Trust Drammen Norway
| | - Demetrios G. Vavvas
- Department of Ophthalmology Retina Service Massachusetts Eye and Ear Infirmary Harvard Medical School Boston Massachusetts USA
| | - Ragnheiður Bragadóttir
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- University of Oslo Oslo Norway
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Cao JL, Conti TF, Hom GL, Babiuch AS, Greenlee T, Ehlers JP, Rachitskaya A, Sharma S, Yuan A, Kaiser PK, Singh RP. Comparative Assessment of Widefield Fundus Autofluorescence Patterns in Retinoschisis and Retinal Detachment. JOURNAL OF VITREORETINAL DISEASES 2020; 4:286-292. [PMID: 37009186 PMCID: PMC9976111 DOI: 10.1177/2474126420907020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This article characterizes widefield fundus autofluorescence (WF-FAF) patterns in retinoschisis (RS), retinal detachment (RD), and combined retinoschisis-detachment (RS/RD), and to correlate them with spectral-domain optical coherence tomography (SD-OCT) findings. Methods: A retrospective case series of 13 eyes with senile RS, RD, or RS/RD is presented. One eye underwent imaging of 2 areas within the retina, resulting in 14 data points. Independent, masked graders classified pathology on SD-OCT as RS, RD, or RS/RD and graded WF-FAF images for either hypoautofluorescent areas or mixed autofluorescence (AF) (hyper-AF, iso-AF, hyper-AF with hypo-AF, hyper-AF with iso-AF, or hypo-AF with iso-AF). Results: There was no statistically significant correlation between the autofluorescence pattern and the type of retinal abnormality ( P = .74). Conclusions: High variability was found in the characterization of WF-FAF in patients with RS and RD. SD-OCT remains the criterion-standard imaging modality in distinguishing RS from RD in clinically ambiguous cases.
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Affiliation(s)
- Jessica L. Cao
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Thais F. Conti
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Grant L. Hom
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Case Western Reserve University, Cleveland, OH, USA
| | - Amy S. Babiuch
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Tyler Greenlee
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Justis P. Ehlers
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Sumit Sharma
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Alex Yuan
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Peter K. Kaiser
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Rishi P. Singh
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Case Western Reserve University, Cleveland, OH, USA
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Comparing fundus autofluorescence and infrared imaging findings of peripheral retinoschisis, schisis detachment, and retinal detachment. Am J Ophthalmol Case Rep 2020; 18:100666. [PMID: 32258825 PMCID: PMC7125323 DOI: 10.1016/j.ajoc.2020.100666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/03/2019] [Accepted: 03/11/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose The primary goal of this study was to identify characteristic features of peripheral degenerative retinoschisis (RS), schisis detachment (SD) and retinal detachment (RD) on both fundus autofluorescence (FAF) and infrared (IR) imaging, using spectral domain optical coherence tomography (SD-OCT) imaging of the peripheral retina as the confirmatory imaging tool. Methods This is a descriptive case series study. A total of 27 eyes of 22 patients were included. Thirteen eyes of 10 patients diagnosed with RS, 4 eyes of 3 patients diagnosed with SD, and 10 eyes of 9 patients diagnosed with RD were included. Patients with images of poor quality were excluded. Heidelberg Spectralis HRA + OCT machine (Heidelberg Engineering, Heidelberg, Germany) were used to acquire the images. Results All conditions appeared as areas of hypo-AF on FAF and hypo-reflectance on IR imaging. Accentuated vasculature of the lesion was noted with IR imaging due to elevation of the RS and RD, which was less frequently observed with FAF. On FAF, a hyper-AF leading edge around the RS lesion indicated the presence of intraretinal or subretinal fluid and an extension of the RS. Retinal breaks/holes were best visualized with IR imaging. SD-OCT confirmed the diagnosis in all performed cases. Conclusions We were unable to differentiate between RS and RD based solely on findings from FAF and IR imaging. However, the combination of them with SD-OCT can assist in the diagnosis of RS from RD and in the evaluation of RS progression. OCT remains the main modality imaging to differentiate these conditions.
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Leshno A, Barak A, Barzelay A, Zloto O, Neudorfer M. Diagnosis of Peripheral Retinoschisis Using Ultrasound Biomicroscopy. Ophthalmic Surg Lasers Imaging Retina 2020; 50:e196-e202. [PMID: 31415704 DOI: 10.3928/23258160-20190806-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/17/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVE Retinal imaging can help differentiate retinoschisis (RS) from retinal detachment (RD). This study describes new sonographic features of RS using ultrasound biomicroscopy (UBM) and evaluates their diagnostic value. PATIENTS AND METHODS Medical records of subjects diagnosed with RS and RD who underwent imaging prior to intervention were reviewed. Images were evaluated for detachment shape ultrasound (US) B-mode, as well as presence of intraretinal pillars, retinal layers split, and intraretinal cysts on UBM. RESULTS Of 48 eyes from 48 patients in the study, 25 were diagnosed as RS and 23 as RD. "Retinal layers split" was the most common UBM finding in the RS group (72%), followed by intraretinal pillars (64%) and intraretinal cysts (36%). No RD case exhibited these findings (P < .001). CONCLUSIONS UBM might assist in difficult cases to differentiate between RS and RD by detection of the unique sonographic features of RS described herein. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e196-e202.].
