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Vitreoretinal surgery improves outcomes in juvenile retinoschisis

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BOSTON — Vitreoretinal surgery helped improve visual outcomes in most patients with posterior segment complications of X-linked juvenile retinoschisis, according to a study.

“Visual impairment in cases of congenital retinoschisis is usually very often seen because of the early macular involvement, but the surgical intervention is not required in more than 10% to 15% of these cases,” Parveen Sen, MBBS, MS, said at the American Society of Retina Specialists meeting. Sen and colleagues conducted a retrospective consecutive case series of 30 eyes of 25 patients with congenital retinoschisis who underwent surgery for posterior segment complications associated with the condition. Indications for surgery primarily included rhegmatogenous retinal detachment (RRD) and vitreous hemorrhage with RRD. Mean age at presentation was 9 years.

“The most common presenting complaint was a drop in visual acuity that was usually severe,” Sen said.

Of 28 eyes with RRD, pars plana vitrectomy with encirclage was done in 19 eyes and scleral buckle was done in nine. Primary reattachment was achieved in five of the nine patients who underwent scleral buckling.

“We did see that scleral buckling, although less invasive, is not universally applicable and can only be used in a small, well-defined segment of these kinds of cases,” she said. “Pars plana vitrectomy is required in the majority of these eyes.”

Overall, visual acuity improved in 15 of 30 eyes, stayed the same in seven eyes, and worsened in eight eyes.

“Surgical intervention is challenging but gratifying in [X-linked retinoschisis]. Scleral buckling is an option, but case selection has to be very careful and meticulous. Early detection and counseling of patients is very important because these patients may need multiple procedures,” Sen said. – by Patricia Nale, ELS

References:

Sen P. Outcome of vitreoretinal surgery for complications of X-linked juvenile retinoschisis. Presented at: American Society of Retina Specialists 35th Annual Meeting, Aug. 11-15, 2017; Boston.

Disclosure: Sen reports no relevant financial disclosures.