Case #22 – Retinoschisis/Retinal Detachment

Retinoschisis/Retinal Detachment – Page 32 of 42

Case 10: Elevations vs. Excavations A 49-year-old male with history of a unilateral congenital optic nerve abnormality detected five days after birth and enlarged blind spot in the left eye. Patient reported that vision in both eyes is excellent. BCVA measured 20/15+2 OD and 20/15-1 OS. Fundus photo of the anomalous disc

Retinoschisis/Retinal Detachment – Page 32 of 422020-12-10T18:05:07+00:00

Retinoschisis/Retinal Detachment – Page 31 of 42

case 9: Topcon 3D OCT Images Figure A: The 3D representation of the lesion's elevation measuring about 250 microns is depicted on the left. This image is composed of the 128 horizontal slices within the green box. Figure B: One horizontal slice of the 128 sections contained in the 6x6 mm box is

Retinoschisis/Retinal Detachment – Page 31 of 422020-12-10T18:05:15+00:00

Retinoschisis/Retinal Detachment – Page 30 of 42

White without pressure is surrounding an oval island of normal retina. Some observers interpret the island of normal retina as a hole but this "pseudo hole" is due to the difference in contrast between the white without pressure and the normal retina. Sometimes this is considered dark without pressure surrounded by white without

Retinoschisis/Retinal Detachment – Page 30 of 422020-12-10T18:05:26+00:00

Retinoschisis/Retinal Detachment – Page 29 of 42

Patient is an asymptomatic 23-year-old male with 3 D of myopia. The first question in the introduction: Is the lesion flat or elevated? The B-Scan in this case does not reveal any elevation.

Retinoschisis/Retinal Detachment – Page 29 of 422020-12-10T18:05:35+00:00

Retinoschisis/Retinal Detachment – Page 28 of 42

Case 7: Retinal Detachment with Intra-retinal Macrocyst After being compliant with follow-up exams for 3 decades, a 38-year-old female with Marfan syndrome and an extensive history of visual conditions in both eyes was seen for the first time after being lost to follow-up for the past 5 years. A retinal detachment (red arrow) utilizing B-Scan

Retinoschisis/Retinal Detachment – Page 28 of 422020-12-10T18:05:45+00:00

Retinoschisis/Retinal Detachment – Page 27 of 42

Retinoschisis Retinoschisis is defined as a splitting of the sensory retina into two layers, which most often results In an elevated lesion that resembles an intra-retinal blister. It is typically an acquired disorder that is nearly always found in the peripheral temporal fundus, either superior or inferior. The split is usually at the

Retinoschisis/Retinal Detachment – Page 27 of 422020-12-10T18:05:54+00:00

Retinoschisis/Retinal Detachment – Page 26 of 42

Retinal Detachments B-Scan of a patient following trauma demonstrating a total retinal detachment, blood and other vitreal debris anterior to the retinal detachment. This B-Scan was captured with the DGH ScanMate. Image provided by Arthur Jung, OD Normally the retina appears on a B-mode ultrasonogram as a concave, smooth white surface,

Retinoschisis/Retinal Detachment – Page 26 of 422020-12-10T18:06:02+00:00

Retinoschisis/Retinal Detachment – Page 25 of 42

Choroidal Detachments Choroidal detachments present typically as a convex elevation that is attached at the ora serrata with a sonolucent area between the retina-choroid complex and sclera. A choroidal detachment is due to fluid accumulation in the potential space between the choroid and sclera. Unlike a retinal detachment, there is no separation between

Retinoschisis/Retinal Detachment – Page 25 of 422020-12-10T18:06:10+00:00

Retinoschisis/Retinal Detachment – Page 23 of 42

Retinal Detachment vs. Retinoschisis OCT Images A retinoschisis appears as multiple splits of the neurosensory retina with a portion of the outer retina still visibly attached to the underlying RPE in OCT. In contrast, a retinal detachment appears as a complete separation of the neurosensory retina from the RPE. The distinction between the

Retinoschisis/Retinal Detachment – Page 23 of 422020-12-10T18:06:26+00:00