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Nadelmann JB, Gupta MP, Kiss S, Askin G, Chan RP, Papakostas T, D'Amico DJ, Orlin A. Ultra-Widefield Autofluorescence Imaging of Retinal Detachment Compared to Retinoschisis. Ophthalmic Surg Lasers Imaging Retina 2019; 50:550-556. [DOI: 10.3928/23258160-20190905-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/17/2019] [Indexed: 11/20/2022]
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Schaefer EAF, Whiting REH, Pearce JW, Grahn BH, Hamm CW, Moore CP, Narfström KL. Bilateral retinoschisis in a dog: A veterinary clinical application for optical coherence tomography. Vet Ophthalmol 2018. [DOI: 10.1111/vop.12557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth A. F. Schaefer
- Department of Veterinary Medicine and Surgery; University of Missouri College of Veterinary Medicine; Columbia MO USA
| | | | - Jacqueline W. Pearce
- Department of Veterinary Medicine and Surgery; University of Missouri College of Veterinary Medicine; Columbia MO USA
| | - Bruce H. Grahn
- Department of Small Animal Clinical Sciences; University of Saskatchewan; Saskatoon SK Canada
| | - Charles W. Hamm
- Department of Ophthalmology; School of Medicine; Columbia MO USA
| | - Cecil P. Moore
- Department of Veterinary Medicine and Surgery; University of Missouri College of Veterinary Medicine; Columbia MO USA
| | - Kristina L. Narfström
- Department of Veterinary Medicine and Surgery; University of Missouri College of Veterinary Medicine; Columbia MO USA
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Landa G, Shirkey BL, Garcia PM, Milman T, Garcia JP, Rosen RB. Acquired Senile Retinoschisis of the Peripheral Retina Imaged by Spectral Domain Optical Coherence Tomography: A Case Report. Eur J Ophthalmol 2018; 20:1079-81. [DOI: 10.1177/112067211002000610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose We report spectral domain optical coherence tomography findings of the peripheral retina in a patient with senile (acquired) retinoschisis. Methods This is an observational case report. Spectral domain optical coherence tomography was performed to image the peripheral retina at the area of retinoschisis in a 70-year-old man with bilateral inferonasal elevated peripheral retinal lesions. Since the lesions were not entirely transparent and smooth, and demonstrated a certain degree of mobility, the diagnosis of retinal detachment could not be excluded. Results Spectral domain optical coherence tomography scans obtained at the margin of the lesions demonstrated attached retina with a characteristic splitting of the neurosensory retina at the outer plexiform layer and cystic changes in the inner retina. Conclusions Spectral domain optical coherence tomography can assist in the diagnosis of senile (acquired) retinoschisis, particularly in cases where retinal detachment cannot be excluded on clinical examination alone.
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Affiliation(s)
- Gennady Landa
- Retina Center, Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY - USA
- Department of Ophthalmology, New York Medical College, Valhalla, NY - USA
| | - Belinda L. Shirkey
- Retina Center, Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY - USA
- Department of Ophthalmology, New York Medical College, Valhalla, NY - USA
| | - Patricia M.T. Garcia
- Retina Center, Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY - USA
- Department of Ophthalmology, New York Medical College, Valhalla, NY - USA
| | - Tatyana Milman
- Department of Ophthalmology, New York Medical College, Valhalla, NY - USA
- Department of Pathology and Laboratory Medicine, New York Eye and Ear Infirmary, New York, NY - USA
| | - Julian P.S. Garcia
- Retina Center, Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY - USA
- Department of Ophthalmology, New York Medical College, Valhalla, NY - USA
| | - Richard B. Rosen
- Retina Center, Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY - USA
- Department of Ophthalmology, New York Medical College, Valhalla, NY - USA
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Eibenberger K, Sacu S, Rezar-Dreindl S, Pöcksteiner J, Georgopoulos M, Schmidt-Erfurth U. Monitoring retinoschisis and non-acute retinal detachment by optical coherence tomography: morphologic aspects and clinical impact. Acta Ophthalmol 2017; 95:710-716. [PMID: 28321986 DOI: 10.1111/aos.13424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 01/26/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE To differentiate retinoschisis (RS) from non-acute retinal detachment (naRD) in clinical routine using optical coherence tomography (OCT), describe unique morphological OCT characteristics and monitor disease progression. METHODS This prospective, observational study included 64 eyes of 44 patients with either RS or naRD. Patients were examined clinically and using Heidelberg Spectralis OCT® , Topcon DRI OCT® and Cirrus HRA-OCT® over 2 years with follow-up at 1, 3, 6, 12 and 24 months. Main outcomes were typical morphologic findings of RS and naRD described in OCT. Progression was monitored using Spectralis OCT® follow-up mapping and an eye-tracking method. RESULTS Forty-seven eyes were diagnosed with RS and 17 with naRD. Optical coherence tomography (OCT) provided a definite diagnosis in four eyes diagnosed clinically as uncertain. Seventy-seven percentage of eyes with RS were atrophic in the inner leaf (IL), whereas 41% with naRD showed cystoid alteration. A discontinuation of the IL clinically observed as an inner-layer break (ILB) could be imaged. We described a tissue retraction within the outer leaf (OL), which corresponded to outer-layer breaks (OLBs) in clinical examinations in nine eyes (19%). CONCLUSION Optical coherence tomography (OCT) is a reliable method to differentiate and monitor RS from naRD. Morphological characteristics, including ILB and OLB, could be accurately illustrated in RS.
