This 35YO pregnant female presented with 3 days of flashes in her left eye. She had a family history of retinal tears in her father and rhegmatogenous retinal detachment (RRD) in her maternal uncle. Vision was 20/20 OS.
Silverstone color RG imaging shows a macula-on combined retinoschisis-RRD. There was no posterior vitreous detachment. Schisis is noted more peripherally, with the rhegmatogenous fluid noted more posteriorly. Swept-source OCT confirms the presence of a full-thickness retinal detachment. Treatment options were discussed, including laser demarcation, primary scleral buckle with cryotherapy, and pars plana vitrectomy. She elected for laser retinopexy, which was performed that day.
She delivered a healthy baby, and her retina has remained stable over the past 9 months as of her last visit.
Learning Points:
Isolated degenerative retinoschisis should not be treated. However, it can progress to a combined schisis-RRD in the presence of breaks in both the inner and outer layers. Asymptomatic combined detachments can be demarcated, as in our patient. Symptomatic detachments are usually treated with pars plana vitrectomy.
