Degenerative “Senile” Retinoschisis: Observations From Ultra-Widefield Imaging

Purpose : To explore the imaging characteristics, including ultra wide-field color fundus photography, autofluorescence and angiography of patients with senile retinoschisis (SR) using Optomap technology. Methods : This is a multi-center, retrospective, non-comparative, consecutive case series of patients who were examined at four institutions. All patients underwent ultra-widefield fundus imaging (UWFI) using the Optos 200Tx or P200dTx imaging system. Inclusion criteria were presence of degenerative peripheral retinoschisis in either eye. Exclusion criteria included any evidence (by history or examination) of congenital X-linked retinoschisis, retinal detachment surgery, or retinal vascular disease causing retinal capillary nonperfusion, including diabetic retinopathy, familial exudative vitreoretinopathy, and sickle cell retinopathy. Results : A total of 35 consecutive patients (58 eyes) with SR were identified who underwent 55 sessions of UWF imaging, including color fundus photography, fundus autofluorescence and fluorescein angiography. Ultra widefield fundus autofluorescence images illustrated the extent of the schisis cavity in 67% of cases with variable features. A crescent of hypo-autofluorescence was often evident at the edge of the schisis cavity aiding in its identification. A total of 31 UWF fluorescein angiograms (UWFFA) were reviewed and 90% of these studies illustrated abnormalities in the area affected by the schisis. The most common finding was retinal vascular leakage observed in 29 (93.5%) eyes. Conclusions : UWF color fundus photography and fundus autofluorescence are reliable noninvasive tools that can aid in the diagnosis and objective monitoring of patients with SR.The breadth of retinal vascular abnormalities that were identified in areas of SR using UWF fluorescein angiography may indicate the presence of a vascular component in the pathogenesis of this condition