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Vitreoretinal surgery for complications of congenital retinoschisis
P J Ferrone1, M T Trese, H Lewis
1Associated Retinal Consultants, PC, Royal Oak, Michigan, USA.
Insights
Vitreoretinal surgery effectively reattached retinas in most children with congenital retinoschisis complications. This surgical approach improved visual acuity and visual fields in many patients, offering a promising management strategy.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Congenital retinoschisis is a genetic disorder causing retinal splitting.
- Complications include hemorrhage, macular threat, and retinal detachment.
Purpose of the Study:
- To evaluate the efficacy of vitreoretinal surgery in managing congenital retinoschisis complications in children.
Main Methods:
- Retrospective review of seven patients (nine eyes) undergoing vitreoretinal surgery.
- Procedures included vitrectomy, inner schisis wall retinectomy, and gas tamponade.
- Follow-up averaged 26 months, assessing retinal reattachment, visual acuity, and visual fields.
Main Results:
- Successful retinal reattachment in 8 of 9 eyes.
- Improved visual acuity or visual fields in 6 eyes.
- Visual acuity stabilization in one eye; decrease in two eyes.
Conclusions:
- Vitreoretinal surgery, including inner schisis wall excision, is effective for retinal reattachment in pediatric congenital retinoschisis.
- This intervention can lead to improved visual outcomes.
Purpose:
To report the results of vitreoretinal surgery for the management of complications associated with congenital retinoschisis in children.
Methods:
We conducted a review of consecutive children with complications of congenital retinoschisis treated with advanced vitreoretinal techniques. Nine eyes of seven patients with congenital retinoschisis had vitreoretinal surgery for one of the following complications of congenital retinoschisis: hemorrhage within a large schisis cavity with a dense vitreous hemorrhage; rapid progression of schisis threatening the macula; obscuration of the macula by the overhanging inner wall of a schisis cavity; a combined schisistraction retinal detachment; or a combined schisis-rhegmatogenous retinal detachment. Vitreoretinal surgery consisted of vitrectomy, inner schisis wall retinectomy, fluid-gas exchange, endolaser treatment, and perfluoropropane gas injection. After vitreoretinal surgery, patients were followed up for a mean of 26 months (range, 9 to 67 months). Retinal reattachment, visual acuity, and visual fields were used as outcome measures.
Results:
Eight of nine eyes had successful retinal reattachment. Six eyes postoperatively had improved visual acuity or visual field, or both. One eye had stabilization of visual acuity, and two eyes had a decrease in visual acuity.
Conclusion:
In children with complications of congenital retinoschisis, vitreoretinal surgery with excision of the inner wall of the peripheral schisis cavity may be effective in achieving retinal reattachment, thereby improving visual acuity or visual field size.