odd macula and poor vision

Posted by - Posted on 04/13/2015 01:15:41 Retina and Uveitis

Retino schesis.jpg

Abnormal macular reflex with decreased vision in a 25 year old

25 year old presented with decreased vision (20/100). Macular exam suggested abnormal reflex and so an OCT was obtained. Describe the finding on the OCT and diagnosis

Note the schisis changes in the middle layers of the OCT of the macula. Retinoschisis refers to a splitting of the neurosensory retina. Can be 1. degenerative peripheral schisis 2. congenital X linked recessive schisms 3. secondary forms associated with some form of vitreoretinal traction, optic pit or pathological myopia. Note that X linked recessive schisis is has a foveal schisis that does not leak on FA The gene associated with X linked schisis is RS1 (retinoschisin) leading to damaged Muller cells. May be associated with peripheral retinal schisis in up to 50% of patients and the split is in the nerve fiber layer (where as in the degenerative retinoschisis the level of splitting is variable and usually occurs in the deeper layers). ERG - Flat B wave with "negative wave form" appearance.

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