Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

PERIPHERAL RETINOSCHISIS AND EXUDATIVE RETINAL DETACHMENT IN PARS PLANITIS

POLLACK, ARYEH L. MD*; McDONALD, H. RICHARD MD; JOHNSON, ROBERT N. MD; AI, EVERETT MD*; IRVINE, ALEXANDER R. MD; LAHEY, J. MICHAEL MD§; LEWIS, HILEL MD; RODRIGUEZ, ALVARO MD; RYAN, EDWIN H. Jr. MD**; SHIELDS, CAROL L. MD††

Article

Purpose To review and describe bullous retinoschisis and exudative retinal detachment in patients with pars planitis.

Methods Retrospective, multicenter study of patients with pars planitis who presented with retinoschisis and exudative retinal detachments.

Results The authors describe 13 eyes of 9 patients with pars planitis who presented with inferior peripheral retinoschisis and/or exudative retinal detachment. Four patients were male; five were female. Patients’ ages ranged from 8 years to 35 years (median, 12 years). The follow-up interval ranged from 1 month to 10 years (median, 4 years). These peripheral retinal elevations had a tendency to remain stable, although those with telangiectatic vessels or vasoproliferative tumors occasionally demonstrated an increase in accumulation of exudate. Treatment of such eyes with cryotherapy, or low-dose plaque radiotherapy, resulted in vasoproliferative tumor and telangiectatic vessel regression, absorption of the hard exudate, and resolution of the retinal elevation in four of five eyes. One patient had spontaneous regression of the retinoschisis cavity over a 4-year period.

Conclusion Patients with pars planitis may present with bullous retinoschisis and/or exudative retinal detachment. These findings may be related to a Coats disease–like vascular response (telangiectatic vessels and vasoproliferative tumors) secondary to chronic inflammation. Treatment of the vascular leakage tended to result in resolution of the detachment and/or schisis.

From the *California Pacific Medical Center, San Francisco, †Retina Research Fund, St. Mary’s Medical Center, San Francisco; ‡Department of Ophthalmology, University of California, San Francisco; §Department of Ophthalmology, Kaiser Permanente, Hayward, California; ¶Cole Eye Institute, The Cleveland Clinic Foundation, Ohio; ∥Calle 50, No. 13-50, Bogota, Columbia; **Vitreoretinal Surgeons, Edina, Minnesota; and ††Department of Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania.

Reprint requests: H. Richard McDonald, MD, 1 Daniel Burnham Court, Number 210C, San Francisco, CA 94109.

Supported by the Retina Research Fund of St. Mary’s Medical Center (San Francisco, CA), a grant from the Wayne and Gladys Valley Foundation (Oakland, CA), and the Pacific Vision Foundation (San Francisco, CA).

© The Ophthalmic Communications Society, Inc.