Novel Features of Degenerative Retinoschisis Identified Using Ultra-Widefield Multicolor Channels: A Review of 139 Eyes
Authora: Samantha M. A. Orr1, Amin Hatamnejad2, Netan Choudhry1. 1Vitreous Retina Macula Specialists of Toronto, 2Michael DeGroote School of Medicine, McMaster University.
Author Disclosures: S.M.A. Orr: None. A. Hatamnejad: None. N. Choudhry: Membership on advisory boards or speakers’ bureaus; Name of for-profit or not-for-profit organization(s); Topcon, Optos, Carl Zeiss Meditec, Broadspot Imaging Corp., Novartis, Bayer, Hoffman La Roche, Allergan, Abbvie, Apellis, Johnson & Johnson, Bausch & Lomb, Alcon, Viatris. Membership on advisory boards or speakers’ bureaus; Description of relationship(s); Speaker, Advisor, Research equipment, Speaker, Advisor, Research equipment, Advisor, Speaker, Advisor, Speaker, Advisor, Research support, Advisor, Consultant, Advisor, Advisor, Advisor, Advisor, Consultant, Consultant. Funded grants or Clinical Trials; Name of for-profit or not-for-profit organization(s); Novartis, Apellis, Hoffman La Roche, REGENXBIO Inc.. Funded grants or Clinical Trials; Description of relationship(s); Clinical Trial, Clinical Trial, Clinical Trial, Clinical Trial.
Abstract Body:
Purpose: To utilize ultra-widefield pseudocolour, green channel, red channel, and autofluorescence images (Optos, PLC Edinburgh) to describe characteristics of degenerative retinoschisis. We aim to describe novel findings on pseudocolour and green channel images to improve detection and diagnosis of this condition and further explore the clinical utility of color-separated images.
Study Design: This is a single center, retrospective, noncomparative case series.
Methods: Consecutive cases of degenerative retinoschisis from 2013 to 2022 with quality imaging were included. In addition to clinical information, ultra-widefield pseudocolour images, green and red channel images and autofluorescence images were captured in primary gaze, along with additional eye-steered images. Peripheral OCT of retinoschisis was acquired at the discretion of the technician. In unilateral retinoschisis, images from the contralateral eye were also included. Initial images were analyzed for retinoschisis imaging characteristics and patterns and documented independently by two graders, and adjudicated by a third masked grader.
Results: Our analysis included 139 eyes of 93 patients with degenerative retinoschisis. In this group, approximately 70% of patients were managed with observation only, while the remainder were managed with laser retinopexy, most commonly due to inner retinal holes. A hyporeflective reticular pattern of variable size appears to be associated with areas of schisis. This pattern was seen on pseudocolour images in approximately 40% of eyes (54 eyes) and was visible in 50% of eyes (73 eyes) on the green channel image. Fine hyperreflective dots were also observed over the area of schisis or at its anterior edge in approximately 52% (72 eyes) of cases. In 27% (37 eyes), diagnosis of retinoschisis was confirmed with OCT. Peripheral OCT imaging of the reticular pattern was captured and correlated with the schisis cavities and the hyperreflective dots were seen scattered between the inner and outer retina.
Conclusions: Ultra-widefield imaging with pseudocolour and green channel images is a useful adjunct in the diagnosis and characterization of degenerative retinoschisis. Features that may be subtle or undetected on pseudocolour images appear clearly on green channel images, displaying details of the neurosensory retina captured with the green laser. This was particularly true with the reticular pattern corresponding to degenerative retinoschisis. Hyperreflective dots were typically visible on pseudocolour and green channel images and may alert the interpreter to the presence of an otherwise subtle retinoschisis. These findings may prompt further evaluation and confirmation of degenerative retinoschisis with the use of peripheral OCT.
