Resolution of retinoschisis after vitreous surgery in X-linked retinoschisis.

Abstract

To describe the efficacy of vitreous surgery to treat X-linked retinoschisis. Retrospective, comparative, interventional case series. Three patients (5 eyes) had foveal retinoschisis with peripheral retinoschisis. The patients' ages were 26, 7, and 17 years at the first surgery. The preoperative best-corrected visual acuity (BCVA) was 20/100 and 20/40 in patient 1, 20/30 in patient 2, and 20/100 and 20/200 in patient 3. The vitreous surgery consisted of core vitrectomy, surgically induced posterior vitreous detachment (PVD), removal of the internal limiting membrane (except for the right eye of patient 1), and 30% sulfur hexafluoride gas tamponade. The follow-up periods ranged from 6 months to 12 years. Best-corrected visual acuity and retinal tomography monitored by optical coherence tomography. Restoration of the foveal depression with collapse of the schisis cavity was achieved with the first surgery in 4 (80%) of the 5 eyes. In the right eye of patient 1, the retinoschisis persisted after the first surgery because of failed surgically induced PVD; the retinoschisis resolved promptly after the second surgery with successful induction of PVD. The BCVA improved in 3 eyes and was unchanged in 2 eyes. Vitreous surgery resulted in reattachment of the retinoschisis with visual improvement. Vitreous traction may play a role in the development of foveal retinoschisis.