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Affiliation(s)
- Katharina Eibenberger
- Department of Ophthalmology and Optometry; Medical University of Vienna; Vienna Austria
| | - Stefan Sacu
- Department of Ophthalmology and Optometry; Medical University of Vienna; Vienna Austria
| | - Sandra Rezar-Dreindl
- Department of Ophthalmology and Optometry; Medical University of Vienna; Vienna Austria
| | - Julia Pöcksteiner
- Department of Ophthalmology and Optometry; Medical University of Vienna; Vienna Austria
| | - Michael Georgopoulos
- Department of Ophthalmology and Optometry; Medical University of Vienna; Vienna Austria
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A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment. J Ophthalmol 2017; 2017:6742164. [PMID: 28409023 PMCID: PMC5376471 DOI: 10.1155/2017/6742164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 11/28/2016] [Accepted: 12/05/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p < 0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p = 0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.
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Wallsh JO, Gallemore RP. Identifying rhegmatogenous detachments in bullous retinoschisis with optical coherence tomography studies. Am J Ophthalmol Case Rep 2016; 6:38-40. [PMID: 29260053 PMCID: PMC5722190 DOI: 10.1016/j.ajoc.2016.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/03/2016] [Accepted: 09/08/2016] [Indexed: 11/27/2022] Open
Abstract
Purpose To demonstrate a novel technique for capturing optical coherence tomography images of peripheral retina and its application in identifying rhegmatogenous retinal detachments within bullous retinoschisis. Observations We report two patients presenting with bullous retinoschisis noted on clinical examination. After performing optical coherence tomography studies utilizing our image acquisition technique these lesions were found to be associated with rhegmatogenous retinal detachments. Both patients were subsequently treated without further complications. Conclusions and importance The image acquisition technique described herein allows visualization of peripheral retina utilizing optical coherence tomography studies to identify areas of rhegmatogenous retinal detachment within bullous retinoschisis that are otherwise difficult to discern.
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Affiliation(s)
- Josh O Wallsh
- Retina Macula Institute, 4201 Torrance Blvd Ste 220, Torrance, CA, 90503, United States
| | - Ron P Gallemore
- Retina Macula Institute, 4201 Torrance Blvd Ste 220, Torrance, CA, 90503, United States
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Rachitskaya AV, Yuan A, Singh RP, Sears JE, Schachat AP. Optical coherence tomography of outer retinal holes in senile retinoschisis and schisis-detachment. Br J Ophthalmol 2016; 101:445-448. [DOI: 10.1136/bjophthalmol-2016-308551] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/04/2016] [Accepted: 06/06/2016] [Indexed: 11/04/2022]
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Prevalence of macular complications associated with high myopia by multimodal imaging. J Fr Ophtalmol 2016; 39:355-63. [PMID: 27016335 DOI: 10.1016/j.jfo.2015.11.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 11/04/2015] [Accepted: 11/12/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE To describe the prevalence of macular complications in patients with visual acuity decrease related to high myopia (HM). To establish correlations between these complications and demographic or anatomical characteristics. MATERIALS AND METHODS Cross-sectional observational study including HM patients undergoing best-corrected visual acuity (BCVA), fundus examination, macular SD-OCT, and fluorescein angiography in the case of suspicion of choroidal neovascularization (CNV). The presence of anatomical criteria (staphyloma, subfoveal choroidal thickness [CT]) and macular complications (CNV, lacquer cracks, central chorioretinal atrophy, dome-shaped macula with serous retinal detachment [SRD], retinal foveoschisis, macular hole and epiretinal membrane) was investigated. RESULTS A total of 87 eyes of 47 patients were included (39 eyes without macular complication and 48 eyes with macular complications). In the case of macular complications, decrease in BCVA was related to CNV in 33%, macular hole in 25%, chorioretinal atrophy in 19%, foveoschisis in 11%, lacquer crack in 6%, to a dome-shape macula with serous retinal detachment in 4% and epiretinal membrane in 2%. After adjusting for interocular correlation and degree of myopia, staphyloma (P=0.0023), choroidal thinning (P=0.0036), and extrafoveal chorioretinal atrophy (P=0.042) were significantly associated with macular complications. CONCLUSIONS High myopic patients with staphyloma or choroidal thinning should undergo regular comprehensive retinal screening for retinal complications.
