The improvement of Spoke‐Wheel pattern foveoschisis in a patient with X‐linked retinoschisis treated with topical dorzolamide observed by high‐resolution adaptive optics camera

Abstract

PurposeThe purpose of the study is to report the improvement of foveomacular cavities and spoke‐wheel pattern retinoschisis observed by spectral‐domain optical coherence topmography (SD‐OCT) and high‐resolution adaptive optics fundus camera in a patient with XLRS treated with topical dorzolamide.MethodsA 42 y.o. man with XLRS underwent detailed ophthalmic examinations. A mutation of RS1 gene was detected earlier. The ophthalmological examinations included SD‐OCT, fundus autofluorescence imaging, and full‐field and multifocal ERGs. Fundus images with microscopic resolution were obtained using the AO retinal camera (rtx1, Imagine Eyes, France). He was treated with topical dorzolamide three times a day. Transverse foveomacular cavities was observed by SD‐OCT and the en‐face images of spoke‐wheel pattern foveoschisis was observed by AO fundus camera during a follow‐up period.ResultsHis BCVA was 0.15 in the right eye and 0.3 in the left eye. The right eye showed atrophic macular degeneration and left eye showed spoke‐wheel pattern foveoschisis. SD‐OCT showed the thinning of retinal thickness in the right eye and cystoid foveoschisis in the left eye. AO images showed spoke‐wheel pattern retinal fold in the left eye. The spoke‐wheel pattern in AO was sharper compared to the images obtained by fundus photography and autofluorescence imaging. After 14 month of treatment with topical dorzolamid, improvement of foveomacular cavities in SD‐OCT was observed. The spoke‐wheel pattern retinal fold in AO become obscure after treatment, however still detectable even after foveomacular cavities in SD‐OCT was almost disappeared.ConclusionsAO imaging showed detailed microstructure of spoke‐wheel pattern foveoschisis and their improvement during a follow‐up period. AO imaging may be helpful in clarifying the pathology of the foveoschisis in XLRS.