Kim Ye Ji, Ribarich Nicolò, Querques Giuseppe, Park Dong Ho, Kim Yong Joon, Choi Eun Young, Byeon Suk Ho, Kim Sung Soo, Lee Christopher Seungkyu
Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, University Vita-Salute San Raffaele, Via Olgettina 60, Milan, Italy.
Retina. 2025 Jun 19. doi: 10.1097/IAE.0000000000004570.
This study aimed to describe the structural and clinical characteristics of optic disc pit maculopathy-like retinoschisis without a clinically visible optic disc pit and discuss possible pathogenesis and treatment.
This retrospective observational case series reviewed 20 eyes in 19 patients diagnosed with peripapillary retinoschisis (PPRS) without a visible optic disc pit. Patients were divided into three groups according to management method: observation, intraocular pressure (IOP) control, and vitrectomy. Clinical features, optical coherence tomography (OCT) findings, and clinical outcomes were analyzed.
Eighteen patients had unilateral retinoschisis, and one had bilateral involvement. Initial mean best-corrected visual acuity (BCVA) was 20/40. Eight eyes had glaucoma, and 11 eyes had posterior vitreous detachment. OCT revealed foveal detachment in 5 eyes and abnormal lamina cribrosa (LC) findings in all 20 eyes, including focal LC defects and LC disinsertions. The vitrectomy group showed improvement in BCVA and CFT compared to the observation and IOP control groups (P=0.016 and 0.011, respectively).
LC defects were associated with PPRS without a visible optic disc pit. Vitrectomy may play a role in managing retinoschisis in eyes with PPRS without a visible optic disc pit.
本研究旨在描述无临床可见视盘小凹的视盘小凹黄斑病变样视网膜劈裂的结构和临床特征，并探讨其可能的发病机制及治疗方法。
本回顾性观察病例系列研究对19例诊断为无可见视盘小凹的视乳头周围视网膜劈裂（PPRS）患者的20只眼进行了分析。根据治疗方法将患者分为三组：观察、眼压（IOP）控制和玻璃体切除术。分析临床特征、光学相干断层扫描（OCT）结果及临床转归。
18例患者为单侧视网膜劈裂，1例为双侧受累。初始平均最佳矫正视力（BCVA）为20/40。8只眼患有青光眼，11只眼存在玻璃体后脱离。OCT显示5只眼有黄斑脱离，所有20只眼均有筛板（LC）异常表现，包括局限性LC缺损和LC插入异常。与观察和IOP控制组相比，玻璃体切除术组的BCVA和中央黄斑厚度（CFT）有所改善（P分别为0.016和0.011）。
LC缺损与无可见视盘小凹的PPRS相关。玻璃体切除术可能在治疗无可见视盘小凹的PPRS眼中的视网膜劈裂中发挥作用。