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Characterization of retinal structure and diagnosis of peripheral acquired retinoschisis using high-resolution ultrasound B-scan. Graefes Arch Clin Exp Ophthalmol 2015; 254:69-75. [DOI: 10.1007/s00417-015-3013-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 02/26/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022] Open
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Stehouwer M, Tan SH, van Leeuwen TG, Verbraak FD. Senile retinoschisis versus retinal detachment, the additional value of peripheral retinal OCT scans (SL SCAN-1, Topcon). Acta Ophthalmol 2014; 92:221-7. [PMID: 23773202 DOI: 10.1111/aos.12121] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE A peripheral senile retinoschisis is sometimes difficult to distinguish from a retinal detachment by biomicroscopy alone. This study evaluated spectral domain OCT (SD-OCT) scans of the far peripheral retina to improve the differentiation between these diseases. METHODS Patients were included in whom the distinction between retinal detachment and senile retinoschisis was not clear based on biomicroscopy alone, or who had a presumed clinical diagnosis of senile retinoschisis. OCT scans were made with the SLSCAN-1, through a hand-held lens and a 3-mirror contact lens, while the area of interest was simultaneously observed with the slit lamp. The SLSCAN-1 is a SD-OCT integrated into a slit lamp, superluminescent diode light source with a central wavelength of 830 nm, bandwidth 30 nm, scan resolution 8-9 μm in tissue, scan depth 2 mm, scan speed 5000 A-scans per second. RESULTS In the 11 patients with an uncertain diagnosis, OCT scans showed a senile retinoschisis in four and a retinal detachment in seven patients. Fifteen of the 18 patients with a presumed diagnosis of retinoschisis showed a retinoschisis on OCT. In five of them, the OCT scans revealed a schisis detachment. Interestingly, three of the 18 patients had a retinal detachment. CONCLUSION Senile retinoschisis may mimic a peripheral retinal detachment and vice versa. Differentiation is important with respect to therapeutic decisions. OCT scans of the far peripheral retina, which can be made with the SLSCAN-1 through a 3-mirror contact lens, can contribute significantly to this differentiation. The obtained scans of the far peripheral retina clearly visualize the anatomic differences between both diseases.
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Affiliation(s)
- Marilette Stehouwer
- Department of Ophthalmology, Academic Medical Centre, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Biomedical Engineering and Physics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Maalej A, Wathek C, Khallouli A, Rannen R, Gabsi S. [Foveoschisis in highly myopic eyes: clinical and tomographic features]. J Fr Ophtalmol 2014; 37:42-6. [PMID: 24588030 DOI: 10.1016/j.jfo.2013.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Foveoschisis is a rare condition in highly myopic eyes, characterized by intra-retinal cleavage associated with abnormalities of the vitreous cortex and occasionally cortical retraction. The natural history of foveoschisis is unpredictable. The functional prognosis is often favorable after surgical treatment. MATERIALS AND METHODS We report 7 cases of macular retinoschisis in highly myopic eyes. We describe the optical coherence tomographic features as well as associated signs. The correlation with visual acuity was assessed. RESULTS Foveoschisis was undetected on clinical exam and visualized only on optical coherence tomography (OCT) in 4 cases. Mean central foveal thickness was 540 , mean visual acuity was 1/10—P10. The thicker the macula was, the worse was the visual acuity. The presenceor absence of serous retinal detachment did not affect visual acuity, whereas an epiretinal membrane or retraction of the vitreous cortex appeared to induce visual loss. CONCLUSION OCT has been demonstrated to be particularly useful for the diagnosis of visual loss in the high myope, notably in the case of foveoschisis. Anatomic-functional correlations in high myopic foveoschisis are not yet well clarified. Posterior pole retinal detachment and macular hole are the most serious complications.
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Surgical outcomes of macular buckling techniques for macular retinoschisis in highly myopic eyes. Saudi J Ophthalmol 2013; 27:235-9. [PMID: 24409086 DOI: 10.1016/j.sjopt.2013.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 07/26/2013] [Accepted: 08/14/2013] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To report the anatomic and visual results following macular buckling for patients with macular retinoschisis related to high myopia. METHODS Thirty-nine highly myopic eyes (mean refractive error -16.7 D; range, -9 to -24 D) of 36 patients (mean age 59 years; range, 35-79 years) presenting with macular retinoschisis associated with a posterior staphyloma, who underwent combined vitrectomy and macular buckling were evaluated. Main outcome measures included best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings. Three cases were excluded due to short follow-up (less than 3 months). The mean follow-up was 16 months. RESULTS The mean BCVA increased from 0.76 to 0.43 LogMAR (p = 0.001). Visual acuity improved in 30 eyes (83.3%), remained stable in three eyes (8.3%) and decreased in three eyes (8.3%). OCT showed resolution of foveoschisis with foveal reattachment in all eyes. None of the evaluated patients developed a macular hole during follow-up. CONCLUSION Macular buckling associated with vitrectomy results in good anatomic and visual outcomes in patients with myopic foveoschisis.
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Henaine-Berra A, Zand-Hadas IM, Fromow-Guerra J, García-Aguirre G. Prevalence of Macular Anatomic Abnormalities in High Myopia. Ophthalmic Surg Lasers Imaging Retina 2013; 44:140-4. [DOI: 10.3928/23258160-20130219-01] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 12/18/2012] [Indexed: 11/20/2022]
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Ikuno Y, Ohji M. High Myopia and the Vitreoretinal Complications. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Use of spectral-domain optical coherence tomography to differentiate acquired retinoschisis from retinal detachment in difficult cases. Retina 2012; 32:1574-80. [PMID: 22481477 DOI: 10.1097/iae.0b013e3182411d90] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study presents a series of 10 patients who posed a diagnostic challenge regarding the diagnosis of acquired retinoschisis (RS) or retinal detachment (RD), where spectral-domain optical coherence tomography (OCT) with the Spectralis HRA and OCT device (Heidelberg Engineering, Heidelberg, Germany) was able to help make a correct diagnosis. METHODS Ten patients (five with acquired RS and five with RD) were referred to a vitreoretinal clinic at Moorfields Eye Hospital for definitive diagnosis and further management. All patients underwent scans with the Spectralis HRA and OCT device. RESULTS The Spectralis HRA and OCT was able to make a clear diagnosis of RS or RD in all patients. Of the five patients with RS confirmed on OCT, two were referred with RD, and of the five patients with RD, four were referred with RS. New OCT features of RS include the double schisis cavity phenomenon, intraretinal pillars through the schisis cavity, and irregularity of the inner surface of the attached outer leaf. CONCLUSION Spectral-domain OCT is a useful tool in distinguishing RS from RD, eliminating previous diagnostic uncertainty. The Spectralis HRA and OCT device has the added advantages of being able to reliably image anterior retinal pathology and produce high-definition images.
