Rishi Singh, MD’s, blog takes an evidence-based approach to hot topics in eye care and examines their clinical relevance.

BLOG: Can we use fundus autofluorescence to differentiate retinoschisis from retinal detachments?

Retinoschisis 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 RS. 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). 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. In fact, we found multiple patterns of WF-FAF within patients with RS and RD.

You can read more at https://journals.sagepub.com/doi/10.1177/2474126420907020.


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Disclosure: Singh reports he is a consultant to Zeiss, Novartis, Regeneron, Genentech and Alcon and receives grant support from Apellis and Graybug.