The relationship of retinal morphological features and visual acuity of X-linked juvenile retinoschisis

Abstract

Objective To observe the optical coherence tomography (OCT) features of X-linked juvenile retinoschisis (XLRS) and its relationship and visual acuity.Methods Twenty-three XLRS patients (38 eyes) were enrolled in this study.All patients underwent best corrected visual acuity (BCVA) and frequency-domain optical coherence tomography (SD-OCT) examination.The international standard visual acuity chart was used for BCVA test and the results were then converted into logarithm of the minimum angle of resolution (logMAR) visual acuity.The mean logMAR BCVA of all patients was 0.41 ± 0.28.Topcon 3D-OCT 1000 and Topcon DRLOCT were applied to detect the retinal layers of retinoschisis.Based on the OCT features,retinoschisis was classified into 3 types,including splitting between outer nuclear layer (ONL) and outer plexiform layer (OPL),inner nuclear layer morphology (INL) splitting,splitting between ganglion cell layer (GCL) and nerve fiber layer (NFL).Based on the OCT features of fovea,there were photoreceptor inner segment (IS)/outer segment (OS) presence group and IS/OS absence group.Results There were 17 eyes (44.7％) with splitting between ONL/OPL,38 eyes (100％) with 1NL splitting,13 eyes (34.2％) with splitting between GCL/NFL.INL splitting can coexist with splitting in other retinal layers.There were 25 eyes (65.8％) with splitting in 2 or more retinal layers.The mean logMAR BCVA were 0.32±0.17 and 0.44±0.22 respectively in the IS/OS absence group and presence group,the difference was statistically significant (t=6.531,P =0.008).The mean fovea thickness (FT) were(517.10 ± 96.92) and (523.08±72.84) μm respectively in the IS/OS absence group and presence group,the difference was not statistically significant (t=2.282,P=0.061).There was no correlation between logMAR BCVA and FT (r=0.200,P=0.929).Conclusions In patients with XLRS,the foveomacular schisis involved in multiple retinal layers and most frequently in the INL.The defect of IS/OS is the important reason of the low visual acuity. Key words: Retinoschisis/congenital; Tomography, optical coherence