Management of Degenerative Retinoschisis–Associated Retinal Detachment

Jeroudi, Abdallah; Shah, Vaishali; Blinder, Kevin J.; Shah, Gaurav K.

doi:10.1016/j.oret.2017.01.012

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…While eyes in this case series had a 100% final reattachment rate, the SSAS rate was 66%, which is significantly lower than for the repair of uncomplicated rhegmatogenous retinal detachment (RRD) [20]. Similar success rates, ranging from 62 to 86%, have been seen for other recent PSRDCR case series, demonstrating that PSRDCR repair is associated with comparatively poor outcomes [6,8,10,[16][17][18][19]. While multiple retrospective studies have attempted to identify an optimal surgical procedure and have looked at the poor visual outcomes associated with PSRDCR, the discussion has been limited regarding the prognostic factors that may be associated with the low SSAS rates [6,8,16,17].…”

Section: Discussionsupporting

confidence: 58%

“…The treatment of PSRDCR is controversial in part due to its rare occurrence, with an estimated annual incidence of 0.85 persons per million [16]. Consequentially, no surgical method has emerged as superior for the treatment of PSRDCR due to the low sample size and statistical power in previous studies [6,8,[16][17][18]. Of the 4973 charts with RD repairs from Jan 1, 2008 to Dec 31, 2019, only 18 (0.4%) met inclusion criteria for this study.…”

Section: Discussionmentioning

confidence: 99%

“…In 2013, a national survey of vitreoretinal surgeons in the United Kingdom revealed a significant variation in surgical intervention preference for different clinical scenarios involving PSRDCR [11]. Meanwhile, the literature comparing the efficacy of interventions for PSRDCR is sparse, and a number of case series have suggested using a variety of techniques, including pneumatic retinopexy, external drainage of the schisis cavity, barrier laser photocoagulation, cryotherapy, SB, and pars plana vitrectomy (PPV) [7,9,[12][13][14][15][16][17][18]. Without definitive evidence, some authors have advocated PPV for extensive detachments because of the superior ability to visualize retinal breaks using the operating microscope [6,8,10,13,19].…”

Section: Introductionmentioning

confidence: 99%

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Repair of progressive retinal detachment complicating degenerative retinoschisis: surgical management and outcomes in phakic eyes

Arévalo¹,

Pham²,

Ong³

et al. 2021

Int J Retin Vitr

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Background Degenerative retinoschisis is a common condition defined by the splitting of the neurosensory retina that may rarely be associated with progressive retinal detachment (RD). Here, we aim to describe the anatomic and functional outcomes of surgical treatment of progressive symptomatic retinal detachment complicating degenerative retinoschisis (PSRDCR) using pars plana vitrectomy (PPV), scleral buckle (SB), or combined PPV/SB procedure. Methods A retrospective chart review of patients with PSRDCR between Jan 1, 2008 and Dec 31, 2019 was conducted. Data regarding demographics, surgical approach, and anatomic/functional outcomes were collected. Results Of the 4973 charts with RD repair during the study period, 36 eyes (0.7%) had retinoschisis with RD. 18 eyes met inclusion criteria (0.4%). The median age was 54 years (range 18–74) and all eyes were phakic. All eyes had outer layer breaks (OLBs) and 16 eyes (89%) had identifiable inner layer breaks. All OLBs were posterior to the equator in charts where position was recorded (16 eyes). The single surgery anatomic success (SSAS) and final anatomical success rates were 66% (12/18) and 100%, respectively. Eyes treated with PPV/SB had an SSAS rate of 75% (9/12), while PPV and SB had SSAS rates of 66% (2/3) and 33% (1/3), respectively. Conclusions PSRDCR is an exceedingly rare complication of degenerative retinoschisis associated with an SSAS rate lower than for uncomplicated rhegmatogenous RD. The majority of PSRDCR were repaired via combined PPV/SB in our study, and the rarity of this complication limits statistical support of an optimal surgical method in our and prior studies. The role of SB combined with PPV for PSRDCR requires further investigation.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Repair of progressive retinal detachment complicating degenerative retinoschisis: surgical management and outcomes in phakic eyes

