Optic disc pit maculopathy-like retinoschisis without a clinically visible optic disc pit.

PURPOSE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.