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RAPID PROGRESSION OF FOVEOMACULAR RETINOSCHISIS IN YOUNG MYOPICS

Sun, Zhongcui, MD, PhD*; Gao, Hua, MD, PhD; Wang, Min, MD, PhD*; Chang, Qing, MD, PhD*; Xu, Gezhi, MD, PhD*

doi: 10.1097/IAE.0000000000002203
Original Study: PDF Only

Purpose: To describe a foveomacular retinoschisis that has not been described.

Methods: Patients with foveomacular retinoschisis were included. Exclusion criteria included refractive error over −6.00 diopters, presence of posterior staphyloma, positive RS1-gene mutation, family history of retinoschisis, optic disk abnormalities, or glaucoma. Vitrectomy was performed on eyes with functional or structural deterioration.

Results: Seventeen eyes from 10 patients (15–30 years old, 8 females and 2 males) with foveoschisis were recruited, with bilateral involvement in 7 patients and unilateral in 3 patients. Vitrectomy was performed in 13 eyes (13/17, 76.5%). Seven eyes (6 patients) were operated soon after the first presentation because of poor vision and severe foveoschisis. Six eyes (6 patients) were operated 2 weeks to 13 months later because of deterioration of vision and foveoschisis. Preoperative vision was 20/134 ± 20/165, and postoperative vision was 20/25 ± 20/57, with visual improvement of 6.9 (4–14) lines. The mean postoperative follow-up period was 36.5 (15–69) months. Four eyes (4 patients) were asymptomatic, despite progression of foveoschisis. Three eyes (3 patients) maintained normal macula structures.

Conclusion: We report a foveomacular retinoschisis characterized by young age of onset, female predominant, no highly myopia, mostly bilateral involvement, and rapid progression of foveoschisis and visual acuity. Vitrectomy is effective in restoring anatomical structure and stabilize vision.

We report a category of foveomacular retinoschisis characterized by young age of onset, female predominant, rapid progression, mostly bilateral involvement, no high myopia or elongated axial length, and excellent anatomical and visual recovery after surgical intervention.

*Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China; and

Department of Ophthalmology, Henry Ford Medical Center, West Bloomfield, Michigan.

Reprint requests: Gezhi Xu, MD, PhD, Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai 200031, China; e-mail: drxugezhi@163.com

Supported by Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University, Shanghai 200031, China), by the National Natural Science Foundation of China (No. 81170857 and No. 81700851), by grant from Science and Technology Commission of Shanghai Municipality (16411953700), and by grant from Shanghai Hospital Development Center (No. SHDC12016116). The funding organizations had no role in designing or conducting of this research. We thank Dr. Zhenyang Zhao from the University of Texas Medical Branch for contributing to the manuscript preparation and revision.

None of the authors has any financial/conflicting interests to disclose.

Authors have full control of all primary data and they agree to allow RETINA to review their data on request. The corresponding author (G.X.) has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

© 2018 by Ophthalmic Communications Society, Inc.