Features Associated With Foveal Retinal Detachment in Myopic Macular Retinoschisis

PURPOSE: To determine the retinal features seen on enhanced spectral-domain optical coherence tomography (SD-OCT) associated with foveal retinal detachment in eyes with myopic macular retinoschisis. DESIGN: Retrospective case series. METHODS: We reviewed fundus photographs and conventional and enhanced SD-OCT images of 21 eyes of 19 patients with myopic macular retinoschisis. Features seen on enhanced SD-OCT images were identified and compared between eyes with and without foveal detachment. RESULTS: On enhanced SD-OCT images, the retinoschisis in the outer retina was accompanied by splitting in the inner plexiform layer (IPL) in 11 eyes (50.0%) and a detachment of the inner limiting membrane (ILM) in 11 eyes (50.0%) in the superior and/or inferior peripheral macula; 9 eyes (42.9%) had both features. Multiple columnar structures were seen throughout the outer retinoschisis in 20 of 21 eyes (95.2%), and in ILM detachment/IPL retinoschisis in all eyes. Thirteen eyes had or progressed to a fovea! detachment; an ILM detachment developed in 10 eyes (76.9%) with a foveal detachment and in 1 eye (12.5%) without a fovea! detachment (P = .008). IPL retinoschisis was detected in 8 eyes (61.5%) with a foveal detachment and 3 eyes (37.5%) without a fovea! detachment, but this difference was not significant. CONCLUSIONS: An ILM detachment in the superior and/or inferior peripheral macula was associated with a foveal retinal detachment in highly myopic eyes with macular retinoschisis. This feature may indicate strong tractional forces on the ILM that are transmitted to the outer retina through the dense columnar structures, resulting in a foveal retinal detachment. (Am J Ophthalmol 2010;150:863-870. (C) 2010 by Elsevier Inc. All rights reserved.)