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Pathology of macular foveoschisis associated with degenerative myopia. J Ophthalmol 2010; 2010. [PMID: 20814547 PMCID: PMC2931386 DOI: 10.1155/2010/175613] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 06/09/2010] [Accepted: 07/13/2010] [Indexed: 11/18/2022] Open
Abstract
This is a clinicopathological paper on the histologic findings in myopia-associated macular foveoschisis. The findings on ophthalmic pathological study of a 73-year-old woman with high myopia are reviewed. Multiple retinoschisis cavities involving both the macula and retinal periphery were disclosed. Our paper offers tissue evidence and supports recent ocular coherence tomography reports of eyes with high myopia and associated macular foveoschisis.
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Peripheral Retinal Lesions. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00109-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Yeh SI, Chang WC, Chen LJ. Vitrectomy without internal limiting membrane peeling for macular retinoschisis and foveal detachment in highly myopic eyes. Acta Ophthalmol 2008; 86:219-24. [PMID: 17680839 DOI: 10.1111/j.1600-0420.2007.00974.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To report the surgical outcome of pars plana vitrectomy (PPV) without internal limiting membrane (ILM) peeling in three highly myopic patients with macular retinoschisis and associated posterior staphyloma. METHODS We report three highly myopic patients with macular retinoschisis and foveal detachment who underwent simple PPV without ILM peeling, with long-acting gas tamponade. Main outcome evaluations included best corrected visual acuity, biomicroscopic appearance and optical coherence tomography findings. RESULTS Pars plana vitrectomy without ILM peeling resulted in anatomic and functional improvement in all three operated eyes for follow-up periods of > or = 12 months. CONCLUSIONS Pars plana vitrectomy without ILM peeling is effective for treating macular retinoschisis and foveal detachment in highly myopic eyes with posterior staphyloma. Visual and anatomic outcomes are comparable with those in previous studies in which ILM removal was performed.
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Affiliation(s)
- Shu-I Yeh
- Department of Ophthalmology, Mackay Memorial Hospital, Taipei, Taiwan
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Optical Coherence Tomography and Retinal Thickness Assessment for Diagnosis and Management. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50093-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Reiser BJ, Ignacio TS, Wang Y, Taban M, Graff JM, Sweet P, Chen Z, Chuck RS. In vitro measurement of rabbit corneal epithelial thickness using ultrahigh resolution optical coherence tomography. Vet Ophthalmol 2005; 8:85-8. [PMID: 15762921 DOI: 10.1111/j.1463-5224.2005.00345.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The objective of this study was to reproducibly measure corneal epithelial thickness centrally and at the limbus in the rabbit cornea using ultrahigh resolution optical coherence tomography (OCT). Twelve freshly enucleated New Zealand white rabbit eyes were kept in a moist chamber at 4 degrees C. An ultrahigh resolution OCT system with a spatial resolution of 1.3 microm was used to image the cornea and its component layers. The central and peripheral (limbal) regions of all the samples were scanned within 6 h of harvest in order to minimize the post-mortem degradation of the corneal epithelium. The thickness of the corneal epithelium was determined by measuring the pixel equivalents of the obtained image. Unpaired Student's t-test was used to evaluate differences. The epithelial thickness centrally was found to be 45.8 +/- 2.2 microm, and 37.6 +/- 1.4 microm at the limbus (P < 0.001). Rabbit corneal epithelium is thicker centrally than at the limbus when measured by ultrahigh resolution OCT. This technique will aid in delineating the pathophysiology of diseases of the anterior cornea.
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Affiliation(s)
- Bibiana J Reiser
- Department of Ophthalmology, University of California, Irvine, California, USA
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Mason C, Markusen JF, Town MA, Dunnill P, Wang RK. The potential of optical coherence tomography in the engineering of living tissue. Phys Med Biol 2004; 49:1097-115. [PMID: 15128192 DOI: 10.1088/0031-9155/49/7/002] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The better repair of human tissue is an urgent medical goal and in order to achieve a safe outcome there is a parallel need for sensitive, non-invasive methods of assessing the quality of the engineered tissues and organs prior to surgical implantation. Optical coherence tomography (OCT) can potentially fulfil this role. The current status of OCT as an advanced imaging tool in clinical medicine, developmental biology and material science is reviewed and the parallels to the engineering of living tissue and organs are discussed. Preliminary data are also presented for a tissue engineering bioreactor with in situ OCT imaging. The data suggest that OCT can be utilized as a real time, non-destructive, non-invasive tool to critically monitor the morphology of tissue-engineered constructs during their fabrication and growth.
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Affiliation(s)
- C Mason
- Department of Biochemical Engineering, University College London, London WC1E 7JE, UK.
