First Author: R.Yamakawa JAPAN
Co Author(s): H. Oshima C. Taguchi 0 0 0 0 0 0 0 0 0
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In retinitis pigmentosa, macular lesions such as epiretinal membrane and cystoid macular edema have been reported. However, there have been few reports on foveal retinoschisis. We present a case of foveal retinoschisis in a patient with retinitis pigmentosa and the outcome of vitreous surgery.
Kurume University Hospital
A 67-year-old man was referred to our hospital with a complaint of decreased vision in his left eye. His visual acuity was 1.0 in the right eye and 0.5 in the left eye with moderate myopia. Anterior and intermediate segments were normal with mild cataract, but both fundus showed atrophy and bone spicule pigmentation in the periphery. Electroretinogram demonstrated reduced reponses, and Goldmann perimetry showed concentric constriction. We diagnosed this case as retinitis pigmentosa. However, foveal retinoschisis was observed in the posterior pole, but a macular hole was not detected. Although axial length was 24.97 mm, a mild posterior staphyloma was observed. Optical coherence tomography (OCT) showed epiretinal membrane and retinoschisis, but not retinal detachment.
Twenty-five-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation was performed. Vitreous liquefaction was evident, but there remained thick, sticky vitreous membrane forming epiretinal membrane. After the removal of this membrane stained with triamcinolone acetonide, internal limiting membrane was also removed with the staining of brilliant blue G. Fluid-air exchange was performed, and the surgery was completed with air tamponade. One year later, OCT revealed that the retinoschisis completely resolved, and visual acuity improved to 0.7.
It was considered that the mild staphyloma and the tractional forces from epiretinal membrane caused the foveal retinoschisis in a patient with retinitis pigmentosa.