Jalalizadeh Rohan A, Smith Bradley T
The Retina Institute, 2201 S Brentwood Blvd, Saint Louis, MO, 63144, USA.
Graefes Arch Clin Exp Ophthalmol. 2023 Feb;261(2):375-380. doi: 10.1007/s00417-022-05801-8. Epub 2022 Aug 19.
To characterize retinoschisis in a large series using spectral domain optical coherence tomography (SD-OCT), including rates of schisis detachment and macular involvement in cases of peripheral retinoschisis.
In this retrospective, cross-sectional, descriptive study, consecutive patients with diagnosis of retinoschisis in at least one eye were identified using billing codes between January 2012 and May 2021. Charts were reviewed to verify diagnosis of retinoschisis or schisis detachment. SD-OCT and clinical examination was used to identify frequency of macular schisis, peripheral schisis, and schisis detachment, and characteristics of retinoschisis including frequency of inner and outer wall breaks, distribution of layers split, and location of involvement of peripheral pathology. SD-OCT images of insufficient quality were excluded from the pertinent analysis.
281 eyes of 191 patients were included. 195 (69.4%) eyes had peripheral retinoschisis, 15 (5.3%) had schisis detachment, 66 (23.5%) had macular retinoschisis alone, and 5 (1.8%) had combined macular and peripheral retinoschisis. Of the eyes without macular retinoschisis, 7.0% had schisis detachment. Of the remainder, 4 (2.1%) had inner wall breaks, and 24 (12.3%) had outer wall breaks. In eyes with peripheral retinoschisis, splitting occurred in the outer plexiform layer in 58.9%, the retinal nerve fiber layer in 8.9%, a combination of layers in 26.8%, and indeterminate in 5.4%. Location of peripheral involvement was inferotemporal in 58.5%, superotemporal in 14.1%, temporal in 13.7%, and inferior in 12.2%.
SD-OCT helped to identify the presence of schisis detachment and breaks, confirmed diagnosis in challenging cases, and demonstrated the layer of splitting within the neurosensory retina. This series represents the largest such study to date.
使用光谱域光学相干断层扫描（SD-OCT）对大量视网膜劈裂病例进行特征描述，包括周边视网膜劈裂病例中的劈裂脱离率和黄斑受累情况。
在这项回顾性、横断面、描述性研究中，利用2012年1月至2021年5月期间的计费代码识别至少一只眼睛诊断为视网膜劈裂的连续患者。查阅病历以核实视网膜劈裂或劈裂脱离的诊断。使用SD-OCT和临床检查来确定黄斑劈裂、周边劈裂和劈裂脱离的频率，以及视网膜劈裂的特征，包括内外壁裂孔的频率、分层劈裂的分布以及周边病变的累及部位。质量不佳的SD-OCT图像被排除在相关分析之外。
纳入191例患者的281只眼睛。195只（69.4%）眼睛有周边视网膜劈裂，15只（5.3%）有劈裂脱离，66只（23.5%）仅有黄斑视网膜劈裂，5只（1.8%）有黄斑和周边视网膜劈裂合并存在。在没有黄斑视网膜劈裂的眼睛中，7.0%有劈裂脱离。其余眼睛中，4只（2.1%）有内壁裂孔，24只（12.3%）有外壁裂孔。在有周边视网膜劈裂的眼睛中，58.9%的劈裂发生在外丛状层，8.9%发生在视网膜神经纤维层，26.8%为多层联合劈裂，5.4%情况不明。周边受累部位位于颞下象限的占58.5%，颞上象限的占14.1%，颞侧的占13.7%，下方的占12.2%。
SD-OCT有助于识别劈裂脱离和裂孔的存在，在疑难病例中确诊，并显示神经感觉视网膜内的劈裂层。该系列研究是迄今为止规模最大的此类研究。
