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Abstract

We thank Drs Byeon et al for their interest in our article. Because of limited space, we could not describe the detailed history of each patient. A 29-year-old male (patient 1) was referred to us for blurred vision in his right eye. He had bilateral foveal retinoschisis and foveal detachment in his right eye. Best-corrected visual acuity (BCVA) in the right eye was 20/60 at the initial visit, which declined to 20/100 in a month, and surgery was recommended. Best-corrected visual acuity in his fellow eye was 20/20 at the initial visit. Seven years later, the fellow eye developed foveal retinoschisis and retinal detachment, and BCVA decreased to 20/50. Patients 2 and 3 also had decreased vision during several months before surgery.We do not have a conclusive answer as to whether intraoperative fluid gas exchange is necessary. Because postoperative gas injection caused displacement of subfoveal fluid and led to early retinal reattachment in patient 1, fluid–gas exchange with a facedown position may be beneficial for early resolution of retinoschisis. Indications for vitreous surgery in these patients should be conservative. We cannot predict the visual outcome of surgery and the natural history of X-linked retinoschisis. Nevertheless, it is encouraging that reattachment of foveal retinoschisis and restored foveal depression were maintained for 1 to 7 years in all 5 eyes of 3 patients. We thank Drs Byeon et al for their interest in our article. Because of limited space, we could not describe the detailed history of each patient. A 29-year-old male (patient 1) was referred to us for blurred vision in his right eye. He had bilateral foveal retinoschisis and foveal detachment in his right eye. Best-corrected visual acuity (BCVA) in the right eye was 20/60 at the initial visit, which declined to 20/100 in a month, and surgery was recommended. Best-corrected visual acuity in his fellow eye was 20/20 at the initial visit. Seven years later, the fellow eye developed foveal retinoschisis and retinal detachment, and BCVA decreased to 20/50. Patients 2 and 3 also had decreased vision during several months before surgery. We do not have a conclusive answer as to whether intraoperative fluid gas exchange is necessary. Because postoperative gas injection caused displacement of subfoveal fluid and led to early retinal reattachment in patient 1, fluid–gas exchange with a facedown position may be beneficial for early resolution of retinoschisis. Indications for vitreous surgery in these patients should be conservative. We cannot predict the visual outcome of surgery and the natural history of X-linked retinoschisis. Nevertheless, it is encouraging that reattachment of foveal retinoschisis and restored foveal depression were maintained for 1 to 7 years in all 5 eyes of 3 patients. X-Linked RetinoschisisOphthalmologyVol. 115Issue 5PreviewWe read with interest the article by Ikeda et al describing the resolution of retinoschisis after vitrectomy in patients with X-linked juvenile retinoschisis.1 We agree that a vitreous tractional element may contribute to the development and progression of foveal retinoschisis in X-linked juvenile retinoschisis. Wide phenotypic variation in X-linked juvenile retinoschisis patients, even in members of the same family, suggests that factors other than genetic mutation may be involved in the macular manifestations of this disease. Full-Text PDF