Multimodal imaging in a case of stellate nonhereditary idiopathic foveomacular retinoschisis

Middle-Inner Macular Layers Dysfunction in a Case of Stellate Foveomacular Retinoschisis Detected by Abnormal Multifocal Photopic Negative Response Recordings

“…Indeed, dark- and light-adapted ffERG as well as 10 Hz and 30 Hz flicker ERGs recorded normal a- and b-wave amplitudes, and normal photoreceptors and bipolar cells function by mfERG was recorded from localized retinal areas of the macula. Our functional findings are in contrast with those reported by Yadav et al [ 5 ], who described a case of SNIFR in a 64-year-old woman, but with concomitant diabetes and rheumatoid arthritis in treatment with hydrochloroquine therapy, reduced macular mfERG amplitudes and reduced amplitude of b-wave of scotopic ffERG. Since it is known that diabetes and the treatment with hydrochloroquine therapy might influence the macular function assessed by mfERG [ 10 , 11 ], in our opinion all that observed by Yadav et al [ 5 ] cannot be ascribed exclusively to the retinal involvement due to the SNIFR.…”

“…The diagnosis is based on the typical appearance of the fovea presenting with the characteristic radial cartwheel pattern and with the splitting of the retinal layers at the level of the Henle fiber layer (HFL) and the outer plexiform layer (OPL) seen by Spectral Domain-Optical Coherence Tomography (SD-OCT). At the present, the SNIFR condition has been studied by multimodal imaging combining together SD-OCT [ 1 , 2 ], OCT angiography (OCTA), [ 3 , 4 , 5 ] fluorescin angiography (FA), [ 1 ] and multifocal electroretinogram (mfERG) [ 4 ]. However, there is a lack of information about the function of cellular elements located in middle-inner retinal layers, where the retinoschisis resides.…”

“…Although accurate multimodal imaging of retinas has been already performed by previous authors in SNIFR [ 1 , 2 , 3 , 4 , 5 ], there is a lack of information about the functional assessment of the middle-inner retina, involved in the structural damage. We thought the application of the novel technique of mfPhNR recordings that records mainly the function of retinal ganglion cells and their axons [ 12 ] from localized areas valuable.…”