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Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping

PURPOSE: To present a selected case series of advanced glaucoma-associated peripapillary and macular retinoschisis and response to various treatment strategies with a comprehensive literature review. METHODS: Retrospective observational case series. Retrospective review of five selected cases of adv...

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Autores principales: Senthilkumar, Vijayalakshmi A, Mishra, Chitaranjan, Kannan, Naresh B, Raj, Priyanka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837292/
https://www.ncbi.nlm.nih.gov/pubmed/34826994
http://dx.doi.org/10.4103/ijo.IJO_668_21
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author Senthilkumar, Vijayalakshmi A
Mishra, Chitaranjan
Kannan, Naresh B
Raj, Priyanka
author_facet Senthilkumar, Vijayalakshmi A
Mishra, Chitaranjan
Kannan, Naresh B
Raj, Priyanka
author_sort Senthilkumar, Vijayalakshmi A
collection PubMed
description PURPOSE: To present a selected case series of advanced glaucoma-associated peripapillary and macular retinoschisis and response to various treatment strategies with a comprehensive literature review. METHODS: Retrospective observational case series. Retrospective review of five selected cases of advanced glaucoma with peripapillary and macular retinoschisis. RESULTS: All five patients had advanced glaucomatous damage with macular and peripapillary retinoschisis, three (patients 2, 3, and 5) had a neurosensory detachment of the macula. Increased intraocular pressure was managed with maximal antiglaucoma medications and G6 micropulse diode laser treatment in the first patient, transscleral diode laser in the second patient, mitomycin-C augmented trabeculectomy in the third patient, maximal antiglaucoma medications alone in the fourth patient, pars plana vitrectomy followed by trabeculectomy in the fifth patient. CONCLUSION: We speculate that peripapillary and macular retinoschisis may indicate a vision-threatening sequelae of advanced glaucoma. The probable inciting factor for this vision-threatening pathology being elevated intraocular pressure, fluctuations in intraocular pressure, and chronic glaucoma with advanced cupping. We emphasize that meticulous examination of the macula in patients with advanced glaucoma is mandatory. It is imperative to do OCT macula in patients with advanced glaucoma to diagnose this distinct entity at an earlier stage and preserve the existing visual potential.
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spelling pubmed-88372922022-03-07 Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping Senthilkumar, Vijayalakshmi A Mishra, Chitaranjan Kannan, Naresh B Raj, Priyanka Indian J Ophthalmol Special Focus, Glaucoma, Original Article PURPOSE: To present a selected case series of advanced glaucoma-associated peripapillary and macular retinoschisis and response to various treatment strategies with a comprehensive literature review. METHODS: Retrospective observational case series. Retrospective review of five selected cases of advanced glaucoma with peripapillary and macular retinoschisis. RESULTS: All five patients had advanced glaucomatous damage with macular and peripapillary retinoschisis, three (patients 2, 3, and 5) had a neurosensory detachment of the macula. Increased intraocular pressure was managed with maximal antiglaucoma medications and G6 micropulse diode laser treatment in the first patient, transscleral diode laser in the second patient, mitomycin-C augmented trabeculectomy in the third patient, maximal antiglaucoma medications alone in the fourth patient, pars plana vitrectomy followed by trabeculectomy in the fifth patient. CONCLUSION: We speculate that peripapillary and macular retinoschisis may indicate a vision-threatening sequelae of advanced glaucoma. The probable inciting factor for this vision-threatening pathology being elevated intraocular pressure, fluctuations in intraocular pressure, and chronic glaucoma with advanced cupping. We emphasize that meticulous examination of the macula in patients with advanced glaucoma is mandatory. It is imperative to do OCT macula in patients with advanced glaucoma to diagnose this distinct entity at an earlier stage and preserve the existing visual potential. Wolters Kluwer - Medknow 2021-12 2021-11-26 /pmc/articles/PMC8837292/ /pubmed/34826994 http://dx.doi.org/10.4103/ijo.IJO_668_21 Text en Copyright: © 2021 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Special Focus, Glaucoma, Original Article
Senthilkumar, Vijayalakshmi A
Mishra, Chitaranjan
Kannan, Naresh B
Raj, Priyanka
Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping
title Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping
title_full Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping
title_fullStr Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping
title_full_unstemmed Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping
title_short Peripapillary and macular retinoschisis - A vision-threatening sequelae of advanced glaucomatous cupping
title_sort peripapillary and macular retinoschisis - a vision-threatening sequelae of advanced glaucomatous cupping
topic Special Focus, Glaucoma, Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837292/
https://www.ncbi.nlm.nih.gov/pubmed/34826994
http://dx.doi.org/10.4103/ijo.IJO_668_21
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