Successful surgical treatment of macula-involving degenerative retinoschisis by vitrectomy and drainage of the schisis cavity
- 2022-01-01.
/pmc/articles/PMC7035175/ /pubmed/31453931
PURPOSE: To demonstrate the potential for visual recovery following surgery for early foveal involvement by progressive degenerative retinoschisis. METHOD: Surgical case report. RESULTS: A 79-year-old woman was monitored over 4 years for degenerative retinoschisis in the inferotemporal periphery of both eyes. Over the course of follow-up, visual acuity in the left eye decreased from 20/40 to 20/100, concurrent with extension of the schisis cavity into the macula. Macular involvement was confirmed on OCT imaging and there was no rhegmatogenous retinal detachment. The patient elected to undergo 25-gauge pars plana vitrectomy and drainage of the schisis cavity. Eleven weeks after surgery, the macula remained attached, and the uncorrected visual acuity was 20/30. Fundus examination and SD-OCT confirmed ongoing resolution of the macula-involving retinoschisis. CONCLUSION: Bullous degenerative retinoschisis is thought to result in an absolute scotoma that is not surgically correctable. Our patient's excellent visual recovery suggests that the synaptic integrity of the macular outer plexiform layer can be preserved and a permanent scotoma avoided if early macular involvement by progressive degenerative retinoschisis is surgically repaired.