Jul 31, 2023

Objectives To investigate the relationship between the shape of the optic nerve head (ONH) margin detected by optical coherence tomography (OCT) and the clinical characteristics of glaucomatous eyes with papillomacular retinoschisis (PMRS). Methods The medical record of patients with a PMRS in a glaucomatous eye were reviewed. The eyes were placed into two groups determined by the shape of the ONH margin in the OCT images; eyes with an externally oblique ONH margin (Group 1) and eyes with an internally oblique ONH margin (Group 2). We compared the clinical characteristics of the PMRS of these two groups. Results We studied 31 eyes of 29 patients with PMRS and glaucoma with 24 eyes in Group 1 and 7 eyes in Group 2. The optic nerve fibre layer schisis on the lamina cribrosa (LC), beta zone, and gamma zone, and found that the LC defects were detected significantly more frequently in Group 1 than in Group 2 eyes (P < 0.05). A retinal nerve fibre schisis was observed around the ONH significantly more frequently in Group 2 than in Group 1 eyes (P < 0.01). Conclusion The cases of glaucoma-associated PMRS could be classified into two groups according to the obliquity of the ONH. They had differences in the findings of OCT and FA. The possibility that the mechanism of PMRS development is different in both groups is suggested. Access options $259.00 per year Prices vary by article type from$1.95 Additional access options: Fig. 2: Representative case with PMRS in a Group 2 eye. Fig. 3: Vitreous tractions in eyes with an externally and an internally oblique margin of the ONH. Data availability The datasets generated during and/or analysed during the current study are available from the corresponding author (TI) on reasonable request. References Hirakata A, Okada AA, Hida T. Long-term results of vitrectomy without laser treatment for macular detachment associated with an optic disc pit. Ophthalmology. 2005;112:1430–5. Fujimoto S, Kokame GT, Ryan EH, Johnson W, Hirakata A, Shirriff A. Macular retinoschisis from optic disc without a visible optic pit or advanced glaucomatous cupping (No Optic Pit Retinoschisis [NOPIR]). Ophthalmol Retina. 2023. https://doi.org/10.1016/j.oret. Hollander DA, Barricks ME, Duncan JL, Irvine AR. Macular schisis detachment associated with angle-closure glaucoma. Arch Ophthalmol. 2005;123:270–2. Ornek N, Buyuktortop N, Ornek K. Peripapillary and macular retinoschisis in a patient with pseudoexfoliation glaucoma. BMJ Case Rep. 2013. https://doi.org/10.1136/bcr-2013-009469 . Takashina S, Saito W, Noda K, Katai M, Ishida S. Membrane tissue on the optic disc may cause macular schisis associated with a glaucomatous optic disc without optic disc pits. Clin Ophthalmol. 2013;7:883–7. Acknowledgements The authors thank Professor Emeritus Duco Hamasaki of the Bascom Palmer Eye Institute, University of Miami, Miami, Florida, for the discussions and thorough editing of the manuscript. Author information Department of Ophthalmology, Kyorin University, School of Medicine, Tokyo, Japan Tomoka Ishida, Yoshiyuki Kita, Yuji Itoh, Masaharu Mizuno, Kazunari Hirota, Takashi Koto, Makoto Inoue & Akito Hirakata Authors Yoshiyuki Kita Yuji Itoh Masaharu Mizuno Kazunari Hirota Takashi Koto Makoto Inoue Akito Hirakata Contributions All authors declare they meet the current ICMJE criteria. TI, YK, MI, MM, KH, TK and MI collected data and analysed the ophthalmological findings. TI and YK analysed statistical findings. YI, YK and AH gave critical suggestions. TI, YK and AH prepared the manuscript. YI proofread the manuscript. Corresponding author Competing interests TI: Personal fees (lecture fees) from Nikon Co., Ltd., and Santen Pharmaceutical Co., Ltd., outside the submitted work. YK: Personal fees (lecture fees) from Santen Pharmaceutical Co., Ltd., and Senju Pharmaceutical Co., Ltd., Glaukos, outside the submitted work., YI None. MM: Personal fees (lecture fees) from Novartis Pharma K.K., Santen Pharmaceutical Co., Ltd., and KOWA Co., Ltd., outside the submitted work., KH: None, TK: Research grants from Ellex, and personal fees (lecture fees) from Alcon Laboratories, Inc., Novartis Pharma K.K., Bayer AG, Carl Zeiss Meditec AG, Novartis Pharma K.K., Santen Pharmaceutical Co., Ltd., HOYA Co., Ltd., Rohto Nitten Co., Ltd., River field Co., Ltd., and Senju Pharmaceutical Co., Ltd., AMO., outside the submitted work. MI: Research grants from Alcon Laboratories, Inc., Santen Pharmaceutical Co., Ltd., and personal fees (lecture fees) from Alcon Laboratories, Inc., Novartis Pharma K.K., Bayer AG, Carl Zeiss Meditec AG, Novartis Pharma K.K., HOYA Co., Ltd., Chugai Pharmaceutical Co., Ltd., Santen Pharmaceutical Co., Ltd., and Senju Pharmaceutical Co., Ltd., AMO Japan Co., Ltd., Logic and design Co., Ltd.,, outside the submitted work. AH: Research grants from Santen Pharmaceutical Co., Ltd., and personal fees (lecture fees) from Santen Pharmaceutical Co., Ltd., Alcon Laboratories, Inc., Novartis Pharma K.K., Bayer AG, Carl Zeiss Meditec AG, Novartis Pharma K.K., Sanwa Kagaku Kenkyusho Co., Ltd and., Senju Pharmaceutical Co., Ltd., HOYA Co., Ltd., outside the submitted work. Institutional Review Board Statement: This study was approved by the Institutional Review Committee of the Kyorin University School of Medicine (approval number #1627). Informed Consent Statement: The patients received a detailed explanation of the surgical and ophthalmic procedures, and all signed an informed consent form. The patients consented to our review of their medical records and their anonymized use in medical publications. The patient consent for this study was obtained in an opt-out format. Additional information Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.