Different presentations of rhegmatogenous retinal detachments
Thomas H. Williamson in Vitreoretinal Disorders in Primary Care, 2017
The term retinoschisis refers to a process whereby fluid accumulates within the retinal neuroepithelium to form a large intraretinal cyst, thereby splitting the retina. The cyst cavity has an inner leaf (in the vitreous cavity) and an outer leaf (on the RPE). Retinal breaks may develop in one or both of these leaves. When fluid passes through an inner leaf break and then an outer leaf breaks, the outer layer detaches from the pigment epithelium and the schisis is said to have progressed to a retinal detachment. Occasionally, fluid within the schisis can enter the subretinal space through the outer leaf break (without an inner leaf break) and very slowly lift the retina, giving a slow onset retinal detachment (Figure 5.12).
Retinal Tears and Detachments
Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen in Practical Emergency Ophthalmology Handbook, 2019
Retinoschisis: This is derived from a microcystoid degeneration of the neurosensory retina with splitting at the level of the outer plexiform layer. Retinoschisis is more common in hyperopes and generally occurs inferiorly, temporally and commonly bilaterally. Myopic patients are much more likely to have retinal detachments than a retinoschisis. These can be differentiated through recognition that a retinoschisis causes an absolute scotoma whilst a detachment does not and that argon laser applied to the retina causes a visible burn in an area of retinoschisis but not with a detachment. There are also differences on examination though these are variable and should not be relied upon so will not be mentioned here.
Special Senses
Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard in Toxicologic Pathology, 2018
A common background finding occurring in many laboratory mammals, especially dogs and nonhuman primates, is peripheral cystoid retinal degeneration (Dubielzig et al. 2010; Rubin 1974). This finding, which increases in prevalence with age, is noted in the superior nasal quadrant of dogs as early as 8 weeks, and in the peripheral temporal retina of nonhuman primates. The finding should be distinguished from splitting of the retinal layers (retinoschisis).
Safety review of anti-VEGF therapy in patients with myopic choroidal neovascularization
Published in Expert Opinion on Drug Safety, 2022
Danny S. C. Ng, Mary Ho, Lawrence P.L. Iu, Timothy Y.Y. Lai
RADIANCE was a phase III, randomized, double-mask active-controlled, multicentered clinical trial which evaluated the efficacy and safety of two regimens of ranibizumab 0.5 mg compared with vPDT control group for myopic CNV [23,24]. Details of the treatment schedule and the main outcomes are listed in Table 1. At the 3-month primary endpoint and 12-month end of study, the two ranibizumab-treated groups had significantly better mean BCVA improvement compared with the vPDT control group. In terms of ocular serious adverse events, two cases were observed in the study eye including a case of corneal erosion (n = 1 [0.9%] in the visual stabilization group) that was suspected to be related to the ocular injection procedure [23]. The other ocular serious adverse event was a case of retinoschisis (n = 1 [0.8%] in the disease activity group). Non-ocular serious adverse events were observed in 11 patients (n = 6 [5.7%] in visual stabilization group and n = 5 [4.2%] in disease activity group) but none of them was suspected to be due to the study drug or intravitreal injection [23]. Other complications such as deaths, endophthalmitis, retinal detachment, myocardial infarction, or cerebrovascular events were not observed in the study [23]. The number of reported ocular adverse events in the visual stabilization and disease activities groups were 46 (43.4%) and 44 (37.3%) respectively, compared with 16 (42.1%) in the vPDT group. Most of the ocular adverse events were minor such as conjunctival hemorrhage and punctate keratitis.
Exclude hereditary and acquired differential disorders before attributing retinoschisis to Kears-Sayre syndrome
Published in Ophthalmic Genetics, 2021
Retinoschisis may be hereditary or acquired. Causes of hereditary retinoschisis include X-linked juvenile retinoschisis (XLRS) due to mutations in RS1, autosomal recessive familial, foveal retinoschisis (ARFRS) due to mutations in CRB1, autosomal recessive bestrophinopathy due to mutations in BEST1, helicoid subretinal fibrosis due to mutations in NR2E3, autosomal recessive Goldman-Favre syndrome, S-cone syndrome, X-linked choroideremia, or partial monosomy 6q with partial trisomy 11q (2). Causes of acquired retinoschisis include myopia (3), trauma, high voltage electrical injury (4), and stellate non-hereditary idiopathic foveo-macular retinoschisis (SNIFR) (1). We should know if all these differential diagnoses, in addition to XLRS, SNIFR, and ARFRS, were excluded before attributing retinoschisis to KSS. Particularly, we should know if a chromosomal defect in addition to the mtDNA deletion was excluded.
Clinical and genetic study of a pseudo-dominant retinoschisis pedigree: the first female patient reported in Chinese population
Published in Ophthalmic Genetics, 2022
Huajin Li, Jing Li, Yanfeng Huang, Ruifang Sui
Hereditary retinoschisis is a group of disorders characterized by primary early onset retinoschisis. Though it has been described in X-linked recessive, autosomal dominant and autosomal recessive-inherited patterns, X-linked recessive is the only genetically confirmed mode of transmission by now (1–3). X-linked juvenile retinoschisis (XLRS; OMIM_312700) is one of the most common hereditary macular degenerations in males, with an estimated prevalence of 1:5000 to 1:25000 worldwide (4). Patients with XLRS manifest deteriorated visual acuity in the first decade of their lives, and show minimum progression in the majority of cases (5,6). The hallmark feature of XLRS is foveoschisis, characterized by splitting of inner retinal layers. Peripheral retinoschisis presented in approximately 50% of the patients (7). Phenotypic variability has been widely reported in XLRS patients intra and inter-families, even within the same family at the same age (8,9).
Related Knowledge Centers
- Cyst
- Eye
- Retina
- Sex Linkage
- Visual Impairment
- Outer Plexiform Layer
- Asymptomatic
- X-Linked Recessive Inheritance
- Macula
- Glasses