Monitoring retinoschisis and non-acute retinal detachment by optical coherence tomography: morphologic aspects and clinical impact

Abstract

Purpose: To differentiate retinoschisis (RS) from non-acute retinal detachment (naRD) in clinical routine using optical coherence tomography (OCT), describe unique morphological OCT characteristics and monitor disease progression. Methods: This prospective, observational study included 64 eyes of 44 patients with either RS or naRD. Patients were examined clinically and using Heidelberg Spectralis OCT®, Topcon DRI OCT® and Cirrus HRA-OCT® over 2 years with follow-up at 1, 3, 6, 12 and 24 months. Main outcomes were typical morphologic findings of RS and naRD described in OCT. Progression was monitored using Spectralis OCT® follow-up mapping and an eye-tracking method. Results: Forty-seven eyes were diagnosed with RS and 17 with naRD. Optical coherence tomography (OCT) provided a definite diagnosis in four eyes diagnosed clinically as uncertain. Seventy-seven percentage of eyes with RS were atrophic in the inner leaf (IL), whereas 41% with naRD showed cystoid alteration. A discontinuation of the IL clinically observed as an inner-layer break (ILB) could be imaged. We described a tissue retraction within the outer leaf (OL), which corresponded to outer-layer breaks (OLBs) in clinical examinations in nine eyes (19%). Conclusion: Optical coherence tomography (OCT) is a reliable method to differentiate and monitor RS from naRD. Morphological characteristics, including ILB and OLB, could be accurately illustrated in RS.