Case Report: Glaucoma-associated Peripapillary Retinoschisis with Corresponding Lamina Cribrosa Defect.

SIGNIFICANCE: Peripapillary retinoschisis is associated with primary and secondary glaucoma. It is important that clinicians are familiar with the presentation and management of peripapillary retinoschisis to understand its effects on the patient's glaucoma and to avoid unnecessary referral when the macula is not involved. PURPOSE: We present a case of peripapillary retinoschisis found incidentally on routine optical coherence tomographic (OCT) surveillance of primary open-angle glaucoma. CASE REPORT: A 70-year-old man presented for his annual diabetic eye examination. Surveillance with OCT revealed a splitting of the inner peripapillary retina corresponding to a previously noted notch in the right optic nerve. Further imaging of the right eye using enhanced depth imaging OCT revealed a defect in the lamina cribrosa that may have contributed to the formation and persistence of peripapillary retinoschisis. Retinal nerve fiber layer analysis showed a 5-year history of progressive temporal and inferotemporal thickening in the right eye. The patient was managed conservatively with instruction on regular Amsler grid testing. CONCLUSIONS: As seen in this case, peripapillary retinoschisis typically alters retinal nerve fiber layer thickness on OCT and can be mistakenly attributed to glaucomatous change. Glaucoma-associated peripapillary retinoschisis is usually not vision threatening and can be managed conservatively; in rare cases of progression to macular involvement, patients should be referred to a retina specialist.

An algorithm to identify the aetiology of crystalline retinopathy.

Due to the extensive differential diagnoses and overlapping clinical features, determining the aetiology of a crystalline retinopathy can be challenging. More effective ways are needed to help clinicians isolate the cause of a crystalline retinopathy and determine the appropriate management of concomitant ocular and/or systemic disease. This paper reviews literature on crystalline retinopathy focusing upon the key features of each aetiology, including medical history, laterality, and examination findings. Based on this review, an algorithm was formulated to clinically classify causes of crystalline retinopathy, which may help practising clinicians identify and manage key causes of crystalline retinopathy.

Peripheral Exudative Hemorrhagic Chorioretinopathy in Patients With Nonexudative Age-Related Macular Degeneration.

Although uncommon, peripheral exudative hemorrhagic chorioretinopathy should be considered when evaluating a peripheral dark elevated lesion to prevent unnecessary treatments in patients.