Abstract
BackgroundPosterior microphthalmos combined with acquired retinoschisis is a rare entity. This report presents a case of acquired retinoschisis in a patient with posterior microphthalmos and discusses the management for such disease. The patient exhibited acquired peripheral retinal schisis in both eyes.Case presentationThe patient presented with a fix scotoma and decrease in visual acuity for 2 weeks in his left eye. Ocular examination revealed that his best-corrected visual acuity was 0.6 in right eye and 0.2 in left eye. The patient had amblyopia because of hyperopia with spherical equivalent of +11.75 diopters in the right eye and +12.00 diopters in the left eye. The axial lengths were 18.41 mm in right and 18.43 mm in left eyes respectively. Slip lamp examination found normal anterior segments. Funduscopy showed bilateral retinoschisis in inferotemporal retina. The schisis in right eye was limited to peripheral retina whereas the schisis in left eye was bullous type. The schisis in the left eye extended from the periphery to the posterior macular region in left eye. A pars plana vitrectomy was performed in the left eye and visual acuity was restored to 0.6.ConclusionPosterior microphthalmos combined with retinoschisis is rare. When it appears in peripheral retina, the schisis remains stable. In cases where the schisis extends to posterior pole and affects the macula, surgery in the form of pars plana vitrectomy could be an option.
Highlights
ConclusionPosterior microphthalmos combined with retinoschisis is rare
Posterior microphthalmos combined with acquired retinoschisis is a rare entity
Posterior microphthalmos combined with retinoschisis is rare
Summary
Foveoschisis in nanothalmols or in PM has been reported. While previous reports present foveoschisis that was always combined with RPE abnormalities, or papillomacular folds caused by microphthalmos [1,4], in our case there were no signs of RPE abnormalities, or foveoschisis. Similar retinal findings have been described in association with nanophthalmos by Dhrami-Gavazi et al in 2009 [7] In his three cases, the schisis was just localized in peripheral. According to our long-term observation of X-linked retinoschisis, in 82% (9 out of 11 eyes) of the eyes the schisis or retinal detachment progressed and visual acuity decreased. The outcome after surgery proved that vitrectomy is effective for preventing the schisis progression and deterioration of visual acuity. In this rare case we found that if schisis is limited to the peripheral retina it may be stable but, if it progressed to the posterior pole, vitrectomy may prevent the progression of acquired retinoschisis.
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