Peripheral retinal neovascularization secondary to highly myopic superficial Retinoschisis: a case report

Abstract

Background: Peripheral Retinal neovascularization is well-described as a complication of X-linked retinoschisis, but less often observed in myopic and primary retinoschisis. We present a case of a myopic female who developed retinal microvascular abnormalities due to retinoschisis and subsequent vitreous hemorrhage which would cause severe visual damage without timely and proper treatment. Case presentation: A 38-year-old highly myopic Chinese female complained of blurred vision in her right eye. Her best corrected visual acuitiy was 20/20 OU, and her refraction was − 9.00S OU. Dilated fundus examination revealed mild vitreous hemorrhage and abnormal vascular network nasal to the optic disc in her right eye. Optical Coherence Tomography (OCT)-angiography (OCTA) B-Scan showed superficial retinoschisis and well-depicted abnormal retinal microvascular network in inner retinal layer. Sectoral scatter laser photocoagulation was administered. Regression of most abnormal vessels was achieved in 1 month, but the patient experienced an unexpected episode of vitreous hemorrhage 3 months after the initial treatment, which was absorbed spontaneously in 2 weeks. Supplemental laser photocoagulation was applied and regular follow-up visit was suggested. Conclusion: Superficial retinoschisis in pathological myopia can be a driver of retinal microvascular abnormalities, possibly neovascularization, an extremely rare but severe complication which can be vision-threatening without timely and proper intervention.

Treatments of retinoschisis with multiple abnormal blood vessels in high myopia: a case report

“…[8,9] Patients with high myopic retinoschisis and abnormal blood vessels often have no speci c complaints, so no signi cant abnormalities are seen in the early stage of disease development, [10] and those with combined vitreous hemorrhage often present with complaints of blurred vision, visual distortion, and oaters. [2] In this article, we reported two cases of high myopia with retinoschisis near the vascular arcade with abnormal blood vessels, which have rarely been reported previously. Similar to previously reported cases, [4,5] the location of the abnormal blood vessels was around the arcade rather than the macular area.…”

“…It was reported that focal retinal laser photocoagulation was an option of management. [2] To the best of our knowledge, this is the rst report of vitrectomy for the treatment of retinoschisis with abnormal blood vessels near the arcade area in high myopia and demonstrated satisfactory outcomes. Notably, laser was not applied to the abnormal blood vessel during vitrectomy, therefore, we speculate that vitrectomy might reduce the pulling force on the retina and subsequently the stretching force on the intraretinal blood vessels, restoring the retinal vessels to a normal condition.…”

“…However, few cases of retinoschisis near the vascular arcade with abnormal vessels have been reported. [2] Such abnormal vessels may even cause vitreous hemorrhage, [3] and vision is severely impaired as the disease progresses. At the same time, due to the small number of reported cases, opinions on the treatment of these abnormal blood vessels are not uni ed.…”

An Unusual Case of Peripheral Retinoschisis Complicated by Vascular Malformations: A Case Report

“…Various pathologies of such vascular malformations have been described. There have been case reports suggesting the aneurysmal microvascular capillary terminals could be a result of initial compensation for schitic process [6]. Campo., et al [1] in his case series reported similar vascular abnormalities due to ischemia, secondary to long standing inner retinal elevation.…”

Retinal Neovascularization in Acquired Peripheral Retinoschisis Through Inner Retinal Ischemia: Optical Coherence Tomography Angiographic Findings

“…Similar vascular abnormalities are reported in myopic retinoschisis and in acquired retinoschisis. 10,[16][17][18] Microaneurysms, aneurysmal dilatation, and telangiectatic vessels are common abnormalities in superficial acquired peripheral retinoschisis. 10 Angioflow to the deep capillary plexus in OCTA was still intact in the second case; even absent flow to the superficial capillary plexus could not be detected as hypofluorescence on FA, considering that the imaging modality overlapped all the fluorescence to the depth direction.…”