Factors Determining the Morphology of Peripapillary Retinoschisis

Nishijima, Reimi; Ogawa, Shumpei; Nishijima, Euido; Itoh, Yoshinori; Yoshikawa, Keiji; Nakano, Tadashi

doi:10.2147/opth.s301196

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…Few studies have examined peripapillary retinoschisis in HM eyes; thus, our research provided additional evidence in this field. 29 – 31 Decreased macular and peripapillary ChT and increased PPA area have been reported in HM eyes. 32 – 34 In the present study, we found that macular ChT was associated with further thinning, and the PPA area was additionally enlarged after the occurrence of peripapillary retinoschisis.…”

Section: Discussionmentioning

confidence: 98%

Relationship Between Paravascular Abnormalities and Choroidal Thickness in Young Highly Myopic Adults

et al. 2022

Trans. Vis. Sci. Tech.

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Purpose The purpose of this study was to investigate the clinical characteristics of paravascular abnormalities (PVAs) and retinoschisis, and their associations with choroidal thickness (ChT) in young highly myopic (HM) adults. Methods A total number of 645 eyes were included. Paravascular microfolds (PMs), paravascular cystoid spaces (PCs), paravascular lamellar holes (PLHs), and retinoschisis were detected using swept-source optical coherence tomography. Their associations with macular ChT and risk factors were analyzed. Results PMs, PCs, and PLHs were detected in 203 (31.5%), 141 (21.9%), and 30 (4.7%) eyes, respectively. Retinoschisis was found in 50 (7.8%) eyes, 43 (86.0%) of which were located around the retinal vessels surrounding the optic disc. A decreasing trend of macular ChT ( P < 0.001) was observed in the eyes with PMs only, with both PCs and PMs, and with PLHs, PCs, and PMs. After adjustments for age, sex, and axial length (AL), the presence of PCs, PLHs, or retinoschisis around the optic disc was negatively associated with macular ChT (all P < 0.05). Eyes with longer AL, incomplete posterior vitreous detachment (PVD), and myopic atrophic maculopathy (MAM) were more likely to have PCs (all P < 0.01) and retinoschisis around the optic disc (all P < 0.05). Conclusions PVAs were observed in approximately one third of the young HM adults in this study. The presence of PCs, PLHs, or retinoschisis around the optic disc was associated with thinner macular ChT. Eyes with longer AL, incomplete PVD, and MAM may be at risk of developing PVAs and retinoschisis around the optic disc. Translational Relevance PCs, PLHs, and retinoschisis around the optic disc could serve as early indicators for myopia progression.

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Section: Discussionmentioning

confidence: 98%

Relationship Between Paravascular Abnormalities and Choroidal Thickness in Young Highly Myopic Adults

et al. 2022

Trans. Vis. Sci. Tech.

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“…In primary glaucoma dysfunction of photoreceptors, bipolar cells and horizontal cells are observed, as are changes in color and contrast sensitivity [85,87,91]. Peripapillary retinoschisis is observed in 1-6% of patients with all types of glaucoma [92][93][94][95][96] and associated with vitreous traction and dysfunction of Muller cells, and it correlates with disease progression. We suggest that discharge of the interstitial fluid into the vitreous is more likely as an explanation of peripapillary retinoschisis rather than vitreous traction because the PVD correlates with thickening of peripapillary fiber layer [97].…”

Section: Discussionmentioning

confidence: 99%

Hydrostatic Pressure Gradients and a New Membrane-glymphatic Theory of Primary Glaucoma

Beisekeeva¹,

Kulumbetova²,

Beisekeev³

et al. 2022

IJOVS

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The paper describes a novel theory of primary glaucoma etiopathogenesis based on a new understanding of the glymphatic system of the eye. Glymphatic flow routes of the eye include the vitreous body, uveal tract, paravascular spaces, and the retina. There are different pressure gradients of the intraocular fluid flow within the divided central channel of the vitreous body. In normal conditions above the foveola there is highly positive pressure gradient whereas above the optic disc it is 3 times lower. The retinal pigment epithelium is responsible for water and metabolic exchanges between choroid and the vitreous, therefore may contribute to intra-ocular fluid accumulation. Impairment of the outer blood-ocular and/or bloodaqueous barriers is the key pathogenic element of glaucoma including secondary forms due to uveitis. A disbalance of the pressure gradients above the macula and above the optic disc leads to fluid accumulation above the latter. An abundant intraretinal fluid flow through the glymphatic pathways in the outer and inner plexiform layers, formed by Muller cell processes, contributes to accumulation of the interstitial fluid before the lamina cribrosa. Excessive interstitial fluid from the retina passes not only through the retinal pigment epithelium to choroid but also through paravascular spaces to the optic disc cup and discharges partly back to the vitreous body through the prevascular vitreous fissures. There is an interstitial fluid flow existing through paravascular spaces, the plexiform layers of retina and along the axons of ganglion cells to the optic nerve and its sheath where excessive fluid is absorbed into the subarachnoid space. The RPE plays a major role in glaucoma etiopahogenesis, probably acting as a regulator of fluid transport in the eye.

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“…It is widely acknowledged that two opposing forces provided by posterior staphyloma and anterior vitreous traction contribute to the formation of macular schisis ( 75 ). In addition, paravascular microfolds, cysts, and lamellar holes have been implicated in this mechanism ( 67 ).…”

Section: Papillary/peripapillary Schisismentioning

confidence: 99%

Multimodal imaging of optic nerve head abnormalities in high myopia

Hu,

Wu,

et al. 2024

Front. Neurol.

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Highly myopic optic nerve head (ONH) abnormalities encompass a series of complications resulting from the stretching of papillary and peripapillary structures during significant axial elongation. The morphological changes in the ONH typically initiate with disk tilting or rotation, progressing to PHOMS and PPA. Tissue defects in each layer manifest as focal lamina cribrosa defects (FLDs), peripapillary intrachoroidal cavitations (PICCs), and acquired pits of the optic nerve (APON). Anterior vitreous/vascular traction and posterior scleral protrusion may lead to prelaminar schisis as well as paravascular cysts and holes, which can potentially develop into retinoschisis. Traditional color fundus photography (CFP) is often insufficient for visualizing most of these lesions, yet their description and quantification benefit significantly from the advancements in optical coherence tomography (OCT) and OCT angiography (OCTA), complemented by fundus autofluorescence (FAF), indocyanine green angiography (ICGA), and three-dimensional imaging. The effective diagnosis and classification of ONH abnormalities heavily rely on a comprehensive understanding of their multimodal imaging features, as outlined in this review. These findings provide valuable insights into optic neuropathy in high myopia, establishing a solid foundation for future endeavors in disease monitoring and treatment guidance.

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Factors Determining the Morphology of Peripapillary Retinoschisis

Cited by 5 publications

References 33 publications

Relationship Between Paravascular Abnormalities and Choroidal Thickness in Young Highly Myopic Adults

Relationship Between Paravascular Abnormalities and Choroidal Thickness in Young Highly Myopic Adults

Hydrostatic Pressure Gradients and a New Membrane-glymphatic Theory of Primary Glaucoma

Multimodal imaging of optic nerve head abnormalities in high myopia

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