How Can Multi-modal Imaging Distinguish Retinal Detachments From Retinoschisis?

We were recently presented a case from our optometrist who referred a 49 year old patient with bilateral retinal tears. The patient’s vision was 20/20 bilaterally with normal intraocular l pressure.

The color photograph in the right eye demonstrate possible schisis with a possible outer retina break temporally. It’s unclear if this is retinoschisis or a retinal detachment on the color photograph.

The color photograph of the left eye demonstrates another area of possible outer retinal break temporally with either retinoschisis or detachment.

It is important to distinguish between retinal detachment and retinoschisis given that retinal detachment would be a surgical indication. The fundus autofluorescence helps localize the areas of possible subretinal fluid in both eyes.

Peripheral focused OCT is able to demonstrate retinoschisis in one area of the right eye along with a subclinical retinal detachment temporally.

Peripheral OCT of the left eye demonstrates a mac on retinal detachment temporally.

Watch out the video below to see multimodal imaging in action.

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