Peripapillary Retinoschisis in Glaucomatous Eyes

Abstract

PurposeTo investigate the structural and clinical characteristics of peripapillary retinoschisis observed in glaucomatous eyes using spectral-domain optical coherence tomography (SD-OCT).MethodsCircumpapillary retinal nerve fiber layer (cpRNFL) and macular cross-hair SD-OCT scans and infrared fundus images of the glaucoma patients from the Investigating Glaucoma Progression Study (IGPS) and healthy volunteers were reviewed. Optic disc images obtained using enhanced depth imaging (EDI) SD-OCT were also evaluated. The structural characteristics and clinical course of the retinoschisis associated with glaucoma were investigated.ResultsTwenty-five retinoschisis areas were found in 22 of the 372 patients (5.9%) included in the IGPS, and in 1 area in 1 of 187 healthy control subjects (0.5%). In the 22 glaucomatous eyes with retinoschisis, the schisis was attached to the optic disc and overlapped with the retinal nerve fiber layer (RNFL) defect. The RNFL was the layer most commonly affected by the retinoschisis, either alone or together with other deeper layers. Acquired optic disc pit was identified in 8 eyes on disc photography and/or B-scan images obtained by EDI SD-OCT. Spontaneous resolution of this condition was observed in nine eyes. No retinal detachment or macular involvement of the retinoschisis was observed in any of the eyes. Multivariate analysis showed a significant influence of a higher intraocular pressure at SD-OCT scanning on the presence of retinoschisis (Odds ratio = 1.418, P = 0.001).ConclusionsThe present study investigated 22 cases of peripapillary retinoschisis in glaucomatous eyes. The retinoschisis was attached to the optic nerve and topographically correlated with RNFL defect. It often resolved spontaneously without causing severe visual disturbance. Care should be taken not to overestimate the RNFL thickness in eyes with retinoschisis, and also not to misinterpret the resolution of retinoschisis as a rapid glaucomatous RNFL deterioration.

Wide-Field En Face Swept-Source Optical Coherence Tomography Features of Extrafoveal Retinoschisis in Highly Myopic Eyes

“…It showed subtle dehiscence at the nerve fiber layer in sectional OCT scans, but the affected area was dramatically larger than expected from an en face view. Recent studies showed that peripapillary retinoschisis was occasionally detected in glaucomatous eyes, [21][22][23] but all our subjects denied history of glaucoma. Intraocular pressure and perimetry test were within normal range.…”

Peripapillary Retinoschisis in Glaucoma Patients

“…More recently, two different studies with larger samples of peripapillary retinoschisis in glaucomatous eyes have been published [ 15 , 16 ]. One study was about the structural and clinical characteristics [ 15 ] and the other was about the effect of retinoschisis on RNFL thickness [ 16 ].…”

The Effect of Peripapillary Detachment on Retinal Nerve Fiber Layer Measurement by Spectral Domain Optical Coherence Tomography in High Myopia

“…Lee et al [20] evaluated by HD-OCT imaging 22 cases of peripapillary retinoschisis without a serous detachment in glaucomatous eyes. The resolution of the retinoschisis during follow-up was associated with an IOP reduction.…”