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Baba T, Hirose A, Moriyama M, Mochizuki M. Tomographic image and visual recovery of acute macula-off rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 2004; 242:576-81. [PMID: 14997321 DOI: 10.1007/s00417-004-0884-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2003] [Revised: 01/09/2004] [Accepted: 01/14/2004] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To observe the macula of acute rhegmatogenous retinal detachment involving the macula with optical coherence tomography (OCT) after scleral buckling and to study the relation between pre- and postoperative visual acuity and the OCT image. METHODS Prospective study of 15 eyes of 15 patients with macula-off rhegmatogenous retinal detachment. We selected cases with preoperative visual acuity worse than 0.5 to analyze the improvement in postoperative visual acuity. The time period between macula-off retinal detachment and surgery was less than 1 week. RESULTS Indirect ophthalmoscopy indicated that all retinal detachments were reattached at 2 weeks postoperatively. Accumulation of subretinal fluid at the fovea was observed in nine (60%) cases with OCT. In four of these nine eyes, the accumulation of subretinal fluid persisted up to 6 months after the operation. The presence of residual subretinal fluid did not influence visual recovery during the 6 months' postsurgical follow-up. CONCLUSIONS OCT revealed postoperative residual subretinal fluid at the macula in some acute macula-off retinal detachment cases. Residual subretinal fluid did not influence the recovery of visual acuity for at least 6 months after surgery.
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Affiliation(s)
- Takayuki Baba
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan.
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Tantri A, Vrabec TR, Cu-Unjieng A, Frost A, Annesley WH, Donoso LA. X-linked retinoschisis: A clinical and molecular genetic review. Surv Ophthalmol 2004; 49:214-30. [PMID: 14998693 DOI: 10.1016/j.survophthal.2003.12.007] [Citation(s) in RCA: 144] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
X-linked retinoschisis is a leading cause of macular degeneration in male children. It is characterized by a high degree of clinical variability. Clinical features include a stellate foveal retinoschisis, with or without peripheral retinoschisis. The schisis occurs within the inner retina, primarily at the level of the nerve fiber layer. The disease-causing gene, X-linked retinoschisis 1, has recently been identified, and is expressed in photoreceptor and bipolar cells. This gene codes for retinoschisin, a secreted protein containing a discoidin domain which may be involved in cellular adhesion or cell-cell interactions. The identification of this gene allows for improved diagnosis and contributes to the understanding of this condition. Visual prognosis is variable, as X-linked retinoschisis exhibits a high degree of phenotypic variability. Although there is no treatment to halt the progressive maculopathy, clinical management is directed toward treatment of amblyopia and surgical correction of certain complications. X-linked retinoschisis is an important condition to study, both to improve the clinical management of this disorder, and to better understand retinal function and development. Herein, we review the clinical, histopathologic, and molecular genetic and treatment options of X-linked retinoschisis.
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Affiliation(s)
- Avinash Tantri
- The Henry and Corinne Bower Laboratory, Wills Eye Hospital, and the Eye Research Institute, Philadelphia, Pennsylvania, USA
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Thomas D, Duguid G. Optical coherence tomography—a review of the principles and contemporary uses in retinal investigation. Eye (Lond) 2004; 18:561-70. [PMID: 14765099 DOI: 10.1038/sj.eye.6700729] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- D Thomas
- St Thomas' Hospital, Lambeth Palace Road, London, UK
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Iijima H, Imai M. Differentiation of retinal detachment from retinoschisis using optical coherence tomography. Am J Ophthalmol 2003; 136:577; author reply 577-8. [PMID: 12967829 DOI: 10.1016/s0002-9394(03)00439-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Baba T, Ohno-Matsui K, Futagami S, Yoshida T, Yasuzumi K, Kojima A, Tokoro T, Mochizuki M. Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia. Am J Ophthalmol 2003; 135:338-42. [PMID: 12614751 DOI: 10.1016/s0002-9394(02)01937-2] [Citation(s) in RCA: 214] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To report the prevalence of foveal retinal detachment without macular hole in a large number of highly myopic eyes using optical coherence tomography (OCT), and to clarify the demographic characteristics associated with foveal retinal detachment in these eyes. DESIGN A consecutive, prospective, observational case series. METHODS In 134 eyes of 78 consecutive patients with high myopia (refractive error of -8 diopters or more), we performed complete ophthalmic examinations and studied cross-sectional images of the macula with OCT. The patients were divided into two groups according to the presence (group 1, n = 78 eyes of 45 patients) or absence (group 2, n = 56 eyes of 33 patients) of posterior staphyloma. Slit-lamp examination with a Goldmann three-mirror lens indicated that none of the eyes had a macular hole. RESULTS In seven of 78 eyes (9.0%) with posterior staphyloma (group 1), OCT revealed foveal retinal detachment. Two of the seven eyes had foveal retinoschisis. Optical coherence tomography revealed no retinal detachment or retinoschisis in any eye without posterior staphyloma (group 2). Visual acuity of the seven eyes with foveal retinal detachment ranged from 20/40 to 20/200. Two of the seven eyes had visual acuity 20/50 or better. No patients complained of recent, progressive visual impairment. All seven eyes with foveal retinal detachment had severe myopic fundus changes (focal chorioretinal atrophy or bare sclera). CONCLUSIONS In highly myopic eyes with posterior staphyloma, the prevalence of foveal retinal detachment without macular hole was 9.0%. In eyes with this type of retinal detachment, visual acuity varies and foveal retinal detachment tends to be missed on routine examination. Periodic examination using OCT is recommended for highly myopic eyes with severe myopic degenerative changes and posterior staphyloma.
