Proteomic Analysis of Macular Fluid Associated With Advanced Glaucomatous Excavation

Patel, Shriji; Ling, Jeanie D.; Kim, Stephen J.; Schey, Kevin L.; Rose, Kristie L.; Kuchtey, Rachel W.

doi:10.1001/jamaophthalmol.2015.4105

Cited by 19 publications

(7 citation statements)

References 6 publications

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“… 21 , 26 Supporting the former hypothesis, a proteomic analysis found that the source of the fluid that filled the schisis cavity in a case of advanced glaucoma was most likely the vitreous humor. 27 …”

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confidence: 99%

Peripapillary Retinoschisis in Glaucoma: Association With Progression and OCT Signs of Müller Cell Involvement

Fortune

Kelly

Gardiner

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PurposeTo examine demographic and clinical factors associated with glaucomatous peripapillary retinoschisis (PPRS) and assess its association with glaucoma progression.MethodsUsing a case control study design and longitudinal data from a cohort of 166 subjects with a diagnosis of glaucoma or glaucoma suspect, we compared functional, structural, clinical, and demographic characteristics between PPRS cases and controls.ResultsThe frequency of PPRS was 6.0% (12 eyes from 10/166 subjects) with two eyes having PPRS in different sectors for a total of 15 retinoschisis events. There were no significant differences (P > 0.05) in age, sex, visual acuity, central corneal thickness, intraocular pressure, or presence of vitreous adhesion between PPRS and controls. However, eyes with PPRS tended to have a higher cup-to-disc ratio (P = 0.06), thinner RNFL (P = 0.02), and worse visual field mean deviation (MD, P = 0.06) than controls. The rate of RNFL thinning was faster in PPRS (average: −2.8%/year; range: −7.4% to 0.0%/year) than controls (−1.3%/year; range: −4.4% to 0.6%/year; P = 0.021). The rate of visual field MD change was faster in PPRS (−0.49 dB/year; range: −2.0 to 0.9 dB/year) than controls (−0.06 dB/year; range: −0.8 to 0.3 dB/year; P = 0.030). OCT scans showed hyperreflective structures spanning the PPRS whose morphology and spacing (50 ± 7 μm) are consistent with Müller glia, causing signal attenuation casting “shadows” onto distal retina.ConclusionsThis is the first report showing that glaucomatous PPRS is associated with a faster overall rate of RNFL thinning and visual field deterioration and to specifically identify OCT signs of Müller cell involvement.

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confidence: 99%

Peripapillary Retinoschisis in Glaucoma: Association With Progression and OCT Signs of Müller Cell Involvement

Fortune

Kelly

Gardiner

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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“…Proteomic analysis revealed that the source of fluid filling the schisis cavity in a case of advanced glaucoma was most likely vitreous humor. [ 15 ] Bayraktar et al . [ 16 ] compared the RNFL measurements and OCT B-scans of 940 glaucoma patients with 801 glaucoma suspects and concluded that increased RNFL thickness measurements were observed at the time of retinoschisis.…”

Section: Discussionmentioning

confidence: 99%

Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping

Senthilkumar¹,

Mishra

Kannan

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To present a selected case series of advanced glaucoma-associated peripapillary and macular retinoschisis and response to various treatment strategies with a comprehensive literature review. Methods: Retrospective observational case series. Retrospective review of five selected cases of advanced glaucoma with peripapillary and macular retinoschisis. Results: All five patients had advanced glaucomatous damage with macular and peripapillary retinoschisis, three (patients 2, 3, and 5) had a neurosensory detachment of the macula. Increased intraocular pressure was managed with maximal antiglaucoma medications and G6 micropulse diode laser treatment in the first patient, transscleral diode laser in the second patient, mitomycin-C augmented trabeculectomy in the third patient, maximal antiglaucoma medications alone in the fourth patient, pars plana vitrectomy followed by trabeculectomy in the fifth patient. Conclusion: We speculate that peripapillary and macular retinoschisis may indicate a vision-threatening sequelae of advanced glaucoma. The probable inciting factor for this vision-threatening pathology being elevated intraocular pressure, fluctuations in intraocular pressure, and chronic glaucoma with advanced cupping. We emphasize that meticulous examination of the macula in patients with advanced glaucoma is mandatory. It is imperative to do OCT macula in patients with advanced glaucoma to diagnose this distinct entity at an earlier stage and preserve the existing visual potential.

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“…the development of macular schisis in these eyes. This theory seems to be supported by a recent detection of vitreous proteins in the macular schisis fluid associated with advanced glaucomatous excavation [15]. Another potential mechanism for the development of the schisis is based on the hypothesis that low IOP causes a higher hydrostatic pressure gradient across retinal vasculature that allows movement of fluid into the extracellular spaces.…”

Section: Case Reports In Ophthalmologymentioning

confidence: 95%

Peripapillary Retinoschisis as a Manifestation of Ocular Hypotony

Markopoulos¹,

Tzakos²,

Tzimis³

et al. 2023

Case Rep Ophthalmol

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The aim of this case report was to present an unusual case of peripapillary retinoschisis (PPRS) associated with ocular hypotony after glaucoma surgery. It refers to a 78-year-old man with primary open-angle glaucoma who developed PPRS while hypotonous. Optical coherence tomography of the peripapillary and the macular area of the right eye revealed PPRS temporally and nasally to the optic disc, more prominent at the level of the outer nuclear layer and less so at the inner nuclear layer. The PPRS completely regressed after 1 month of treatment and restoration of intraocular pressure to normal levels. This case report highlights the fact that PPRS in glaucoma patients may present in the setting of ocular hypotony and appears to resolve when the hypotony is successfully managed. Hydrostatic pressure gradient across retinal vasculature that allows movement of fluid into the extracellular spaces is a potential mechanism for the development of PPRS in ocular hypotony.

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Proteomic Analysis of Macular Fluid Associated With Advanced Glaucomatous Excavation

Cited by 19 publications

References 6 publications

Peripapillary Retinoschisis in Glaucoma: Association With Progression and OCT Signs of Müller Cell Involvement

Peripapillary Retinoschisis in Glaucoma: Association With Progression and OCT Signs of Müller Cell Involvement

Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping

Peripapillary Retinoschisis as a Manifestation of Ocular Hypotony

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