Arévalo¹,

Pham²,

Ong³

et al. 2021

Int J Retin Vitr

View full text Add to dashboard Cite

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“…These retinoschisis-related retinal detachments are notoriously difficult to manage. While some authors have reported excellent outcomes with a low redetachment rate following treatment of a retinoschisis-related retinal detachment, [7][8][9] other case series have reported single-surgery success rates of approximately 60% to 70%. [10][11][12] There are no prospective, randomized clinical trials to guide retinal surgeons on the best approach to these particular detachments since retinoschisis-related detachments are relatively uncommon, accounting for less than 1% of all rhegmatogenous retinal detachments.…”

Section: Introductionmentioning

confidence: 99%

Anatomic and Visual Outcomes Following Surgical Repair of Retinoschisis-Related Retinal Detachments

Stem

Garretson

Todorich

et al. 2018

Journal of VitreoRetinal Diseases

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The purpose of this article is to report the characteristics of patients with retinoschisis-related retinal detachments and to summarize their clinical outcomes after surgical repair. Methods: A single-center interventional case series of 37 eyes from 35 patients who underwent surgery to repair a retinoschisis-related retinal detachment between January 1, 2009 and January 1, 2017 was conducted. Results: The mean + SD age at the time of the first retinal detachment repair was 63 + 13 years. As the initial surgery, scleral buckle was performed in 14 eyes, scleral buckle þ vitrectomy in 14 eyes, and vitrectomy in 9 eyes. The singleoperation success rate for the entire cohort was 65% (24/37), and the final anatomic success rate was 97% (36/37). Among eyes requiring more than 1 surgery, 46% (6/13) developed proliferative vitreoretinopathy. Best-corrected visual acuity improved or remained stable after 1 year of follow-up in the majority (n ¼ 27, 73%) of eyes. The mean (SD) number of surgeries required to achieve the final anatomic and visual result was 1.8 (1.2) for all eyes (range, 1-5 surgeries). Conclusion: The single-surgery success rate for retinoschisis-related retinal detachments was lower than that reported for typical rhegmatogenous retinal detachments, and the incidence of proliferative vitreoretinopathy was higher. When counseling patients with retinoschisis-related retinal detachments, it is important to caution them that they may require more than 1 surgery to achieve anatomic success.

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“…Because the symptoms of chronic RRD are usually mild and hardly noticed, chronic RRD cases are often found by chance, and the delay in the diagnosis results in poor visual outcomes even after the successful reattachment surgery. On the other hand, chronic RRD cases are occasionally misdiagnosed as nonrhegmatogenous retinal detachment, uveitis, and degenerative retinoschisis [3].…”

Section: Introductionmentioning

confidence: 99%

Nonperfused Peripheral Retinal Area in Eyes with Chronic Rhegmatogenous Retinal Detachment

Tatsumi

Baba

Yokouchi

et al. 2020

Case Rep Ophthalmol

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We report two cases of chronic rhegmatogenous retinal detachment with a nonperfused peripheral retinal area. Case 1 was an 84-year-old woman who presented with a bullous retinal detachment of the inferior retina and a best-corrected visual acuity of 20/500. A small horseshoe tear was detected in the peripheral superior retina. Fluorescein angiography showed a wide area of nonperfused retina in the inferior retina. The retina was successfully reattached by scleral buckling surgery. Case 2 was a 40-year-old woman who presented with a shallow retinal detachment involving the macula. There were multiple retinal breaks at the pars plana that were secondary to blunt trauma. Fluorescein angiography revealed a wide area of nonperfused retina in the inferior peripheral retina. She underwent scleral buckling surgery, and the retina was successfully reattached. Our findings indicate that clinicians should examine the peripheral retina carefully especially with fluorescein angiography to search for nonperfused areas in eyes with chronic rhegmatogenous retinal detachment.

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Management of Degenerative Retinoschisis–Associated Retinal Detachment

Cited by 6 publications

References 9 publications

Repair of progressive retinal detachment complicating degenerative retinoschisis: surgical management and outcomes in phakic eyes

Repair of progressive retinal detachment complicating degenerative retinoschisis: surgical management and outcomes in phakic eyes

Anatomic and Visual Outcomes Following Surgical Repair of Retinoschisis-Related Retinal Detachments

Nonperfused Peripheral Retinal Area in Eyes with Chronic Rhegmatogenous Retinal Detachment

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