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Affiliation(s)
- Takayuki Baba
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
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Benhamou N, Massin P, Haouchine B, Erginay A, Gaudric A. Macular retinoschisis in highly myopic eyes. Am J Ophthalmol 2002; 133:794-800. [PMID: 12036671 DOI: 10.1016/s0002-9394(02)01394-6] [Citation(s) in RCA: 195] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To describe the characteristics and evolution of macular retinoschisis in high myopia observed by optical coherence tomography (OCT). DESIGN A consecutive, retrospective, observational case series. METHODS Twenty-one highly myopic eyes (mean refractive error, -15.2, range -6 to -25) of 17 patients presenting with the unusual feature of macular thickening without a macular hole and associated with a posterior staphyloma were examined by biomicroscopy and OCT. Ten patients (13 eyes) were followed up for 12 months or more. RESULTS On biomicroscopy, the macula of all 21 eyes had a microcystic appearance without macular hole. In all eyes, OCT showed that retinal thickening was mainly due to an extensive hyporeflective space splitting the neuroretina into a thick inner layer and a thin outer layer. We called this condition outer retinoschisis. In six cases, inner splitting, termed inner retinoschisis, was also present. The macular profile exhibited a foveal cyst in 10 eyes, a lamellar hole in six, and a foveal detachment in six. In four of the 21 eyes, a hyperreflective preretinal structure resembling the posterior hyaloid was stretched over the retinoschisis, causing foveal traction. Two of these four eyes subsequently evolved into a full-thickness macular hole. CONCLUSION Macular retinoschisis is not uncommon in highly myopic eyes with staphyloma and is better characterized by OCT than by biomicroscopy. Intraretinal splitting occurs in both the outer and inner layers of the retina, leading to the formation of cystoid spaces. In most cases, the condition is fairly stable in terms of visual acuity and retinal thickness and change occurs slowly over time. However, a macular hole may occur when the retinoschisis is associated with tangential traction of the posterior hyaloid.
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Affiliation(s)
- Nathanaël Benhamou
- Department of Ophthalmology, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Université Paris 7, Paris, France
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Kaiser PK, Riemann CD, Sears J, Lewis H. Macular traction detachment and diabetic edema associated with posterior hyaloidal traction: Author’s reply. Am J Ophthalmol 2001. [DOI: 10.1016/s0002-9394(01)01014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Imai M, Iijima H, Hanada N. Optical coherence tomography of tractional macular elevations in eyes with proliferative diabetic retinopathy. Am J Ophthalmol 2001; 132:458-61. [PMID: 11530091 DOI: 10.1016/s0002-9394(01)01176-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To document the findings of optical coherence tomography in eyes with tractional macular elevation associated with proliferative diabetic retinopathy, paying special attention to differentiating between tractional retinal detachment and retinoschisis. DESIGN Observational case series. METHODS We retrospectively reviewed images of optical coherence tomography obtained from 17 consecutive eyes (17 patients) with proliferative diabetic retinopathy without vitreous opacity and showing tractional macular elevation with or without foveal involvement. RESULTS Tractional retinal detachment and retinoschisis could be differentiated in the cross-sectional images of optical coherence tomography. Retinoschisis with or without associated retinal detachment was observed in 16 of 17 eyes (94%), whereas retinal detachment was observed in only six of 17 eyes (35%). Five eyes showed both findings of retinal detachment and retinoschisis. CONCLUSIONS Optical coherence tomography is useful for distinguishing tractional retinoschisis from retinal detachment in eyes with proliferative diabetic retinopathy and macular elevation. Tractional retinoschisis with or without retinal detachment is the most frequent pattern of tractional macular elevation in eyes with proliferative diabetic retinopathy.
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Affiliation(s)
- M Imai
- Department of Ophthalmology, Yamanashi Medical University, Tamaho, Yamanashi 409-3898, Japan.
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Jones AL, Sheen NJ, North RV, Morgan JE. The Humphrey optical coherence tomography scanner: quantitative analysis and reproducibility study of the normal human retinal nerve fibre layer. Br J Ophthalmol 2001; 85:673-7. [PMID: 11371486 PMCID: PMC1723988 DOI: 10.1136/bjo.85.6.673] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND/AIMS To determine the reproducibility of the Humphrey optical coherence tomography scanner (OCT), software version 5.0, for measurement of retinal nerve fibre layer (RNFL) thickness in normal subjects and to compare OCT measurements with published histological thickness of the human RNFL. METHODS Three independent measurements were obtained at each session for one eye from 15 normal subjects with a mean age of 30.8 (SD 10.9) years. Scans were taken in the peripapillary retina using the default setting (1.74 mm radius from centre of the optic disc) and were repeated 1 week later. Additional scans were obtained at the optic nerve head (ONH) margin overlying the scleral rim, for comparison with available histological data on the human RNFL. RESULTS For the 1.74 mm circular scan, the mean coefficient of variation (COV) for the global RNFL thickness measurement was 5% (SD 3%). This increased to 8% (3%) for quadrant measurements and to 9% (3%) with further subdivision into 12 segments. Significant differences (p<0.05) between sessions were only found when the data were divided into segments. The mean RNFL thickness for the 1.74 mm scan was 127.87 (9.81) microm. The RNFL was maximal at the superior disc pole, 161.44 microm (14.8), and minimal at the temporal pole, 83.1 (12.8) microm. Peak thickness values occurred superior temporal and inferior temporal to the vertical axis. RNFL thickness for every sector of the disc was greatest at the margin of the optic disc (mean 185.79 microm; SD 32.61). Although the variation in RNFL thickness around the disc follows published histology data, the OCT underestimates RNFL thickness by an average of 37% (SD 11; range 21-48%). CONCLUSION The OCT provides reproducible measurement of the retinal structures that are consistent with the properties of the RNFL. However, comparison with available studies of RNFL thickness in the human suggests that in its present form, the OCT underestimates RNFL thickness. Further refinement of this technology is required to improve the accuracy with which the OCT measures retinal nerve fibre layer thickness.
