Resolution of retinoschisis after vitreous surgery in X-linked retinoschisis

Abstract

Purpose: To describe the efficacy of vitreous surgery to treat X-linked retinoschisis.

Design: Retrospective, comparative, interventional case series.

Participants: Three patients (5 eyes) had foveal retinoschisis with peripheral retinoschisis. The patients' ages were 26, 7, and 17 years at the first surgery. The preoperative best-corrected visual acuity (BCVA) was 20/100 and 20/40 in patient 1, 20/30 in patient 2, and 20/100 and 20/200 in patient 3.

Methods: The vitreous surgery consisted of core vitrectomy, surgically induced posterior vitreous detachment (PVD), removal of the internal limiting membrane (except for the right eye of patient 1), and 30% sulfur hexafluoride gas tamponade. The follow-up periods ranged from 6 months to 12 years.

Main outcome measures: Best-corrected visual acuity and retinal tomography monitored by optical coherence tomography.

Results: Restoration of the foveal depression with collapse of the schisis cavity was achieved with the first surgery in 4 (80%) of the 5 eyes. In the right eye of patient 1, the retinoschisis persisted after the first surgery because of failed surgically induced PVD; the retinoschisis resolved promptly after the second surgery with successful induction of PVD. The BCVA improved in 3 eyes and was unchanged in 2 eyes.

Conclusions: Vitreous surgery resulted in reattachment of the retinoschisis with visual improvement. Vitreous traction may play a role in the development of foveal retinoschisis.