Retinal Neovascularization in Acquired Peripheral Retinoschisis through Inner Retinal Ischemia: Optical Coherence Tomography Angiographic Findings.

Abstract

To present two cases of concomitant retinal neovascularization (RNV) in acquired peripheral retinoschisis and analyze its characteristics on optical coherence tomography angiography (OCTA) and based on a literature review. This was an observational, retrospective case study. Case 1 presented with bullous retinoschisis and RNV near the schisis cavity. OCTA revealed no angioflow into the retinal arterioles of the cavity. An arterial filling delay to the retinoschisis with extensive leakage from the RNV was noted on fluorescein angiography. Case 2 involved the superficial retinoschisis and telangiectatic vessels inside the schisis cavity. OCTA revealed damage to the superficial capillary plexus of the cavity, absence of angioflow to the inner schisis layer, and increased angioflow to the RNV. Fluorescein angiography showed focal leakage from the RNV and diffuse leakage from telangiectasia. No vision-threatening complications were identified in either patient up to the last follow-up, subsequent to laser photocoagulation. Acquired peripheral retinoschisis is associated with RNV. Inner retinal ischemia caused by hemodynamic resistance or a damaged superficial capillary plexus can interrupt angioflow to the inner schisis retinal layer on OCTA findings and develop RNV inside or outside the retinoschisis.