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Symptomatic retinoschisis-detachment involving the macula
J S Ambler1, J D Gass, F A Gutman
1Department of Ophthalmology, Cleveland Clinic Foundation, Ohio.
American Journal of Ophthalmology
|July 15, 1991
Summary
Symptomatic retinoschisis-detachments causing macular elevation require tailored treatment. Combined therapies like cryopexy, drainage, and air injection effectively reattached retinas in complex cases.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Posteriorly situated retinoschisis-detachment can cause macular symptoms.
- Macular elevation due to limited full-thickness retinal detachment adjacent to retinoschisis presents a clinical challenge.
Observation:
- Laser photocoagulation alone achieved long-term macular reattachment in one eye.
- Laser photocoagulation failed in a bilaterally affected patient.
Findings:
- Combined retinal cryopexy, subretinal/retinoschisis fluid drainage, and intravitreal air injection led to successful macular reattachment and retinoschisis cavity collapse in both eyes of one patient.
- Cryopexy, fluid drainage, and scleral buckling failed in another patient; subsequent laser photocoagulation reabsorbed subretinal fluid but did not collapse the retinoschisis cavity.
Implications:
- This case series highlights the variable efficacy of different treatment modalities for symptomatic retinoschisis-detachment with macular involvement.
- Alternative strategies such as retinal cryopexy alone or vitrectomy may be considered for complex or refractory cases.