Degenerative peripheral retinoschisis simulating occlusive retinal vasculitis in intermediate uveitis

Retinoschisis, the horizontal splitting of retinal layers, is classified into four types: hereditary (juvenile or X-linked), degenerative (senile, which is more frequently encountered in clinical practice, or acquired), tractional (associated with vitreoretinal interface abnormalities) and exudative (linked to an optic disc pit).Acquired retinoschisis is reported in intermediate uveitis and is hypothesised to result from chronic vascular leakage and subclinical retinal ischaemia, although evidence remains limited.A senior female patient was referred to the uveitis service for management of suspected left occlusive retinal vasculitis secondary to intermediate uveitis. She presented with chronic bilateral floaters for the past 6 years.Ocular examination showed no signs of anterior segment inflammation, but chronic vitreous cells, snowballs, bilateral retinoschisis and inferotemporal retinal haemorrhages accompanied by exudates in the left eye. Multimodal imaging studies, including angiography, revealed bilateral quiescent intermediate uveitis. The findings were consistent with senile degenerative peripheral retinoschisis, likely incidental in a patient with longstanding quiescent intermediate uveitis, although an association with previous inflammatory processes cannot be definitively ruled out.