Can we use fundus autofluorescence to determine retinoschisis from retinal detachments?

Retinoschisis (RS) is a nonprogressive degenerative splitting of the neurosensory retina, most often at the outer plexiform layer. On clinical examination, retinoschisis (RS) can sometimes prove difficult to distinguish from retinal detachments (RD), specifically in patients with chronic detachments that also may present with a smooth surface similar to that seen in retinoschisis. In addition, some cases of RS can be complicated by a progressive RD (retinoschisis detachment [RS/RD]) if there are both inner and outer layer breaks in the retina.  It is important to differentiate RS from an RD or RS/RD because management differs.

A modality that has only recently been evaluated as a possible tool for the differentiation of RS from RD or RS/RD is widefield fundus autofluorescence (WF-FAF). The two recent reports in the literature suggest that WF-FAF can differentiate these lesions based upon the pattern seen.  We recently conducted our own evaluation at the Cole Eye Institute, Cleveland Clinic to corroborate these findings. We found no statistically significant correlation between the autofluorescence pattern and the type of retinal abnormality (P = .74). In fact, we found multiple patterns of WF-FAF within patients with RS and RD.  

Therefore, at this time it is best for clinicians to use a combination of ultrasound and OCT to distinguish these lesions rather than relying on WF-FAF alone. You can read more HERE.

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