Ultra-widefield optical coherence tomography demonstrates subtle vitreoretinal interface changes driving conversion of retinoschisis to retinal detachment.

PURPOSE: To report a case of retinoschisis associated with retinal detachment, documented with ultra-widefield optical coherence tomography (OCT), and to highlight subtle vitreoretinal interface changes not previously described.

METHODS

A patient with retinoschisis was evaluated using multimodal imaging, including ultra-widefield OCT. Serial OCT scans were reviewed to assess structural alterations of the outer and inner retinal layers, vitreoretinal interface, and hyaloid status.

RESULTS

Ultra-widefield OCT demonstrated the development of a retinal detachment secondary to an isolated outer retinal hole within the region of retinoschisis, occurring in the context of traction from a thickened inner retinoschisis leaf, without evidence of communication with an inner retinal hole. Additionally, undulations on the inner surface of the outer leaf of the retinoschisis cavity were observed possibly representing residua of a tractional separation between the outer and inner leaf of the retinoschisis cavity. These subtle features were only appreciable through the extended coverage of ultra-widefield OCT imaging.

CONCLUSION

Ultra-widefield OCT provided critical structural insights into the progression from retinoschisis to a retinal detachment. It revealed the development of an isolated outer retinal hole with associated inner leaf traction and undulations on the inner surface of the outer leaf of the retinoschisis cavity without detectable inner leaf holes, underscoring OCT's value in detecting and better understanding subtle vitreoretinal changes in this condition.