SD-OCT Use in Myopic Retinoschisis Pre- and Post-Vitrectomy

Purpose. To study the features of posterior retinoschisis in high myopia before and after vitrectomy and its correlation with the visual outcome by spectral-domain optical coherence tomography (SD-OCT). Methods. In this retrospective case series, 11 highly myopic eyes which underwent vitrectomy with internal limiting membrane peeling and gas tamponade for retinoschisis during June 2008 to December 2009 were followed up for 6 months. Visual acuity and SD-OCT (Topcon 3D OCT-1000) examination were performed before surgery and 1, 3, and 6 months after surgery. Results. Retinoschisis within the outer, middle, and inner layers was noted in six eyes, and foveal detachment was found in six eyes by SD-OCT preoperatively. The inner and outer segment junctions of the photoreceptor layer showed defects in all eyes. At 6 months postoperatively, the retina had reattached and schisis resolved in 10 eyes. Two parafoveal holes were noted in one eye after surgery. The best-corrected visual acuity increased from 0.15 to 0.8 in one eye, slightly improved in two eyes, and remained unchanged in eight eyes. The continuity of inner segment-outer segment layer almost completely recovered in the eye with best-corrected visual acuity of 0.8 while still showing defects in the other 10 eyes. Conclusions. SD-OCT can clearly demonstrate the morphological changes of retinoschisis. It provides important evidence as to the advantage of vitrectomy with internal limiting membrane peeling and helps to explain the visual outcome by documenting the recovery of the inner segment-outer segment layer after surgery. An SD-OCT examination should be considered in patients with high myopia and decreasing vision, with no obvious fundoscopic findings. (Optom Vis Sci 2012;89:678-683)