This 48YO male presented with one month of vision loss in his left eye. He was diagnosed elsewhere with idiopathic central serous chorioretinopathy. Vision was 20/20 in his normal OD and 20/40 OS.
Pseudocolor SLO imaging shows a round serous macular detachment, which is confirmed on OCT. The outer nuclear layer has a schisis-like thickening. Fluorescein angiography was normal (not shown). There was no optic pit clinically or on OCT.
Learning Points:
No optic pit retinoschisis (NOPIR) is a rare entity that presents with pit-like findings in the absence of a pit or severe glaucomatous cupping (Fujimoto et al, Ophthalmology Retina 2023;7:811-818). Somewhat similar findings can be observed in paraproteinemia (Mansour et al, Ophthalmology 2014;121:1925-1932), but our patient’s serum protein electrophoresis was normal.
As with optic pit maculopathy, eyes with good vision should be observed. Persistent vision loss from foveal involvement can be managed with vitrectomy, internal limiting membrane peeling, and fluid-gas exchange.
