Macular tractional retinoschisis in proliferative diabetic retinopathy: clinical characteristics and surgical outcome.

PURPOSE: To evaluate the clinical characteristics and surgical outcome of macular tractional retinoschisis (TRS) as compared with tractional retinal detachment (TRD) in proliferative diabetic retinopathy (PDR).

METHODS

This retrospective, longitudinal study collected consecutive cases with optical coherence tomography (OCT)-confirmed TRS and TRD between January 2007 and June 2013. All cases had surgical treatment. Their preoperative findings and follow-up data were subsequently compared.

RESULTS

Thirty-two eyes (32 patients) with TRS and 32 eyes (32 patients) with TRD were included. The TRS group had more clinically inactive fibrosis and less extensive fibrovascular proliferation than the TRD group. The involved area and height of the schisis varied among cases; associated macular abnormalities included inner macular cyst (43.75%), lamellar hole (12.5%) and foveal detachment (9.38%); sequential OCT in some cases showed a progression of macular changes. Both groups had significant visual improvement after surgery. Of the patients with TRS, 40.62% had residual retinoschisis. Preoperative best-corrected visual acuity (BCVA), postoperative BCVA and improvement in visual acuity showed no significant difference between TRS and TRD.

CONCLUSIONS

Unique features exist for macular TRS in PDR. Visual function may benefit from vitreous surgery despite residual macular abnormalities in some cases.