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Affiliation(s)
- A L Jones
- Retinal Imaging Laboratory, Department of Optometry and Vision Sciences, Cardiff University, Cardiff CF10 3YJ, UK
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Imai M, Iijima H, Hanada N. Optical coherence tomography of tractional macular elevations in eyes with proliferative diabetic retinopathy. Am J Ophthalmol 2001; 132:81-4. [PMID: 11438058 DOI: 10.1016/s0002-9394(01)00910-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To document the findings of optical coherence tomography in eyes with tractional macular elevation associated with proliferative diabetic retinopathy, paying special attention to differentiating between tractional retinal detachment and retinoschisis. DESIGN Observational case series. METHODS We retrospectively reviewed images of optical coherence tomography obtained from 17 consecutive eyes (17 patients) with proliferative diabetic retinopathy without vitreous opacity and showing tractional macular elevation with or without foveal involvement. RESULTS Tractional retinal detachment and retinoschisis could be differentiated in the cross-sectional images of optical coherence tomography. Retinoschisis with or without associated retinal detachment was observed in 16 of 17 eyes (94%), whereas retinal detachment was observed in only six of 17 eyes (35%). Five eyes showed both findings of retinal detachment and retinoschisis. CONCLUSIONS Optical coherence tomography is useful for distinguishing tractional retinoschisis from retinal detachment in eyes with proliferative diabetic retinopathy and macular elevation. Tractional retinoschisis with or without retinal detachment is the most frequent pattern of tractional macular elevation in eyes with proliferative diabetic retinopathy.
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Affiliation(s)
- M Imai
- Department of Ophthalmology, Yamanashi Medical University, Tamaho, Yamanashi, Japan.
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Kaiser PK, Riemann CD, Sears JE, Lewis H. Macular traction detachment and diabetic macular edema associated with posterior hyaloidal traction. Am J Ophthalmol 2001; 131:44-9. [PMID: 11162978 DOI: 10.1016/s0002-9394(00)00872-2] [Citation(s) in RCA: 136] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To review the clinical, photographic, fluorescein angiographic, and optical coherence tomographic findings in patients with the diabetic macular traction and edema (DMTE) associated with posterior hyaloidal traction (PHT). METHODS We performed a prospective review of nine eyes of nine patients with diabetic macular edema (DME) and PHT on clinical examination. The patients had a comprehensive ophthalmic history and examination, color photographs, fluorescein angiography, and optical coherence tomography (OCT). RESULTS All patients had diabetic retinopathy and DME. Of the nine eyes, eight patients had previous focal or grid photocoagulation. All nine eyes had a thickened, taut, glistening posterior hyaloid on clinical biomicroscopic examination with no posterior vitreous separation. Fluorescein angiography was performed on seven eyes, and all had early hyperfluorescence with deep, diffuse, late leakage in the macular area consistent with DMTE associated with PHT. Optical coherence tomography scans of the macular region revealed retinal thickening in all eyes with a mean retinal thickness of 556.9 +/- 114.7 microns. In addition, eight of the nine eyes had a shallow macular traction detachment associated with PHT. CONCLUSION Eyes with DME associated with PHT may have a shallow, subclinical, macular detachment. Optical coherence tomography may be useful in evaluating patients with DME to see if a macular detachment is present.
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Affiliation(s)
- P K Kaiser
- Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
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Abstract
This report describes the new optical imaging technique of optical coherence tomography (OCT). OCT is capable of high-resolution, micrometer-scale, cross-sectional imaging of biological tissue. The OCT for ophthalmic application uses 843-nm, near-infrared light, which produces a longitudinal resolution of 10 to 20 microm and a penetration depth of a few millimeters. The scans are displayed in a false color representation scale on which warm colors represent areas of high optical reflectivity and cool colors represent areas of minimal or no reflectivity. A cross-sectional view similar to a histology section is obtained. The cornea, iris, and lens may be visualized as well as the retina and optic nerve. OCT has been used to investigate several ocular diseases. These include macular disease, genetic retinal disease, retinal detachment and retinoschisis, choroidal tumors, optic nerve disorders, and glaucoma.
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Affiliation(s)
- P Hrynchak
- School of Optometry, University of Waterloo, Ontario, Canada.
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Akiba J, Konno S, Sato E, Yoshida. Retinal Detachment and Retinoschisis Detected by Optical Coherence Tomography in a Myopic Eye with a Macular Hole. Ophthalmic Surg Lasers Imaging Retina 2000. [DOI: 10.3928/1542-8877-20000501-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Rivellese M, George A, Sulkes D, Reichel E, Puliafito C. Optical Coherence Tomography After Laser Photocoagulation For Clinically Significant Macular Edema. Ophthalmic Surg Lasers Imaging Retina 2000. [DOI: 10.3928/1542-8877-20000501-06] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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