Degenerative peripheral retinoschisis simulating occlusive retinal vasculitis in intermediate uveitis

Area of Science:

• Ophthalmology
• Retinal Diseases
• Uveitis

Background:

• Retinoschisis involves horizontal splitting of retinal layers, with four main types: hereditary, degenerative, tractional, and exudative.
• Acquired retinoschisis is occasionally reported in intermediate uveitis, potentially due to vascular leakage and ischemia, but evidence is limited.

Purpose of the Study:

• To investigate a case of suspected retinal vasculitis secondary to intermediate uveitis.
• To characterize the ocular findings in a patient with chronic bilateral floaters and intermediate uveitis.

Main Methods:

• Case report of a senior female patient referred for suspected retinal vasculitis.
• Comprehensive ocular examination including multimodal imaging and angiography.
• Assessment of anterior segment inflammation, vitreous cells, retinoschisis, and retinal hemorrhages.

Main Results:

• The patient presented with chronic bilateral floaters, vitreous cells, bilateral retinoschisis, and retinal hemorrhages with exudates in the left eye.
• Multimodal imaging revealed bilateral quiescent intermediate uveitis.
• Findings were consistent with senile degenerative peripheral retinoschisis, likely incidental to the uveitis.

Conclusions:

• Senile degenerative retinoschisis can be incidentally found in patients with intermediate uveitis.
• While an association with prior inflammatory processes cannot be excluded, the retinoschisis was deemed likely incidental in this case.
• This case underscores the need for careful differentiation between incidental retinal findings and active inflammatory disease in uveitis patients.